Reflex Cash Management Application Form Borang

Reflex Cash Management Application Form
Borang Permohonan Perkhidmatan Pengurusan Tunai Reflex
REGISTRATION CENTRE
Please forward complete Application Form together with other documents in the Checklist below to the following address
Officer in Charge
Cash & Payment Operations
Systems & Operations Division
RHB Bank Berhad
Level 3, Tower 3
Jalan Tun Razak
50400 Kuala Lumpur.
CHECKLIST BEFORE SUBMISSION TO BANK:
1.
Complete Application Form
(
)
2.
Photocopy of I/C of your appointed System Administrators (SysAdmin1 and SysAdmin2)
(
)
3.
Board Resolution from Principal account (for Premium Package and / or Financial Supply Chain Management)
(
)
4.
Board Resolution of Subsidiary Companies (if you wish to link additional accounts)
(
)
5.
Form 49
(
)
FOR BANK USE ONLY
Staff ID 1
Code
Sales Code
Campaign Code
Please tick (√) where applicable:
BANK@WORK
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9
Staff ID 2
GUIDE TO COMPLETE REFLEX APPLICATION FORM
Reflex Cash Management Packages
There are 2 available packages as follows:
1. Basic Package – for account inquiry only.
2. Premium Package – for account inquiry plus financial transaction (e.g. Fund transfer, payment via RENTAS, IBG, Remittances, Payroll with
contributions to statutory bodies (EPF, SOCSO, LHDN), etc.) This option requires the submission of Board Resolution. The Board Resolution
must follow the Bank’s standard format downloadable from the Bank’s website (www.rhb.com.my).
3. Financial Supply Chain Management – for Financial Supply Chain transaction (e.g. Upload Invoice, accept Invoice, upload Debit Note, upload
Credit Note, Invoice payment, Request for Financing etc.)
Part A – Principal Applicant
Complete this section with company details. All fields are mandatory and must be completed.
1. Name of Company – Fill in your company / association / club / society name.
2. Registration Number – Fill in with company / association / club / society registration number.
3. Tax No - Fill in your company Tax number with LHDN.
4. EFP No – Fill in the Employer number registered with EPF.
5. SOCSO No – Fill in the company SOCSO number.
6. Address – Fill in your company address (P.O. Box address is not allowed).
7. Postcode – Fill in postcode.
8. Telephone Number – Fill in your company contact number.
9. Fax Number - Fill in your company fax number.
10. E-mail Address - Fill in your company email address is mandatory.
11. Principal Account Number – Fill in the company account number which is consider the main account.
12. Branch – Fill the RHB branch where the account is opened.
13. Type of account – select “Conventional” if it is normal account, “Islamic” if it is an Islamic account.
Part B – Linking of additional accounts
This section allows you to link all accounts and facilities you have with the bank. You may include loan account, multi-currency account as long as they
belong to your company.
1. Would you like to link additional accounts? – Select “Yes” if you choose to, otherwise select “No”.
2. Fill in the account details with the account number and the account name if you choose to link.
Part C – Linking of Subsidiary Accounts
This section allows company to link their subsidiary accounts. Board Resolution from the subsidiary is required to allow the linking. Kindly follow the Bank’s
standard format downloadable from the Bank’s website (www.rhb.com.my).
1. Account Number – specify the account numbers to link.
2. Account Name – specify the name of accounts to be linked.
Part D – Appointed SysAdmin1 and SysAdmin2
Company must appoint 2 persons as System Administrators. SysAdmin1 is responsible to perform setup e.g. creation of user and user profile. SysAdmin2’s
role is to approve the creation and amendment done by SysAdmin1. If the SysAdmin1 and SysAdmin2 roles are hold by the same person, kindly fill in the
both Part C (a) and Part C (b). This section capture the system administrators details
1. Salutation – Select Mr, Mrs, Miss or Ms accordingly.
2. Name – Fill in the person name appointed to the role.
3. Telephone No – Fill in the contact number of the appointed person.
4. NRIC No – Fill in the identification card number of the appointed person.
5. Email Address – Fill in the email address of the appointed person.
6. Signature – signature of the appointed person.
Part E – Number of End-Users
Specify the number of users required for each role for your company to operate Reflex Cash Management for Basic Package, Premium Package &
Financial Supply Chain Management.
1. Number of user(s) required for Data Entry.
2. Number of user(s) required for Reviewer – this is optional.
3. Number of user(s) required for Authorizer.
4. Authorizer details are mandatory for Premium Package & Financial Supply Chain Management. Kindly fill in the personal details of the appointed authorizer as
follows:
a. Name – Name of the appointed authorizer.
b. NRIC – Identity card of the appointed authorizer.
c. Email Address – Email address of the appointed authorizer(s).
d. Reflex User ID – specify the preferred user ID.
5. For Basic Package, Premium Package & Financial Supply Chain Management the 2 tokens for SysAdmin1 and SysAdmin2 are provided for free.
For end users (Data Entry, Reviewer, and Authorizer), for every token requested, RM50.00 will be charged per token. Amount will be debited from
registered Account.
Part F – Declaration by Principal Account
Kindly read and understand before signing. To be signed by the person(s) authorized for operation of current account or the authorized person as per your
Board Resolution (for Premium Package & Financial Supply Chain Management).
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Please mark the box(s) below with  which Reflex Cash Management Services you intend to obtain
Account Management Service only (Basic Package)
Account Management and Transactional Services (Premium Package)
(Must submit this form together with Board Resolution)
Financial Supply Chain Management
(Must submit this form together with Board Resolution)
Do you have the following facilities with us? Please indicate below.
Trade facility
Credit Card Merchant
Your merchant number
Yes
Yes
(If you answered Yes above)
No
No
Part A - Principal Applicant
About Your Company/ Association/ Club / Society /Partnership
*Name of Company / Association / Club / Society:
*Registration Number:
Tax No:
EPF No:
SOCSO No:
*Address:
*Postcode:
*Contact person1
*Contact Person 2
*Telephone Number 1 :
Fax Number 1:
*E-mail Address 1:
Telephone Number 2:
Fax Number 2:
E-mail Address 2:
*Principal Account Number:
Branch:
*Type of account:
Conventional
 Islamic 
* Compulsory to fill in.
For Bank Use Only
Account Number :
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CIF Number :
Authorised Signatory(ies) :
Part B - Reflex Cash Management Services allows linking of additional accounts should you have more than one account with the
Bank (belonging to the principal applicant).
1.
Would you like to link additional accounts? (YES / NO)
2.
If yes, please fill in the account numbers below.
(Please state the account number in a separate letter if the space is insufficient)
1. Account Number
Account Name
2. Account Number
Account Name
3. Account Number:
Account Name
4. Account Number
Account Name
Part C –Linking of Subsidiary / Related Accounts
Reflex Cash Management Services allows you to link your subsidiary/related accounts under the Principal Applicant
1.
Would you like to link your account with your subsidiary accounts? (YES / NO)
2.
If yes, please fill in the account numbers below together with the Board Resolutions from the subsidiary companies allowing the Principal Applicant to
view their accounts (as per attached sample).
(Please state the account number in a separate letter if the space is insufficient)
1. Account Number
Account Name
2. Account Number
Account Name
3. Account Number
Account Name
4. Account Number
Account Name
5. Account Number
Account Name
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Part D - Appointed SysAdmin1 (or System Administrator) and SysAdmin2 (or System Authorizer) Details are mandatory.
I/We appoint the persons named below to receive and acknowledge the Token and PIN Mailer as the SysAdmin1 or SysAdmin2 to operate
the Reflex Cash Management Services on behalf of the Company/ Association/ Club/ Society/Partnership. Such persons shall be fully
responsible for the use of the said Token and PIN Mailer.
a.
SysAdmin1 / System Administrator (please submit photocopy of IC)
Salutation
Mr. 
Name
Mrs. 
Miss 
NRIC No.
b.
Telephone No.
Ms. 

