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By submitting this application form:

I hereby declare that all the above information given by me is correct and complete.

I hereby give consent to Bank Islam Malaysia Berhad (Bank Islam) to collect, keep, use, disclose and continue to use the personal information disclosed by me for a maximum period of one (1) month from the date this form is submitted for the purpose of cross selling, marketing, and promotion whatsoever and disclosure of my information with BIMB Holding group of companies, subsidiaries, its agent, employees, trustee, and/or to any other person or entity in accordance with Bank Islam’s Privacy Notice which is available at Bank Islam’s website www.bankislam.com