APPENDIX 1
Koperasi Kakitangan Petronas Berhad
B-2-15, Megan Avenue II, 12, Jalan Yap Kwan Seng, 50450 Kuala Lumpur
Tel: 603 2166 9901 Fax: 603 2166 9902
Website: www.kopetro.com
APPLICATION FOR CREDIT FACILITIES
/ New Application Revision of an existing application
RM 2000
Amount of Credit Applied: RM_____________
5 MONTHS
Months/ Years: _______________
1. Name of Company: SAPTAVARNAA SDN BHD
2. NO 86A, 1st Floor, Jalan Hang Kasturi, City Centre,
(a) Business Address:_____________________________________________________________________ Tel: 016-664 4105
Wilayah Persekutuan Kuala Lumpur
_____________________________________________________________________ Tel: 03-2072 6494
50050
___________________________________________ Post Code ________________
Fax:
Own Property Mortgaged / Rented No of Years there ____________________
NO 86A, 1st Floor, Jalan Hang Kasturi, City Centre,
(b) Registered Address:________________________________________________
Tel: 016-358 4321
Wilayah Persekutuan Kuala Lumpur
________________________________________________
50050
__________________________ Post Code _____________ Tel: 03-2022 2871
Fax:
3. Business Registration No. : 1135115-A Date of Incorporation : 12th March 2015
4. www.saptavarnaa.com
(a) Company Website :__________________________________________________________
[email protected] /
[email protected] (b) Company Email Address : _____________________________________________________
Mr Jeevaraj A/L Macharagam (010-285 5728)
(c) Contact Person #1:__________________________________________________________
Supervisor
Designation :_______________________________________________________________
Logiswaran A/L Visvanathan (011-3375 9075)
(d) Contact Person #2:__________________________________________________________
Supervisor
Designation : ______________________________________________________________
5. Legal Constitution: / Private Ltd Co. Public Ltd Co Partnership Sole Proprietor
6. If Limited Co. Please state : a) Authorised Capital: b) Paid-up Capital:
7. Nature of Business :
Agent Authorized Distributor
/ Contractor Cooperative Society
Distributor Education Institution
Factory Representative Manufacturer
Non-Profesional Service Contractor / Professional Service Contractor
Retail Dealer Trading Company
Wholesale Dealer Others Please specify:____________________
8. Particulars of Directors/ Partnership/ Proprietor
Name NRIC No. Designation Tel. No.
Mr Tamilvanan A/L Sundral 820604-01-5603 Director 016-664 4105 /
016-358 4321
9. No. of Employees (Worldwide)
/ 1 – 50 51 - 500
500 - 1000 More than 1000
10. Approximate annual sales
Less than RM500,000 / RM500,001 – RM1.5 Million
RM1.5 – RM50 Million More than RM50 Million
11. Name of Banker
Bank Account No. Address Bank Facilities
Public Bank Berhad 3186574309 Tun H.S Lee Current Account
12. Trade Reference
Company Address Tel. No. Credit Limit Credit Term
13. Documents to support Credit Application Form. The following are attached:
/ Last 3 months bank statement Form 9 Cert of Incorporation of private Ltd Co
Form 24 Return of Allotment of shares / Form 49 Particulars of Directors
Memorandum & Articles of Association Latest Annual Return
2 years Audited Accounts Form B Particulars of Sole Proprietor / Partners
14. Declaration:
Neelamagan A/L Nalluran
I ____________________________________ 650516-08-5741
, _______________________ Coordinator
,____________________,acting on behalf of
(Name) (NRIC No.) (Designation)
SAPTAVARNAA SDN BHD
_______________________________________ hereby declares that the information given is true and shall undertake
(Company Name)
to promptly inform your company of any changes to the information supplied and agreed to accept the trading terms of our
company as follows:-
a) To settle all outstanding debts within 30 days from date of invoice.
b) To agree and allow your company at its sole discretion to charge interest, on all outstanding debts at the rate of 1.5%
per month on overdue accounts.
c) To notify your company on discrepancy in delivery orders, invoices, statement of accounts within 14 days on receipt of
the same.
d) Your company reserve the right to withhold approval of credit facilities and may cancel all credit facilities at its
absolute discretion without giving any reasons whatsoever and may demand in full settlement immediately on all
sums that may be owing by me / us at such time.
e) Without prejudice, Koperasi Kakitangan Petronas Berhad or its subsidiaries reserve the right to report your name /
your directors name and your company’s name (whichever applicable) to any approved Institutions deemed
necessary to protect KOPETRO or its subsidiaries interest at all-time should you default any payment to Koperasi
Kakitangan Petronas Berhad and its subsidiaries.
15/07/2021
Signature:__________________________ Date:______________ Co. Chop:____________________
FOR OFFICE USE ONLY
1. Account introduced by :
2. Sales person’s Recommendation :
_____________________________________________________________________________
____________________________________________________________________________
Signature:________________________ Date: _____________________
3. Division Manager / Branch Manager Recommendation :
_____________________________________________________________________________
____________________________________________________________________________
Signature:________________________ Date: _____________________
4. Assessment Summary (Credit Control) :
_____________________________________________________________________________
____________________________________________________________________________
Signature:________________________ Date: _____________________
Date Credit Limit Approved By Designation
Proposed Approved
Account No. Allotted: Date : Allotted By:
Signature: _______________________
