easypaymentplan.my
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Submitted URL: https://flexipayment.com.my/
Effective URL: https://easypaymentplan.my/
Submission: On March 26 via automatic, source certstream-suspicious — Scanned from DE
Effective URL: https://easypaymentplan.my/
Submission: On March 26 via automatic, source certstream-suspicious — Scanned from DE
Form analysis 1 forms found in the DOM
POST
<form data-form_id="1" id="fluentform_1" class="frm-fluent-form fluent_form_1 ff-el-form-top ff_form_instance_1_1 ff-form-has-steps ff-form-loaded" data-form_instance="ff_form_instance_1_1" method="POST">
<fieldset style="border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;
box-shadow: none!important;outline: none!important;">
<legend class="ff_screen_reader_title" style="margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;">Payex Application Form</legend><input type="hidden" name="__fluent_form_embded_post_id"
value="11"><input type="hidden" id="_fluentform_1_fluentformnonce" name="_fluentform_1_fluentformnonce" value="7aaa17384b"><input type="hidden" name="_wp_http_referer" value="/">
<div class="ff-step-container" data-name="step_start-1_8" data-disable_auto_focus="no" data-enable_auto_slider="no" data-enable_step_data_persistency="yes" data-enable_step_page_resume="no">
<div class="ff-step-header">
<div class="ff-el-progress-status">Step 1 of 3 - </div>
<div class="ff-el-progress">
<div class="ff-el-progress-bar" style="width: 33.3333%;"><span>33%</span></div>
</div>
<ul style="display: none" class="ff-el-progress-title">
<li style="display: inline;"></li>
<li style="display: none;"></li>
<li style="display: none;"></li>
</ul>
</div><span class="ff_step_start"></span>
<div class="ff-step-body" style="width: 300%;">
<div class="fluentform-step active" data-name="step_start-1_8" data-disable_auto_focus="no" data-enable_auto_slider="no" data-enable_step_data_persistency="yes" data-enable_step_page_resume="no" style="width: 33.3333%;">
<div class="ff-el-group ff-el-section-break ff_left" data-name="section_break-1_1">
<h3 class="ff-el-section-title">Business Information</h3>
<div class="ff-section_break_desk">
<p>Some information about your business</p>
</div>
<hr>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_entity" aria-label="Type of Business Entity">Type of Business Entity</label> </div>
<div class="ff-el-input--content"><select name="entity" id="ff_1_entity" class="ff-el-form-control" data-name="entity" data-calc_value="0" aria-invalid="false" aria-required="true">
<option value="">– Select Entity –</option>
<option value="sp">Sole Proprietorship</option>
<option value="gp">General/Limited Liability Partnership</option>
<option value="pl">Private Limited (Sdn Bhd)</option>
<option value="as">Association</option>
</select></div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_business_name" aria-label="Business Name">Business Name</label> </div>
<div class="ff-el-input--content"><input type="text" name="business_name" class="ff-el-form-control" data-name="business_name" id="ff_1_business_name" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_business_registration_no" aria-label="Business Registration No.">Business Registration No.</label> </div>
<div class="ff-el-input--content"><input type="text" name="business_registration_no" class="ff-el-form-control" data-name="business_registration_no" id="ff_1_business_registration_no" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group has-conditions ff_excluded">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_director_name" aria-label="Name of Company Director">Name of Company Director</label> </div>
<div class="ff-el-input--content"><input type="text" name="director_name" class="ff-el-form-control" data-name="director_name" id="ff_1_director_name" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group has-conditions ff_excluded">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_director_contact_no" aria-label="Director's Mobile Phone No.">Director’s Mobile Phone No.</label> </div>
<div class="ff-el-input--content"><input type="text" name="director_contact_no" class="ff-el-form-control" data-name="director_contact_no" id="ff_1_director_contact_no" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group has-conditions ff_excluded">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_director_id" aria-label="Director's NRIC/Passport No.">Director’s NRIC/Passport No.</label> </div>
<div class="ff-el-input--content"><input type="text" name="director_id" class="ff-el-form-control" data-name="director_id" id="ff_1_director_id" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_business_nature" aria-label="Nature of Business">Nature of Business</label> </div>
<div class="ff-el-input--content">
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select name="business_nature" id="ff_1_business_nature" class="ff-el-form-control ff_has_multi_select choices__input" data-name="business_nature" data-calc_value="0" aria-invalid="false"
aria-required="true" hidden="" tabindex="-1" data-choice="active">
<option value="">– Select Nature of Business –</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true" data-deletable="">– Select Nature of Business –<button
type="button" class="choices__button" aria-label="Remove item: ''" data-button="">Remove item</button></div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox"
aria-autocomplete="list" aria-label="– Select Nature of Business –" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--ff_1_business_nature-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1" data-value=""
data-select-text="Press to select" data-choice-selectable="" aria-selected="true">– Select Nature of Business –</div>
<div id="choices--ff_1_business_nature-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="8931" data-select-text="Press to select"
data-choice-selectable="">Accounting, auditing, and bookkeeping services</div>
<div id="choices--ff_1_business_nature-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="7311" data-select-text="Press to select"
data-choice-selectable="">Advertising services</div>
<div id="choices--ff_1_business_nature-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="5932" data-select-text="Press to select"
data-choice-selectable="">Antique shops – sales, repairs, and restoration services</div>
<div id="choices--ff_1_business_nature-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="5970" data-select-text="Press to select"
data-choice-selectable="">Artists supply and craft shops</div>
<div id="choices--ff_1_business_nature-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="7512" data-select-text="Press to select"
data-choice-selectable="">Automobile rental agency</div>
<div id="choices--ff_1_business_nature-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="7531" data-select-text="Press to select"
data-choice-selectable="">Automotive body repair shops</div>
<div id="choices--ff_1_business_nature-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="7535" data-select-text="Press to select"
data-choice-selectable="">Automotive paint shops</div>
<div id="choices--ff_1_business_nature-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="5533" data-select-text="Press to select"
data-choice-selectable="">Automotive parts and accessories stores</div>
<div id="choices--ff_1_business_nature-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="7538" data-select-text="Press to select"
data-choice-selectable="">Automotive service shops (non-dealer)</div>
<div id="choices--ff_1_business_nature-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="5532" data-select-text="Press to select"
data-choice-selectable="">Automotive tire stores</div>
<div id="choices--ff_1_business_nature-item-choice-12" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="12" data-value="5462" data-select-text="Press to select"
data-choice-selectable="">Bakeries</div>
<div id="choices--ff_1_business_nature-item-choice-13" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="13" data-value="7230" data-select-text="Press to select"
data-choice-selectable="">Beauty and barber shops</div>
<div id="choices--ff_1_business_nature-item-choice-14" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="14" data-value="5940" data-select-text="Press to select"
data-choice-selectable="">Bicycle shops – sales and service</div>
<div id="choices--ff_1_business_nature-item-choice-15" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="15" data-value="4457" data-select-text="Press to select"
data-choice-selectable="">Boat rentals and leasing</div>
<div id="choices--ff_1_business_nature-item-choice-16" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="16" data-value="5942" data-select-text="Press to select"
data-choice-selectable="">Book stores</div>
<div id="choices--ff_1_business_nature-item-choice-17" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="17" data-value="5192" data-select-text="Press to select"
data-choice-selectable="">Books, periodicals, and newspapers</div>
<div id="choices--ff_1_business_nature-item-choice-18" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="18" data-value="4131" data-select-text="Press to select"
