$ uongreong eanx $ HongLeong lslamic Bank

System Administrator & Authorizer ,: ,.

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Please send the completed form to:
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Password ltllain4ananaa
Maintenance trzr
Form ..r' '':
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Email: cmp@[Link] or Fax: 03

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- 2081 8934
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Company Name
[Link] Svaril(at
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Connect Blz Company ID

iD Conneci BIZ Syatikat
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Esystem Administrator €fsystem Authorizer EsystemAdminislrator EsystemAuthorizer

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User Name Nama Pengs!na User Name Nama PonggLjna

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I hereby confirm that I am duly authoized by the campany to I hereby confirm that I an duly authorized by the company to
sign this form for and on its behalt. sign this form fot and on its behalf.
.S2i,e me4gesali/(3, ,ala \re sayz eaialah nak'isah ,'[Link] Sara fi-Drajesahkari l)4!iaria s*ia adaiah \vakii s.h syerl4a! *nluk
lrenennelln,jar: bnft n<i ir! uttnN d,tfi 'n4?i pi!)ai. ;t1--r. ic.t.!|ga!i! [Link]'1.! j!',iitrlii, dan bag;pihek syzit!!

oate: .?.?... r ..9.F....r.?9.1.f,,,,, """", Date: ........... / ...........1........... iDDriutilYYYY)

kZf UnOtock User lD nktitkan iD eengsuna [ ] Unblock USer lD Aktifto,r lD Penssu,ra

Note: User still aemember Password Note: User still remember password

[ ] Reset Password Tukar (ata Laiua:r

[ ] Reset Password T]kar Kala Laluan
Note: LJserwill get new password
Note: User w{l get new password

E Normal Post Pos Biasa E Courier Kurler E Normal Post Pos Biasa E Courier i<urlor
Default postage delivery .* Charges apply Default postage delivery ** charges apply

"" Courier charue RM 5.30 pet delivety (inclusive GST) wi be debited frcm designated account specified in application form. The charges are
subject to change and will be updated in the latest version of the form.

leiakluk keDacia perubaba, yang akan din,/alakaitj Pada batang ,*ang te*il!.

Notes:
a) Request received after 4:30pm will be processed on the next business day
Permohcian yang diterna se,epas janl t.30 pelang akan diproses peda hari bekerja berikuinya
b)Reset Password New password will be sent to address registered at Connect BlZ. Normal postage delivery takes approximately 5 working
-
days to arrive. Please login gdygtcl receiving the new password to avoid from it being invalid.
"l"r_kar Kala Lallan , Kaia Lalrai baru aka:r di hanta. ke a,amat yang [Link] ii Connecl BlZ. Penghaniarcn pos blasa diiangka ,neis{alrlbil
masa 5 hari bekerja unillk saJyrpar. Sila iaita. rnasuk han!,a selei:ras [Link] kata [Link] beru uniuk r:.[Link] disekat

By: Vermed By: Remarksl

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