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Personal Details
Referral: SIMPLEZ SOLUTION SDN BHD
Full Name - Same as NRIC
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NRIC
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+60
Phone No.
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Email
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Address
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Postcode
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City
State
Banking Information
Maybank
CIMB
Public Bank
RHB
Hong Leong Bank
AmBank
UOB
Bank Rakyat
OCBC
HSBC
Bank Islam
Affin Bank
Alliance Bank
Standard Chartered
MBSB Bank
Citibank
BSN
Bank Muamalat
Agrobank
Al Rajhi Bank
Co-op Bank Pertama
Bank Name
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Account Holder Name
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Account No.
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Nominated Beneficiary
Beneficiary Name
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Beneficiary NRIC
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Beneficiary Phone No.
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Consent to Share Commissions to the Simplez FinHealth Plus Community as My Grant
I hereby give consent to the Simplez FinHealth Plus Community to share a portion of the commission from the sale of my medical products. I also give permission to Simplez FinHealth Plus Community to deduct and retain 3% of the total commission earned by me, for the benefit of this community. I understand that this arrangement is in line with the intention of giving and sharing in the form of Hibah, as well as the spirit of helping (Taawun) among members of the Simplez FinHealth Plus Community. This consent is given with the understanding that the commission payment will be distributed accordingly after the commission payment is successfully received from the Product Provider.
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Proceed to Payment (RM240)