data-choice-selectable="">Bus lines</div>
<div id="choices--ff_1_business_nature-item-choice-19" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="19" data-value="7399" data-select-text="Press to select"
data-choice-selectable="">Business services (not elsewhere classified)</div>
<div id="choices--ff_1_business_nature-item-choice-20" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="20" data-value="5946" data-select-text="Press to select"
data-choice-selectable="">Camera and photographic supply stores</div>
<div id="choices--ff_1_business_nature-item-choice-21" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="21" data-value="5441" data-select-text="Press to select"
data-choice-selectable="">Candy, nut, and confectionery stores</div>
<div id="choices--ff_1_business_nature-item-choice-22" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="22" data-value="5511" data-select-text="Press to select"
data-choice-selectable="">Car and truck dealers (new and used) sales, service, repairs, parts, and leasing</div>
<div id="choices--ff_1_business_nature-item-choice-23" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="23" data-value="7542" data-select-text="Press to select"
data-choice-selectable="">Car washes</div>
<div id="choices--ff_1_business_nature-item-choice-24" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="24" data-value="8398" data-select-text="Press to select"
data-choice-selectable="">Charitable and social service organizations</div>
<div id="choices--ff_1_business_nature-item-choice-25" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="25" data-value="8351" data-select-text="Press to select"
data-choice-selectable="">Child care services</div>
<div id="choices--ff_1_business_nature-item-choice-26" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="26" data-value="5641" data-select-text="Press to select"
data-choice-selectable="">Children’s and infant’s wear stores</div>
<div id="choices--ff_1_business_nature-item-choice-27" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="27" data-value="8041" data-select-text="Press to select"
data-choice-selectable="">Chiropractors</div>
<div id="choices--ff_1_business_nature-item-choice-28" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="28" data-value="7349" data-select-text="Press to select"
data-choice-selectable="">Cleaning, maintenance, and janitorial services</div>
<div id="choices--ff_1_business_nature-item-choice-29" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="29" data-value="7296" data-select-text="Press to select"
data-choice-selectable="">Clothing rental – costumes, uniforms, and formal wear</div>
<div id="choices--ff_1_business_nature-item-choice-30" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="30" data-value="8220" data-select-text="Press to select"
data-choice-selectable="">Colleges, universities, professional schools, and junior colleges</div>
<div id="choices--ff_1_business_nature-item-choice-31" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="31" data-value="7333" data-select-text="Press to select"
data-choice-selectable="">Commercial photography, art, and graphics</div>
<div id="choices--ff_1_business_nature-item-choice-32" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="32" data-value="7379" data-select-text="Press to select"
data-choice-selectable="">Computer maintenance, repair, and services (not elsewhere classified)</div>
<div id="choices--ff_1_business_nature-item-choice-33" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="33" data-value="4816" data-select-text="Press to select"
data-choice-selectable="">Computer network / information services</div>
<div id="choices--ff_1_business_nature-item-choice-34" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="34" data-value="7372" data-select-text="Press to select"
data-choice-selectable="">Computer programming, data processing, and integrated systems design services</div>
<div id="choices--ff_1_business_nature-item-choice-35" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="35" data-value="5734" data-select-text="Press to select"
data-choice-selectable="">Computer software stores</div>
<div id="choices--ff_1_business_nature-item-choice-36" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="36" data-value="5045" data-select-text="Press to select"
data-choice-selectable="">Computers and computer peripheral equipment and services</div>
<div id="choices--ff_1_business_nature-item-choice-37" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="37" data-value="7321" data-select-text="Press to select"
data-choice-selectable="">Consumer credit reporting agencies</div>
<div id="choices--ff_1_business_nature-item-choice-38" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="38" data-value="5977" data-select-text="Press to select"
data-choice-selectable="">Cosmetic stores</div>
<div id="choices--ff_1_business_nature-item-choice-39" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="39" data-value="4215" data-select-text="Press to select"
data-choice-selectable="">Courier services</div>
<div id="choices--ff_1_business_nature-item-choice-40" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="40" data-value="5451" data-select-text="Press to select"
data-choice-selectable="">Dairy products stores</div>
<div id="choices--ff_1_business_nature-item-choice-41" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="41" data-value="5960" data-select-text="Press to select"
data-choice-selectable="">Direct marketing – insurance services</div>
<div id="choices--ff_1_business_nature-item-choice-42" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="42" data-value="5912" data-select-text="Press to select"
data-choice-selectable="">Drug stores and pharmacies</div>
<div id="choices--ff_1_business_nature-item-choice-43" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="43" data-value="5122" data-select-text="Press to select"
data-choice-selectable="">Drugs, drug proprietaries, and druggist sundries</div>
<div id="choices--ff_1_business_nature-item-choice-44" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="44" data-value="5065" data-select-text="Press to select"
data-choice-selectable="">Electrical parts and equipment</div>
<div id="choices--ff_1_business_nature-item-choice-45" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="45" data-value="7622" data-select-text="Press to select"
data-choice-selectable="">Electronics repair shops</div>
<div id="choices--ff_1_business_nature-item-choice-46" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="46" data-value="5732" data-select-text="Press to select"
data-choice-selectable="">Electronics stores</div>
<div id="choices--ff_1_business_nature-item-choice-47" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="47" data-value="7361" data-select-text="Press to select"
data-choice-selectable="">Employment agencies and temporary help services</div>
<div id="choices--ff_1_business_nature-item-choice-48" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="48" data-value="7394" data-select-text="Press to select"
data-choice-selectable="">Equipment, tool, furniture, and appliance rental and leasing</div>
<div id="choices--ff_1_business_nature-item-choice-49" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="49" data-value="5651" data-select-text="Press to select"
data-choice-selectable="">Family clothing stores</div>
<div id="choices--ff_1_business_nature-item-choice-50" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="50" data-value="6012" data-select-text="Press to select"
data-choice-selectable="">Financial institutions merchandise and services</div>
<div id="choices--ff_1_business_nature-item-choice-51" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="51" data-value="5193" data-select-text="Press to select"
data-choice-selectable="">Florist supplies, nursery stock, and flowers</div>
<div id="choices--ff_1_business_nature-item-choice-52" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="52" data-value="5992" data-select-text="Press to select"
data-choice-selectable="">Florists</div>
<div id="choices--ff_1_business_nature-item-choice-53" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="53" data-value="5712" data-select-text="Press to select"
data-choice-selectable="">Furniture, home furnishings, and equipment stores, excepting appliances</div>
<div id="choices--ff_1_business_nature-item-choice-54" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="54" data-value="1520" data-select-text="Press to select"
data-choice-selectable="">General contractors – residential & commercial</div>
<div id="choices--ff_1_business_nature-item-choice-55" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="55" data-value="5947" data-select-text="Press to select"
data-choice-selectable="">Gift, card, novelty and souvenir shops</div>
<div id="choices--ff_1_business_nature-item-choice-56" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="56" data-value="5950" data-select-text="Press to select"
data-choice-selectable="">Glassware / crystal stores</div>
<div id="choices--ff_1_business_nature-item-choice-57" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="57" data-value="5072" data-select-text="Press to select"
data-choice-selectable="">Hardware, equipment and supplies</div>
<div id="choices--ff_1_business_nature-item-choice-58" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="58" data-value="7298" data-select-text="Press to select"
data-choice-selectable="">Health and beauty spas</div>
<div id="choices--ff_1_business_nature-item-choice-59" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="59" data-value="5945" data-select-text="Press to select"
data-choice-selectable="">Hobby, toy, and game shops</div>
<div id="choices--ff_1_business_nature-item-choice-60" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="60" data-value="8062" data-select-text="Press to select"
data-choice-selectable="">Hospitals</div>
<div id="choices--ff_1_business_nature-item-choice-61" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="61" data-value="5722" data-select-text="Press to select"
data-choice-selectable="">Household appliance stores</div>
<div id="choices--ff_1_business_nature-item-choice-62" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="62" data-value="6300" data-select-text="Press to select"
data-choice-selectable="">Insurance sales, underwriting & premiums</div>
<div id="choices--ff_1_business_nature-item-choice-63" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="63" data-value="5944" data-select-text="Press to select"
data-choice-selectable="">Jewelry stores, watches, clocks, and silverware stores</div>
<div id="choices--ff_1_business_nature-item-choice-64" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="64" data-value="7210" data-select-text="Press to select"
data-choice-selectable="">Laundry, cleaning, and garment services</div>
<div id="choices--ff_1_business_nature-item-choice-65" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="65" data-value="8111" data-select-text="Press to select"
data-choice-selectable="">Legal services and attorneys</div>
<div id="choices--ff_1_business_nature-item-choice-66" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="66" data-value="5948" data-select-text="Press to select"
data-choice-selectable="">Luggage and leather goods stores</div>
<div id="choices--ff_1_business_nature-item-choice-67" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="67" data-value="7392" data-select-text="Press to select"
data-choice-selectable="">Management, consulting, and public relations services</div>
<div id="choices--ff_1_business_nature-item-choice-68" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="68" data-value="4468" data-select-text="Press to select"
data-choice-selectable="">Marinas, marine service, and supplies</div>
<div id="choices--ff_1_business_nature-item-choice-69" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="69" data-value="7297" data-select-text="Press to select"
data-choice-selectable="">Massage parlors</div>
<div id="choices--ff_1_business_nature-item-choice-70" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="70" data-value="8099" data-select-text="Press to select"
data-choice-selectable="">Medical services and health practitioners (not elsewhere classified)</div>
<div id="choices--ff_1_business_nature-item-choice-71" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="71" data-value="5047" data-select-text="Press to select"
data-choice-selectable="">Medical, dental, ophthalmic, and hospital equipment and supplies</div>
<div id="choices--ff_1_business_nature-item-choice-72" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="72" data-value="7997" data-select-text="Press to select"
data-choice-selectable="">Membership clubs, country clubs, and private golf courses</div>
<div id="choices--ff_1_business_nature-item-choice-73" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="73" data-value="5611" data-select-text="Press to select"
data-choice-selectable="">Men’s and boy’s clothing and accessories stores</div>
<div id="choices--ff_1_business_nature-item-choice-74" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="74" data-value="5691" data-select-text="Press to select"
data-choice-selectable="">Men’s and women’s clothing stores</div>
<div id="choices--ff_1_business_nature-item-choice-75" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="75" data-value="5999" data-select-text="Press to select"
data-choice-selectable="">Miscellaneous and specialty retail shops</div>
<div id="choices--ff_1_business_nature-item-choice-76" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="76" data-value="5699" data-select-text="Press to select"
data-choice-selectable="">Miscellaneous apparel and accessory shops</div>
<div id="choices--ff_1_business_nature-item-choice-77" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="77" data-value="5499" data-select-text="Press to select"
data-choice-selectable="">Miscellaneous food stores – convenience stores and specialty markets</div>
<div id="choices--ff_1_business_nature-item-choice-78" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="78" data-value="5399" data-select-text="Press to select"
data-choice-selectable="">Miscellaneous general merchandise</div>
<div id="choices--ff_1_business_nature-item-choice-79" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="79" data-value="5719" data-select-text="Press to select"
data-choice-selectable="">Miscellaneous home furnishing specialty stores</div>
<div id="choices--ff_1_business_nature-item-choice-80" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="80" data-value="4214" data-select-text="Press to select"
data-choice-selectable="">Motor freight carriers and trucking</div>
<div id="choices--ff_1_business_nature-item-choice-81" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="81" data-value="5013" data-select-text="Press to select"
data-choice-selectable="">Motor vehicle supplies and new parts</div>
<div id="choices--ff_1_business_nature-item-choice-82" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="82" data-value="5733" data-select-text="Press to select"
data-choice-selectable="">Music stores – musical instruments, pianos, and sheet music</div>
<div id="choices--ff_1_business_nature-item-choice-83" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="83" data-value="5021" data-select-text="Press to select"
data-choice-selectable="">Office and commercial furniture</div>
<div id="choices--ff_1_business_nature-item-choice-84" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="84" data-value="8043" data-select-text="Press to select"
data-choice-selectable="">Opticians, optical goods, and eyeglasses</div>
<div id="choices--ff_1_business_nature-item-choice-85" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="85" data-value="5921" data-select-text="Press to select"
data-choice-selectable="">Package stores – beer, wine, and liquor</div>
<div id="choices--ff_1_business_nature-item-choice-86" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="86" data-value="7523" data-select-text="Press to select"
data-choice-selectable="">Parking lots and garages</div>
<div id="choices--ff_1_business_nature-item-choice-87" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="87" data-value="5995" data-select-text="Press to select"
data-choice-selectable="">Pet shops, pet foods and supplies stores</div>
<div id="choices--ff_1_business_nature-item-choice-88" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="88" data-value="7221" data-select-text="Press to select"
data-choice-selectable="">Photographic studios</div>
<div id="choices--ff_1_business_nature-item-choice-89" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="89" data-value="5044" data-select-text="Press to select"
data-choice-selectable="">Photographic, photocopy, microfilm equipment and supplies</div>
<div id="choices--ff_1_business_nature-item-choice-90" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="90" data-value="5074" data-select-text="Press to select"
data-choice-selectable="">Plumbing and heating equipment and supplies</div>
<div id="choices--ff_1_business_nature-item-choice-91" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="91" data-value="5094" data-select-text="Press to select"
data-choice-selectable="">Precious stones, metals, watches, and jewelry</div>
<div id="choices--ff_1_business_nature-item-choice-92" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="92" data-value="7992" data-select-text="Press to select"
data-choice-selectable="">Public golf courses</div>
<div id="choices--ff_1_business_nature-item-choice-93" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="93" data-value="4225" data-select-text="Press to select"
data-choice-selectable="">Public warehousing and storage</div>
<div id="choices--ff_1_business_nature-item-choice-94" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="94" data-value="6513" data-select-text="Press to select"
data-choice-selectable="">Real estate agents and managers – rentals</div>
<div id="choices--ff_1_business_nature-item-choice-95" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="95" data-value="5735" data-select-text="Press to select"
data-choice-selectable="">Record stores</div>
<div id="choices--ff_1_business_nature-item-choice-96" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="96" data-value="8299" data-select-text="Press to select"
data-choice-selectable="">Schools and educational services (not elsewhere classified)</div>
<div id="choices--ff_1_business_nature-item-choice-97" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="97" data-value="5661" data-select-text="Press to select"
data-choice-selectable="">Shoe stores</div>
<div id="choices--ff_1_business_nature-item-choice-98" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="98" data-value="5941" data-select-text="Press to select"
data-choice-selectable="">Sporting goods stores</div>
<div id="choices--ff_1_business_nature-item-choice-99" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="99" data-value="5655" data-select-text="Press to select"
data-choice-selectable="">Sports and riding apparel stores</div>
<div id="choices--ff_1_business_nature-item-choice-100" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="100" data-value="5943" data-select-text="Press to select"
data-choice-selectable="">Stationery stores, office and school supply stores</div>
<div id="choices--ff_1_business_nature-item-choice-101" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="101" data-value="5111" data-select-text="Press to select"
data-choice-selectable="">Stationery, office supplies, printing, and writing paper</div>
<div id="choices--ff_1_business_nature-item-choice-102" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="102" data-value="4411" data-select-text="Press to select"
data-choice-selectable="">Steamship and cruise lines</div>
<div id="choices--ff_1_business_nature-item-choice-103" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="103" data-value="7276" data-select-text="Press to select"
data-choice-selectable="">Tax preparation service</div>
<div id="choices--ff_1_business_nature-item-choice-104" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="104" data-value="4121" data-select-text="Press to select"
data-choice-selectable="">Taxicabs and limousines</div>
<div id="choices--ff_1_business_nature-item-choice-105" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="105" data-value="4812" data-select-text="Press to select"
data-choice-selectable="">Telecommunication equipment and telephone sales</div>
<div id="choices--ff_1_business_nature-item-choice-106" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="106" data-value="4814" data-select-text="Press to select"
data-choice-selectable="">Telecommunication service</div>
<div id="choices--ff_1_business_nature-item-choice-107" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="107" data-value="7534" data-select-text="Press to select"
data-choice-selectable="">Tire retreading and repair shops</div>
<div id="choices--ff_1_business_nature-item-choice-108" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="108" data-value="4722" data-select-text="Press to select"
data-choice-selectable="">Travel agencies and tour operators</div>
<div id="choices--ff_1_business_nature-item-choice-109" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="109" data-value="7513" data-select-text="Press to select"
data-choice-selectable="">Truck and utility trailer rentals</div>
<div id="choices--ff_1_business_nature-item-choice-110" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="110" data-value="4900" data-select-text="Press to select"
data-choice-selectable="">Utilities – electric, gas, water, sanitary</div>
<div id="choices--ff_1_business_nature-item-choice-111" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="111" data-value="0742" data-select-text="Press to select"
data-choice-selectable="">Veterinary services</div>
<div id="choices--ff_1_business_nature-item-choice-112" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="112" data-value="5631" data-select-text="Press to select"
data-choice-selectable="">Women’s accessory and specialty shops</div>
<div id="choices--ff_1_business_nature-item-choice-113" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="113" data-value="5621" data-select-text="Press to select"
data-choice-selectable="">Women’s ready-to-wear stores</div>
</div>
</div>
</div>
</div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_address" aria-label="Address">Address</label> </div>
<div class="ff-el-input--content"><input type="text" name="address" class="ff-el-form-control" data-name="address" id="ff_1_address" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label asterisk-right"><label for="ff_1_location" aria-label="Location">Location</label> </div>
<div class="ff-el-input--content"><input type="text" name="location" class="ff-el-form-control" data-name="location" id="ff_1_location" aria-invalid="false" aria-required="false"></div>
</div><input type="hidden" name="location_id" data-name="location_id">
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_input_text_11" aria-label="City">City</label> </div>
<div class="ff-el-input--content"><input type="text" name="input_text_11" class="ff-el-form-control" data-name="input_text_11" id="ff_1_input_text_11" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_postcode" aria-label="Postcode">Postcode</label> </div>
<div class="ff-el-input--content"><input type="number" name="postcode" id="ff_1_postcode" class="ff-el-form-control" data-name="postcode" inputmode="numeric" step="any" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_dropdown_2" aria-label="State">State</label> </div>
<div class="ff-el-input--content">
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select name="dropdown_2" id="ff_1_dropdown_2" class="ff-el-form-control ff_has_multi_select choices__input" data-name="dropdown_2" data-calc_value="0" aria-invalid="false" aria-required="true" hidden=""
tabindex="-1" data-choice="active">
<option value="">– Select –</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true" data-deletable="">– Select –<button type="button"
class="choices__button" aria-label="Remove item: ''" data-button="">Remove item</button></div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox"
aria-autocomplete="list" aria-label="– Select –" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--ff_1_dropdown_2-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1" data-value=""
data-select-text="Press to select" data-choice-selectable="" aria-selected="true">– Select –</div>
<div id="choices--ff_1_dropdown_2-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="jhr" data-select-text="Press to select"
data-choice-selectable="">Johor</div>
<div id="choices--ff_1_dropdown_2-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="kdh" data-select-text="Press to select"
data-choice-selectable="">Kedah</div>
<div id="choices--ff_1_dropdown_2-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="ktn" data-select-text="Press to select"
data-choice-selectable="">Kelantan</div>
<div id="choices--ff_1_dropdown_2-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="mlk" data-select-text="Press to select"
data-choice-selectable="">Melaka</div>
<div id="choices--ff_1_dropdown_2-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="nsn" data-select-text="Press to select"
data-choice-selectable="">Negeri Sembilan</div>
<div id="choices--ff_1_dropdown_2-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="phg" data-select-text="Press to select"
data-choice-selectable="">Pahang</div>
<div id="choices--ff_1_dropdown_2-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="prk" data-select-text="Press to select"
data-choice-selectable="">Perak</div>
<div id="choices--ff_1_dropdown_2-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="pls" data-select-text="Press to select"
data-choice-selectable="">Perlis</div>
<div id="choices--ff_1_dropdown_2-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="png" data-select-text="Press to select"
data-choice-selectable="">Penang</div>
<div id="choices--ff_1_dropdown_2-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="sgr" data-select-text="Press to select"
data-choice-selectable="">Selangor</div>
<div id="choices--ff_1_dropdown_2-item-choice-12" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="12" data-value="trg" data-select-text="Press to select"
data-choice-selectable="">Terengganu</div>
<div id="choices--ff_1_dropdown_2-item-choice-13" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="13" data-value="kul" data-select-text="Press to select"
data-choice-selectable="">Kuala Lumpur</div>
<div id="choices--ff_1_dropdown_2-item-choice-14" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="14" data-value="pjy" data-select-text="Press to select"
data-choice-selectable="">Putrajaya</div>
<div id="choices--ff_1_dropdown_2-item-choice-15" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="15" data-value="srw" data-select-text="Press to select"
data-choice-selectable="">Sarawak</div>
<div id="choices--ff_1_dropdown_2-item-choice-16" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="16" data-value="sbh" data-select-text="Press to select"
data-choice-selectable="">Sabah</div>
<div id="choices--ff_1_dropdown_2-item-choice-17" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="17" data-value="lbn" data-select-text="Press to select"
data-choice-selectable="">Labuan</div>
</div>
</div>
</div>
</div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_country_" aria-label="Country">Country</label> </div>
<div class="ff-el-input--content"><input type="text" name="country_" value="MY" class="ff-el-form-control" data-name="country_" id="ff_1_country_" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group ff-el-section-break ff_left" data-name="section_break-1_2">
<h3 class="ff-el-section-title">Contact Person Information</h3>
<div class="ff-section_break_desk">
<p>Contact person for the application</p>
</div>
<hr>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_contact_name" aria-label="Name of Contact Person">Name of Contact Person</label> </div>
<div class="ff-el-input--content"><input type="text" name="contact_name" class="ff-el-form-control" data-name="contact_name" id="ff_1_contact_name" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_contact_no" aria-label="Mobile Phone No.">Mobile Phone No.</label> </div>
<div class="ff-el-input--content"><input type="text" name="contact_no" class="ff-el-form-control" data-name="contact_no" id="ff_1_contact_no" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_ic" aria-label="NRIC/Passport No.">NRIC/Passport No.</label> </div>
<div class="ff-el-input--content"><input type="text" name="ic" class="ff-el-form-control" data-name="ic" id="ff_1_ic" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_email" aria-label="Email">Email</label> </div>
<div class="ff-el-input--content"><input type="email" name="email" id="ff_1_email" class="ff-el-form-control" data-name="email" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label asterisk-right"><label for="ff_1_notification_email" aria-label="Notification Email">Notification Email</label>
<div class="ff-el-tooltip" data-content="*All payment receipts will go to this email. Please indicate a general email like finance@abc.com."><svg width="16" height="16" viewBox="0 0 25 25">
<path
d="m329 393l0-46c0-2-1-4-2-6-2-2-4-3-7-3l-27 0 0-146c0-3-1-5-3-7-2-1-4-2-7-2l-91 0c-3 0-5 1-7 2-1 2-2 4-2 7l0 46c0 2 1 5 2 6 2 2 4 3 7 3l27 0 0 91-27 0c-3 0-5 1-7 3-1 2-2 4-2 6l0 46c0 3 1 5 2 7 2 1 4 2 7 2l128 0c3 0 5-1 7-2 1-2 2-4 2-7z m-36-256l0-46c0-2-1-4-3-6-2-2-4-3-7-3l-54 0c-3 0-5 1-7 3-2 2-3 4-3 6l0 46c0 3 1 5 3 7 2 1 4 2 7 2l54 0c3 0 5-1 7-2 2-2 3-4 3-7z m182 119c0 40-9 77-29 110-20 34-46 60-80 80-33 20-70 29-110 29-40 0-77-9-110-29-34-20-60-46-80-80-20-33-29-70-29-110 0-40 9-77 29-110 20-34 46-60 80-80 33-20 70-29 110-29 40 0 77 9 110 29 34 20 60 46 80 80 20 33 29 70 29 110z"
transform="scale(0.046875 0.046875)"></path>
</svg></div>
</div>
<div class="ff-el-input--content"><input type="email" name="notification_email" id="ff_1_notification_email" class="ff-el-form-control" data-name="notification_email" aria-invalid="false" aria-required="false"></div>
</div>
<div class="ff-el-group ff-el-section-break ff_left" data-name="section_break-1_3">
<h3 class="ff-el-section-title">Website Information</h3>
<div class="ff-section_break_desk">
<p>Some information about your business website</p>
</div>
<hr>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_website" aria-label="Website">Website</label>
<div class="ff-el-tooltip" data-content="*Website is required to include company's registered business name, business registration no. & business address. Indicate n/a if you do not have a website."><svg width="16" height="16"
viewBox="0 0 25 25">
<path
d="m329 393l0-46c0-2-1-4-2-6-2-2-4-3-7-3l-27 0 0-146c0-3-1-5-3-7-2-1-4-2-7-2l-91 0c-3 0-5 1-7 2-1 2-2 4-2 7l0 46c0 2 1 5 2 6 2 2 4 3 7 3l27 0 0 91-27 0c-3 0-5 1-7 3-1 2-2 4-2 6l0 46c0 3 1 5 2 7 2 1 4 2 7 2l128 0c3 0 5-1 7-2 1-2 2-4 2-7z m-36-256l0-46c0-2-1-4-3-6-2-2-4-3-7-3l-54 0c-3 0-5 1-7 3-2 2-3 4-3 6l0 46c0 3 1 5 3 7 2 1 4 2 7 2l54 0c3 0 5-1 7-2 2-2 3-4 3-7z m182 119c0 40-9 77-29 110-20 34-46 60-80 80-33 20-70 29-110 29-40 0-77-9-110-29-34-20-60-46-80-80-20-33-29-70-29-110 0-40 9-77 29-110 20-34 46-60 80-80 33-20 70-29 110-29 40 0 77 9 110 29 34 20 60 46 80 80 20 33 29 70 29 110z"
transform="scale(0.046875 0.046875)"></path>
</svg></div>
</div>
<div class="ff-el-input--content"><input type="text" name="website" value="n/a" class="ff-el-form-control" data-name="website" id="ff_1_website" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_terms_conditions_url" aria-label="Terms & Conditions URL">Terms & Conditions URL</label>
<div class="ff-el-tooltip" data-content="*Mandatory if you have a website. Indicate n/a if you do not have a website."><svg width="16" height="16" viewBox="0 0 25 25">
<path
d="m329 393l0-46c0-2-1-4-2-6-2-2-4-3-7-3l-27 0 0-146c0-3-1-5-3-7-2-1-4-2-7-2l-91 0c-3 0-5 1-7 2-1 2-2 4-2 7l0 46c0 2 1 5 2 6 2 2 4 3 7 3l27 0 0 91-27 0c-3 0-5 1-7 3-1 2-2 4-2 6l0 46c0 3 1 5 2 7 2 1 4 2 7 2l128 0c3 0 5-1 7-2 1-2 2-4 2-7z m-36-256l0-46c0-2-1-4-3-6-2-2-4-3-7-3l-54 0c-3 0-5 1-7 3-2 2-3 4-3 6l0 46c0 3 1 5 3 7 2 1 4 2 7 2l54 0c3 0 5-1 7-2 2-2 3-4 3-7z m182 119c0 40-9 77-29 110-20 34-46 60-80 80-33 20-70 29-110 29-40 0-77-9-110-29-34-20-60-46-80-80-20-33-29-70-29-110 0-40 9-77 29-110 20-34 46-60 80-80 33-20 70-29 110-29 40 0 77 9 110 29 34 20 60 46 80 80 20 33 29 70 29 110z"
transform="scale(0.046875 0.046875)"></path>
</svg></div>
</div>
<div class="ff-el-input--content"><input type="text" name="terms_conditions_url" value="n/a" class="ff-el-form-control" data-name="terms_conditions_url" id="ff_1_terms_conditions_url" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_privacy_policy_url" aria-label="Privacy Policy URL">Privacy Policy URL</label>
<div class="ff-el-tooltip" data-content="*Mandatory if you have a website. Indicate n/a if you do not have a website."><svg width="16" height="16" viewBox="0 0 25 25">
<path
d="m329 393l0-46c0-2-1-4-2-6-2-2-4-3-7-3l-27 0 0-146c0-3-1-5-3-7-2-1-4-2-7-2l-91 0c-3 0-5 1-7 2-1 2-2 4-2 7l0 46c0 2 1 5 2 6 2 2 4 3 7 3l27 0 0 91-27 0c-3 0-5 1-7 3-1 2-2 4-2 6l0 46c0 3 1 5 2 7 2 1 4 2 7 2l128 0c3 0 5-1 7-2 1-2 2-4 2-7z m-36-256l0-46c0-2-1-4-3-6-2-2-4-3-7-3l-54 0c-3 0-5 1-7 3-2 2-3 4-3 6l0 46c0 3 1 5 3 7 2 1 4 2 7 2l54 0c3 0 5-1 7-2 2-2 3-4 3-7z m182 119c0 40-9 77-29 110-20 34-46 60-80 80-33 20-70 29-110 29-40 0-77-9-110-29-34-20-60-46-80-80-20-33-29-70-29-110 0-40 9-77 29-110 20-34 46-60 80-80 33-20 70-29 110-29 40 0 77 9 110 29 34 20 60 46 80 80 20 33 29 70 29 110z"
transform="scale(0.046875 0.046875)"></path>
</svg></div>
</div>
<div class="ff-el-input--content"><input type="text" name="privacy_policy_url" value="n/a" class="ff-el-form-control" data-name="privacy_policy_url" id="ff_1_privacy_policy_url" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_refund_policy_url" aria-label="Refund Policy URL">Refund Policy URL</label>
<div class="ff-el-tooltip" data-content="*Mandatory if you have a website. Indicate n/a if you do not have a website."><svg width="16" height="16" viewBox="0 0 25 25">
<path
d="m329 393l0-46c0-2-1-4-2-6-2-2-4-3-7-3l-27 0 0-146c0-3-1-5-3-7-2-1-4-2-7-2l-91 0c-3 0-5 1-7 2-1 2-2 4-2 7l0 46c0 2 1 5 2 6 2 2 4 3 7 3l27 0 0 91-27 0c-3 0-5 1-7 3-1 2-2 4-2 6l0 46c0 3 1 5 2 7 2 1 4 2 7 2l128 0c3 0 5-1 7-2 1-2 2-4 2-7z m-36-256l0-46c0-2-1-4-3-6-2-2-4-3-7-3l-54 0c-3 0-5 1-7 3-2 2-3 4-3 6l0 46c0 3 1 5 3 7 2 1 4 2 7 2l54 0c3 0 5-1 7-2 2-2 3-4 3-7z m182 119c0 40-9 77-29 110-20 34-46 60-80 80-33 20-70 29-110 29-40 0-77-9-110-29-34-20-60-46-80-80-20-33-29-70-29-110 0-40 9-77 29-110 20-34 46-60 80-80 33-20 70-29 110-29 40 0 77 9 110 29 34 20 60 46 80 80 20 33 29 70 29 110z"
transform="scale(0.046875 0.046875)"></path>
</svg></div>
</div>
<div class="ff-el-input--content"><input type="text" name="refund_policy_url" value="n/a" class="ff-el-form-control" data-name="refund_policy_url" id="ff_1_refund_policy_url" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_facebook" aria-label="Facebook Page">Facebook Page</label>
<div class="ff-el-tooltip" data-content="*Indicate n/a if you do not have a Facebook page."><svg width="16" height="16" viewBox="0 0 25 25">
<path
d="m329 393l0-46c0-2-1-4-2-6-2-2-4-3-7-3l-27 0 0-146c0-3-1-5-3-7-2-1-4-2-7-2l-91 0c-3 0-5 1-7 2-1 2-2 4-2 7l0 46c0 2 1 5 2 6 2 2 4 3 7 3l27 0 0 91-27 0c-3 0-5 1-7 3-1 2-2 4-2 6l0 46c0 3 1 5 2 7 2 1 4 2 7 2l128 0c3 0 5-1 7-2 1-2 2-4 2-7z m-36-256l0-46c0-2-1-4-3-6-2-2-4-3-7-3l-54 0c-3 0-5 1-7 3-2 2-3 4-3 6l0 46c0 3 1 5 3 7 2 1 4 2 7 2l54 0c3 0 5-1 7-2 2-2 3-4 3-7z m182 119c0 40-9 77-29 110-20 34-46 60-80 80-33 20-70 29-110 29-40 0-77-9-110-29-34-20-60-46-80-80-20-33-29-70-29-110 0-40 9-77 29-110 20-34 46-60 80-80 33-20 70-29 110-29 40 0 77 9 110 29 34 20 60 46 80 80 20 33 29 70 29 110z"
transform="scale(0.046875 0.046875)"></path>
</svg></div>
</div>
<div class="ff-el-input--content"><input type="text" name="facebook" value="n/a" class="ff-el-form-control" data-name="facebook" id="ff_1_facebook" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label asterisk-right"><label for="ff_1_instagram" aria-label="Instagram Page">Instagram Page</label> </div>
<div class="ff-el-input--content"><input type="text" name="instagram" class="ff-el-form-control" data-name="instagram" id="ff_1_instagram" aria-invalid="false" aria-required="false"></div>
</div>
<div class="step-nav ff_step_nav_last"><button type="button" data-action="next" class="ff-float-right ff-btn ff-btn-next ff-btn-secondary">Next</button></div>
</div>
<div class=" fluentform-step" data-name="form_step-1_4" style="width: 33.3333%;">
<div class="ff-el-group ff-el-section-break ff_left" data-name="section_break-1_5">
<h3 class="ff-el-section-title">Required Documents</h3>
<div class="ff-section_break_desk">
<p>Submit all required documents for the application.</p>
</div>
<hr>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_ic_front_1" aria-label="Owner(s)/ Signatory's IC (Front)">Owner(s)/ Signatory’s IC (Front)</label> </div>
<div class="ff-el-input--content"><label for="ff_1_ic_front_1" class="ff_file_upload_holder"><span class="ff_upload_btn ff-btn">Choose File</span> <input type="file" name="ic_front" id="ff_1_ic_front_1"
class="ff-el-form-control ff-screen-reader-element" data-name="ic_front" multiple="1" aria-invalid="false" aria-required="true" accept=".jpg,.jpeg,.gif,.png,.bmp,.pdf"></label>
<div class="ff-uploaded-list" style="font-size:12px; margin-top: 15px;"></div>
</div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_ic_back_1" aria-label="Owner(s)/ Signatory's IC (Back)">Owner(s)/ Signatory’s IC (Back)</label> </div>
<div class="ff-el-input--content"><label for="ff_1_ic_back_1" class="ff_file_upload_holder"><span class="ff_upload_btn ff-btn">Choose File</span> <input type="file" name="ic_back" id="ff_1_ic_back_1"
class="ff-el-form-control ff-screen-reader-element" data-name="ic_back" multiple="1" aria-invalid="false" aria-required="true" accept=".jpg,.jpeg,.gif,.png,.bmp,.pdf"></label>
<div class="ff-uploaded-list" style="font-size:12px; margin-top: 15px;"></div>
</div>
</div>
<div class="ff-el-group has-conditions ff_excluded">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_form_d_1" aria-label="Form D">Form D</label> </div>
<div class="ff-el-input--content"><label for="ff_1_form_d_1" class="ff_file_upload_holder"><span class="ff_upload_btn ff-btn">Choose File</span> <input type="file" name="form_d" id="ff_1_form_d_1"
class="ff-el-form-control ff-screen-reader-element" data-name="form_d" multiple="1" aria-invalid="false" aria-required="true" accept=".jpg,.jpeg,.gif,.png,.bmp,.pdf"></label>
<div class="ff-uploaded-list" style="font-size:12px; margin-top: 15px;"></div>
</div>
</div>
<div class="ff-el-group has-conditions ff_excluded">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_ssm_company_profile_1_1" aria-label="SSM Company Profile">SSM Company Profile</label>
<div class="ff-el-tooltip"
data-content="<a href="https://easypaymentplan.my/wp-content/uploads/2023/03/Example_SSM_Profile_Sdn_Bhd.pdf" target="_blank">*Click to view sample.</a> Please note that we do not accept Section 14 or Form 49, and only accept documents in this format. You may download it from <a href="https://www.mydata-ssm.com.my/" target="_blank">https://www.mydata-ssm.com.my/</a>">
<svg width="16" height="16" viewBox="0 0 25 25">
<path
d="m329 393l0-46c0-2-1-4-2-6-2-2-4-3-7-3l-27 0 0-146c0-3-1-5-3-7-2-1-4-2-7-2l-91 0c-3 0-5 1-7 2-1 2-2 4-2 7l0 46c0 2 1 5 2 6 2 2 4 3 7 3l27 0 0 91-27 0c-3 0-5 1-7 3-1 2-2 4-2 6l0 46c0 3 1 5 2 7 2 1 4 2 7 2l128 0c3 0 5-1 7-2 1-2 2-4 2-7z m-36-256l0-46c0-2-1-4-3-6-2-2-4-3-7-3l-54 0c-3 0-5 1-7 3-2 2-3 4-3 6l0 46c0 3 1 5 3 7 2 1 4 2 7 2l54 0c3 0 5-1 7-2 2-2 3-4 3-7z m182 119c0 40-9 77-29 110-20 34-46 60-80 80-33 20-70 29-110 29-40 0-77-9-110-29-34-20-60-46-80-80-20-33-29-70-29-110 0-40 9-77 29-110 20-34 46-60 80-80 33-20 70-29 110-29 40 0 77 9 110 29 34 20 60 46 80 80 20 33 29 70 29 110z"
transform="scale(0.046875 0.046875)"></path>
</svg></div>
</div>
<div class="ff-el-input--content"><label for="ff_1_ssm_company_profile_1_1" class="ff_file_upload_holder"><span class="ff_upload_btn ff-btn">Choose File</span> <input type="file" name="ssm_company_profile_1"
id="ff_1_ssm_company_profile_1_1" class="ff-el-form-control ff-screen-reader-element" data-name="ssm_company_profile_1" multiple="1" aria-invalid="false" aria-required="true" accept=".jpg,.jpeg,.gif,.png,.bmp,.pdf"></label>
<div class="ff-uploaded-list" style="font-size:12px; margin-top: 15px;"></div>
</div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_file-upload_3_1" aria-label="Certificate of Company (Superform Section 17 or Form 9)">Certificate of Company (Superform Section 17 or Form 9)</label>
<div class="ff-el-tooltip" data-content="<a href="https://easypaymentplan.my/wp-content/uploads/2023/03/Example_Section_17.png" target="_blank">*Click to view sample.</a>"><svg width="16" height="16"
viewBox="0 0 25 25">
<path
d="m329 393l0-46c0-2-1-4-2-6-2-2-4-3-7-3l-27 0 0-146c0-3-1-5-3-7-2-1-4-2-7-2l-91 0c-3 0-5 1-7 2-1 2-2 4-2 7l0 46c0 2 1 5 2 6 2 2 4 3 7 3l27 0 0 91-27 0c-3 0-5 1-7 3-1 2-2 4-2 6l0 46c0 3 1 5 2 7 2 1 4 2 7 2l128 0c3 0 5-1 7-2 1-2 2-4 2-7z m-36-256l0-46c0-2-1-4-3-6-2-2-4-3-7-3l-54 0c-3 0-5 1-7 3-2 2-3 4-3 6l0 46c0 3 1 5 3 7 2 1 4 2 7 2l54 0c3 0 5-1 7-2 2-2 3-4 3-7z m182 119c0 40-9 77-29 110-20 34-46 60-80 80-33 20-70 29-110 29-40 0-77-9-110-29-34-20-60-46-80-80-20-33-29-70-29-110 0-40 9-77 29-110 20-34 46-60 80-80 33-20 70-29 110-29 40 0 77 9 110 29 34 20 60 46 80 80 20 33 29 70 29 110z"
transform="scale(0.046875 0.046875)"></path>
</svg></div>
</div>
<div class="ff-el-input--content"><label for="ff_1_file-upload_3_1" class="ff_file_upload_holder"><span class="ff_upload_btn ff-btn">Choose File</span> <input type="file" name="file-upload_3" id="ff_1_file-upload_3_1"
class="ff-el-form-control ff-screen-reader-element" data-name="file-upload_3" multiple="1" aria-invalid="false" aria-required="true" accept=".jpg,.jpeg,.gif,.png,.bmp,.pdf"></label>
<div class="ff-uploaded-list" style="font-size:12px; margin-top: 15px;"></div>
</div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_bank_statement_1" aria-label="Latest Bank Statement">Latest Bank Statement</label> </div>
<div class="ff-el-input--content"><label for="ff_1_bank_statement_1" class="ff_file_upload_holder"><span class="ff_upload_btn ff-btn">Choose File</span> <input type="file" name="bank_statement" id="ff_1_bank_statement_1"
class="ff-el-form-control ff-screen-reader-element" data-name="bank_statement" multiple="1" aria-invalid="false" aria-required="true" accept=".jpg,.jpeg,.gif,.png,.bmp,.pdf"></label>
<div class="ff-uploaded-list" style="font-size:12px; margin-top: 15px;"></div>
</div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_file-upload_4_1"
aria-label="Signboard/Premises/Booth/Stall/Vehicle, and overview of the place of business premises (Min 3)">Signboard/Premises/Booth/Stall/Vehicle, and overview of the place of business premises (Min 3)</label>
<div class="ff-el-tooltip" data-content="Overview of the place of business premises.<br>
*Mandatory if you do not have a website or a valid website is not provided."><svg width="16" height="16" viewBox="0 0 25 25">
<path
d="m329 393l0-46c0-2-1-4-2-6-2-2-4-3-7-3l-27 0 0-146c0-3-1-5-3-7-2-1-4-2-7-2l-91 0c-3 0-5 1-7 2-1 2-2 4-2 7l0 46c0 2 1 5 2 6 2 2 4 3 7 3l27 0 0 91-27 0c-3 0-5 1-7 3-1 2-2 4-2 6l0 46c0 3 1 5 2 7 2 1 4 2 7 2l128 0c3 0 5-1 7-2 1-2 2-4 2-7z m-36-256l0-46c0-2-1-4-3-6-2-2-4-3-7-3l-54 0c-3 0-5 1-7 3-2 2-3 4-3 6l0 46c0 3 1 5 3 7 2 1 4 2 7 2l54 0c3 0 5-1 7-2 2-2 3-4 3-7z m182 119c0 40-9 77-29 110-20 34-46 60-80 80-33 20-70 29-110 29-40 0-77-9-110-29-34-20-60-46-80-80-20-33-29-70-29-110 0-40 9-77 29-110 20-34 46-60 80-80 33-20 70-29 110-29 40 0 77 9 110 29 34 20 60 46 80 80 20 33 29 70 29 110z"
transform="scale(0.046875 0.046875)"></path>
</svg></div>
</div>
<div class="ff-el-input--content"><label for="ff_1_file-upload_4_1" class="ff_file_upload_holder"><span class="ff_upload_btn ff-btn">Choose File</span> <input type="file" name="file-upload_4" id="ff_1_file-upload_4_1"
class="ff-el-form-control ff-screen-reader-element" data-name="file-upload_4" multiple="1" aria-invalid="false" aria-required="true" accept=".jpg,.jpeg,.gif,.png,.bmp"></label>
<div class="ff-uploaded-list" style="font-size:12px; margin-top: 15px;"></div>
</div>
</div>
<div class="step-nav ff_step_nav_last"><button type="button" data-action="prev" class="ff-btn ff-btn-prev ff-btn-secondary">Previous</button><button type="button" data-action="next"
class="ff-float-right ff-btn ff-btn-next ff-btn-secondary">Next</button></div>
</div>
<div class=" fluentform-step" data-name="form_step-1_6" style="width: 33.3333%;">
<div class="ff-el-group ff-el-section-break ff_left" data-name="section_break-1_7">
<h3 class="ff-el-section-title">Settlement Info & Others</h3>
<div class="ff-section_break_desk">
<p>Company Bank Information for payment settlement</p>
</div>
<hr>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_bank_name" aria-label="Bank Name">Bank Name</label> </div>
<div class="ff-el-input--content">
<div class="choices" data-type="select-one" tabindex="0" role="combobox" aria-autocomplete="list" aria-haspopup="true" aria-expanded="false">
<div class="choices__inner"><select name="bank_name" id="ff_1_bank_name" class="ff-el-form-control ff_has_multi_select choices__input" data-name="bank_name" data-calc_value="0" aria-invalid="false" aria-required="true" hidden=""
tabindex="-1" data-choice="active">
<option value="">– Select Bank –</option>
</select>
<div class="choices__list choices__list--single">
<div class="choices__item choices__placeholder choices__item--selectable" data-item="" data-id="1" data-value="" data-custom-properties="null" aria-selected="true" data-deletable="">– Select Bank –<button type="button"
class="choices__button" aria-label="Remove item: ''" data-button="">Remove item</button></div>
</div>
</div>
<div class="choices__list choices__list--dropdown" aria-expanded="false"><input type="text" class="choices__input choices__input--cloned" autocomplete="off" autocapitalize="off" spellcheck="false" role="textbox"
aria-autocomplete="list" aria-label="– Select Bank –" placeholder="">
<div class="choices__list" role="listbox">
<div id="choices--ff_1_bank_name-item-choice-1" class="choices__item choices__item--choice is-selected choices__placeholder choices__item--selectable is-highlighted" role="option" data-choice="" data-id="1" data-value=""
data-select-text="Press to select" data-choice-selectable="" aria-selected="true">– Select Bank –</div>
<div id="choices--ff_1_bank_name-item-choice-2" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="2" data-value="Affin Bank" data-select-text="Press to select"
data-choice-selectable="">Affin Bank</div>
<div id="choices--ff_1_bank_name-item-choice-3" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="3" data-value="Agrobank" data-select-text="Press to select"
data-choice-selectable="">Agrobank</div>
<div id="choices--ff_1_bank_name-item-choice-4" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="4" data-value="Al Rajhi Bank" data-select-text="Press to select"
data-choice-selectable="">Al Rajhi Bank</div>
<div id="choices--ff_1_bank_name-item-choice-5" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="5" data-value="Alliance Bank" data-select-text="Press to select"
data-choice-selectable="">Alliance Bank</div>
<div id="choices--ff_1_bank_name-item-choice-6" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="6" data-value="Ambank" data-select-text="Press to select"
data-choice-selectable="">Ambank</div>
<div id="choices--ff_1_bank_name-item-choice-7" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="7" data-value="Bangkok Bank" data-select-text="Press to select"
data-choice-selectable="">Bangkok Bank</div>
<div id="choices--ff_1_bank_name-item-choice-8" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="8" data-value="Bank Islam" data-select-text="Press to select"
data-choice-selectable="">Bank Islam</div>
<div id="choices--ff_1_bank_name-item-choice-9" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="9" data-value="Bank Kerjasama Rakyat" data-select-text="Press to select"
data-choice-selectable="">Bank Kerjasama Rakyat</div>
<div id="choices--ff_1_bank_name-item-choice-10" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="10" data-value="Bank Muamalat" data-select-text="Press to select"
data-choice-selectable="">Bank Muamalat</div>
<div id="choices--ff_1_bank_name-item-choice-11" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="11" data-value="Bank Of America" data-select-text="Press to select"
data-choice-selectable="">Bank Of America</div>
<div id="choices--ff_1_bank_name-item-choice-12" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="12" data-value="Bank Of China" data-select-text="Press to select"
data-choice-selectable="">Bank Of China</div>
<div id="choices--ff_1_bank_name-item-choice-13" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="13" data-value="Bank Pembangunan Malaysia"
data-select-text="Press to select" data-choice-selectable="">Bank Pembangunan Malaysia</div>
<div id="choices--ff_1_bank_name-item-choice-14" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="14" data-value="Bank Simpanan Nasional"
data-select-text="Press to select" data-choice-selectable="">Bank Simpanan Nasional</div>
<div id="choices--ff_1_bank_name-item-choice-15" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="15" data-value="BNP Paribas" data-select-text="Press to select"
data-choice-selectable="">BNP Paribas</div>
<div id="choices--ff_1_bank_name-item-choice-16" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="16" data-value="CIMB Bank" data-select-text="Press to select"
data-choice-selectable="">CIMB Bank</div>
<div id="choices--ff_1_bank_name-item-choice-17" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="17" data-value="Deutsche Bank" data-select-text="Press to select"
data-choice-selectable="">Deutsche Bank</div>
<div id="choices--ff_1_bank_name-item-choice-18" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="18" data-value="EXIM Bank" data-select-text="Press to select"
data-choice-selectable="">EXIM Bank</div>
<div id="choices--ff_1_bank_name-item-choice-19" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="19" data-value="Hong Leong Bank" data-select-text="Press to select"
data-choice-selectable="">Hong Leong Bank</div>
<div id="choices--ff_1_bank_name-item-choice-20" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="20" data-value="HSBC Bank" data-select-text="Press to select"
data-choice-selectable="">HSBC Bank</div>
<div id="choices--ff_1_bank_name-item-choice-21" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="21" data-value="ICBC Bank" data-select-text="Press to select"
data-choice-selectable="">ICBC Bank</div>
<div id="choices--ff_1_bank_name-item-choice-22" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="22" data-value="India International Bank"
data-select-text="Press to select" data-choice-selectable="">India International Bank</div>
<div id="choices--ff_1_bank_name-item-choice-23" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="23" data-value="J.P. Morgan Chase Bank"
data-select-text="Press to select" data-choice-selectable="">J.P. Morgan Chase Bank</div>
<div id="choices--ff_1_bank_name-item-choice-24" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="24" data-value="Kuwait Finance Bank" data-select-text="Press to select"
data-choice-selectable="">Kuwait Finance Bank</div>
<div id="choices--ff_1_bank_name-item-choice-25" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="25" data-value="Maybank" data-select-text="Press to select"
data-choice-selectable="">Maybank</div>
<div id="choices--ff_1_bank_name-item-choice-26" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="26" data-value="MBSB Bank" data-select-text="Press to select"
data-choice-selectable="">MBSB Bank</div>
<div id="choices--ff_1_bank_name-item-choice-27" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="27" data-value="Mizuho Bank" data-select-text="Press to select"
data-choice-selectable="">Mizuho Bank</div>
<div id="choices--ff_1_bank_name-item-choice-28" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="28" data-value="MUFG Bank" data-select-text="Press to select"
data-choice-selectable="">MUFG Bank</div>
<div id="choices--ff_1_bank_name-item-choice-29" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="29" data-value="OCBC Bank" data-select-text="Press to select"
data-choice-selectable="">OCBC Bank</div>
<div id="choices--ff_1_bank_name-item-choice-30" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="30" data-value="Public Bank" data-select-text="Press to select"
data-choice-selectable="">Public Bank</div>
<div id="choices--ff_1_bank_name-item-choice-31" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="31" data-value="RHB Bank" data-select-text="Press to select"
data-choice-selectable="">RHB Bank</div>
<div id="choices--ff_1_bank_name-item-choice-32" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="32" data-value="SME Bank" data-select-text="Press to select"
data-choice-selectable="">SME Bank</div>
<div id="choices--ff_1_bank_name-item-choice-33" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="33" data-value="Standard Chartered Bank"
data-select-text="Press to select" data-choice-selectable="">Standard Chartered Bank</div>
<div id="choices--ff_1_bank_name-item-choice-34" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="34" data-value="Sumitomo Mitsui Bank" data-select-text="Press to select"
data-choice-selectable="">Sumitomo Mitsui Bank</div>
<div id="choices--ff_1_bank_name-item-choice-35" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="35" data-value="The Bank of Nova Scotia"
data-select-text="Press to select" data-choice-selectable="">The Bank of Nova Scotia</div>
<div id="choices--ff_1_bank_name-item-choice-36" class="choices__item choices__item--choice choices__item--selectable" role="option" data-choice="" data-id="36" data-value="United Overseas Bank" data-select-text="Press to select"
data-choice-selectable="">United Overseas Bank</div>
</div>
</div>
</div>
</div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_bank_account_name" aria-label="Bank Account Name">Bank Account Name</label> </div>
<div class="ff-el-input--content"><input type="text" name="bank_account_name" class="ff-el-form-control" data-name="bank_account_name" id="ff_1_bank_account_name" aria-invalid="false" aria-required="true"></div>
</div>
<div class="ff-el-group">
<div class="ff-el-input--label ff-el-is-required asterisk-right"><label for="ff_1_bank_account" aria-label="Bank Account Number">Bank Account Number</label>
<div class="ff-el-tooltip" data-content="*Settlement only to bank account registered under personal/company’s name"><svg width="16" height="16" viewBox="0 0 25 25">
<path
d="m329 393l0-46c0-2-1-4-2-6-2-2-4-3-7-3l-27 0 0-146c0-3-1-5-3-7-2-1-4-2-7-2l-91 0c-3 0-5 1-7 2-1 2-2 4-2 7l0 46c0 2 1 5 2 6 2 2 4 3 7 3l27 0 0 91-27 0c-3 0-5 1-7 3-1 2-2 4-2 6l0 46c0 3 1 5 2 7 2 1 4 2 7 2l128 0c3 0 5-1 7-2 1-2 2-4 2-7z m-36-256l0-46c0-2-1-4-3-6-2-2-4-3-7-3l-54 0c-3 0-5 1-7 3-2 2-3 4-3 6l0 46c0 3 1 5 3 7 2 1 4 2 7 2l54 0c3 0 5-1 7-2 2-2 3-4 3-7z m182 119c0 40-9 77-29 110-20 34-46 60-80 80-33 20-70 29-110 29-40 0-77-9-110-29-34-20-60-46-80-80-20-33-29-70-29-110 0-40 9-77 29-110 20-34 46-60 80-80 33-20 70-29 110-29 40 0 77 9 110 29 34 20 60 46 80 80 20 33 29 70 29 110z"
transform="scale(0.046875 0.046875)"></path>
</svg></div>
</div>
<div class="ff-el-input--content"><input type="number" name="bank_account" id="ff_1_bank_account" class="ff-el-form-control" data-name="bank_account" inputmode="numeric" step="any" aria-invalid="false" aria-required="true"></div>
</div><input type="hidden" name="source" value="referral" data-name="source"><input type="hidden" name="plan" value="starter" data-name="plan"><input type="hidden" name="hidden" value="epp registered" data-name="hidden">
<div class="ff-step-t-container ff-inner_submit_container ff-column-container ff_columns_total_2">
<div class="ff-t-cell ff-t-column-1">
<div class="step-nav ff_step_nav_last"><button type="button" data-action="prev" class="ff-btn ff-btn-prev ff-btn-secondary">Previous</button></div>
</div>
<div class="ff-t-cell ff-t-column-2">
<div class="ff-el-group ff-text-center ff_submit_btn_wrapper"><button type="submit" class="ff-btn ff-btn-submit ff-btn-md ff_btn_style wpf_has_custom_css" style="display: none;">Submit Form</button></div>
</div>
</div>
</div>
</div>
</div>
</fieldset>
</form>Text Content
Skip to content * Home * EPP Via Payment Link * EPP Via QR Code * Supported Bank for EPP Apply Easy Payment Plan for your business * Home * EPP Via Payment Link * EPP Via QR Code * Supported Bank for EPP Apply Easy Payment Plan for your business Menu WE SUPPORT 11 LOCAL BANKS CREDIT CARD INSTALMENT PLAN Click here for bank rate APPLY EASY PAYMENT PLAN FOR YOUR BUSINESS INSTALMENT FROM 6 MONTHS TO 60 MONTHS! Payex Application Form Step 1 of 3 - 33% * * * BUSINESS INFORMATION Some information about your business -------------------------------------------------------------------------------- Type of Business Entity – Select Entity –Sole ProprietorshipGeneral/Limited Liability PartnershipPrivate Limited (Sdn Bhd)Association Business Name Business Registration No. Name of Company Director Director’s Mobile Phone No. Director’s NRIC/Passport No. Nature of Business – Select Nature of Business – – Select Nature of Business –Remove item – Select Nature of Business – Accounting, auditing, and bookkeeping services Advertising services Antique shops – sales, repairs, and restoration services Artists supply and craft shops Automobile rental agency Automotive body repair shops Automotive paint shops Automotive parts and accessories stores Automotive service shops (non-dealer) Automotive tire stores Bakeries Beauty and barber shops Bicycle shops – sales and service Boat rentals and leasing Book stores Books, periodicals, and newspapers Bus lines Business services (not elsewhere classified) Camera and photographic supply stores Candy, nut, and confectionery stores Car and truck dealers (new and used) sales, service, repairs, parts, and leasing Car washes Charitable and social service organizations Child care services Children’s and infant’s wear stores Chiropractors Cleaning, maintenance, and janitorial services Clothing rental – costumes, uniforms, and formal wear Colleges, universities, professional schools, and junior colleges Commercial photography, art, and graphics Computer maintenance, repair, and services (not elsewhere classified) Computer network / information services Computer programming, data processing, and integrated systems design services Computer software stores Computers and computer peripheral equipment and services Consumer credit reporting agencies Cosmetic stores Courier services Dairy products stores Direct marketing – insurance services Drug stores and pharmacies Drugs, drug proprietaries, and druggist sundries Electrical parts and equipment Electronics repair shops Electronics stores Employment agencies and temporary help services Equipment, tool, furniture, and appliance rental and leasing Family clothing stores Financial institutions merchandise and services Florist supplies, nursery stock, and flowers Florists Furniture, home furnishings, and equipment stores, excepting appliances General contractors – residential & commercial Gift, card, novelty and souvenir shops Glassware / crystal stores Hardware, equipment and supplies Health and beauty spas Hobby, toy, and game shops Hospitals Household appliance stores Insurance sales, underwriting & premiums Jewelry stores, watches, clocks, and silverware stores Laundry, cleaning, and garment services Legal services and attorneys Luggage and leather goods stores Management, consulting, and public relations services Marinas, marine service, and supplies Massage parlors Medical services and health practitioners (not elsewhere classified) Medical, dental, ophthalmic, and hospital equipment and supplies Membership clubs, country clubs, and private golf courses Men’s and boy’s clothing and accessories stores Men’s and women’s clothing stores Miscellaneous and specialty retail shops Miscellaneous apparel and accessory shops Miscellaneous food stores – convenience stores and specialty markets Miscellaneous general merchandise Miscellaneous home furnishing specialty stores Motor freight carriers and trucking Motor vehicle supplies and new parts Music stores – musical instruments, pianos, and sheet music Office and commercial furniture Opticians, optical goods, and eyeglasses Package stores – beer, wine, and liquor Parking lots and garages Pet shops, pet foods and supplies stores Photographic studios Photographic, photocopy, microfilm equipment and supplies Plumbing and heating equipment and supplies Precious stones, metals, watches, and jewelry Public golf courses Public warehousing and storage Real estate agents and managers – rentals Record stores Schools and educational services (not elsewhere classified) Shoe stores Sporting goods stores Sports and riding apparel stores Stationery stores, office and school supply stores Stationery, office supplies, printing, and writing paper Steamship and cruise lines Tax preparation service Taxicabs and limousines Telecommunication equipment and telephone sales Telecommunication service Tire retreading and repair shops Travel agencies and tour operators Truck and utility trailer rentals Utilities – electric, gas, water, sanitary Veterinary services Women’s accessory and specialty shops Women’s ready-to-wear stores Address Location City Postcode State – Select – – Select –Remove item – Select – Johor Kedah Kelantan Melaka Negeri Sembilan Pahang Perak Perlis Penang Selangor Terengganu Kuala Lumpur Putrajaya Sarawak Sabah Labuan Country CONTACT PERSON INFORMATION Contact person for the application -------------------------------------------------------------------------------- Name of Contact Person Mobile Phone No. NRIC/Passport No. Email Notification Email WEBSITE INFORMATION Some information about your business website -------------------------------------------------------------------------------- Website Terms & Conditions URL Privacy Policy URL Refund Policy URL Facebook Page Instagram Page Next REQUIRED DOCUMENTS Submit all required documents for the application. -------------------------------------------------------------------------------- Owner(s)/ Signatory’s IC (Front) Choose File Owner(s)/ Signatory’s IC (Back) Choose File Form D Choose File SSM Company Profile Choose File Certificate of Company (Superform Section 17 or Form 9) Choose File Latest Bank Statement Choose File Signboard/Premises/Booth/Stall/Vehicle, and overview of the place of business premises (Min 3) Choose File PreviousNext SETTLEMENT INFO & OTHERS Company Bank Information for payment settlement -------------------------------------------------------------------------------- Bank Name – Select Bank – – Select Bank –Remove item – Select Bank – Affin Bank Agrobank Al Rajhi Bank Alliance Bank Ambank Bangkok Bank Bank Islam Bank Kerjasama Rakyat Bank Muamalat Bank Of America Bank Of China Bank Pembangunan Malaysia Bank Simpanan Nasional BNP Paribas CIMB Bank Deutsche Bank EXIM Bank Hong Leong Bank HSBC Bank ICBC Bank India International Bank J.P. Morgan Chase Bank Kuwait Finance Bank Maybank MBSB Bank Mizuho Bank MUFG Bank OCBC Bank Public Bank RHB Bank SME Bank Standard Chartered Bank Sumitomo Mitsui Bank The Bank of Nova Scotia United Overseas Bank Bank Account Name Bank Account Number Previous Submit Form Need help? Talk to us EasyPaymentPlan.my Copyright © 2023 Disclaimer Notice: EasyPaymentPlan.my is an informational site about Easy Payment Plan / Instalment payment services, we are not the service provider. We partner up with Payex PLT (Licensed by Bank Negara Malaysia) providers in Malaysia which Payex PLT will contact the registrar and introduce their Easy Payment Plan / Instalment services. Hence we're act as a referral partner for all these major Easy Payment Plan / Instalment providers. Application terms & conditions or service agreements will vary and it is still back to the service provider to finalize it with respective applicant. 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