SysAdmin1 / System Administrator 's Signature
Email Address
SysAdmin2 / System Authorizer (please submit photocopy of IC/Passport)
Salutation
Mr. 
Name
Mrs. 
Miss 
Telephone No.
Ms. 

NRIC No.
SysAdmin2 / System Authorizer's Signature
Email Address
Part E – Number of End-Users
User
Basic Package
Data Entry
Person appointed to
input the data via
Reflex.
Reviewer
Appointed staff to
review information
inserted by Data
Entry.
a.
** Minimum 1 unit required.
b.
Additional required? Quantity ___
Authorizer
Person appointed by
company to authorize
transactions made via
Reflex.
Training (for
Premium Package)
Training by our
Solution Specialist on
how to easily utilize
Reflex. It is highly
recommended for you
to apply.
Not Applicable
Not Applicable
Premium Package
a.
Financial Supply Chain Management
** Minimum 1 unit required.
a.
** Minimum 1 unit required.
Additional required? Quantity
Additional required? Quantity
a.
Optional. Do you require?
**Yes
No
a.
Optional. Do you require?
**Yes
No
b.
Additional required? Quantity
b.
Additional required? Quantity
1.
**Minimum 1
1.
**Minimum 1
2.
Additional required? Quantity
2.
Additional required? Quantity
____
We would like to have / Kami memerlukan:
*** On-site training at your office (Chargeable). Please state location:
 Classroom training at any RHB branch (Free of charge). Please state location:
No training required.
** RM50.00 will be charged per token and will be debited from registered account.
*** RM150.00 will be levied every time a training session is conducted at your site. It will be debited from your account after
training is completed.
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Part F - Declaration by Principal Applicant
1.
I/We hereby apply for the service of Reflex Cash Management provided by RHB Bank Berhad.
2.
I/We hereby authorize the Bank to debit the principal account with the service charges set forth below:
a.
b.
c.
d.
Subscription service charge
Service charge
Token charge
Training charge
Notes on the service charges

The subscription and service charges above shall be debited from your account upon issuance of your Corporate ID/Organization ID.

The service fee shall be debited from your account up on processing of your payment files. It is charged based on per transaction basis.

The subscription fee is charged based on the number of applicant / company’s account to be used for the service.

The training charge is levied every time a training session is conducted at your site. It will be debited fro m your account after training is completed.

The subscription, service, token, and training charges above are non-refundable.

Token charge is applicable for replacement of lost or damaged tokens.

Effective 1st Apr 2015 all fees/charges incurred will be subjected to 6% GST (where applicable).
3.
For more details on the terms and conditions and service charges applicable (as defined in the Form for Selection of Reflex Cash Management), please visit
www.rhb.com.my . At your request, the Bank may provide you with information on the service charges applicable to the Transactional Services (as defined in the Form for
Selection of Reflex Cash Management).
4.
I/We shall be deemed to have read, understood and accept the Terms and Conditions that govern the use of Reflex Cash Management before submitting this application.
The Terms and Conditions are made available at www.r hb.com.my.
5.
Upon receipt of our application for the Services (either the Account Management Services (known as Basic Package) or a combination of Account Management and
Transactional services (known as Premium Package and other services) as stated in Page 1 of this application form), I/we accept and acknowledge that the Bank may in
its absolute discretion accept or reject the application. If the Bank accepts the application, the Bank will give written notice of its acceptance and permit us to commence
access and/or use of the Services.
6.
I/We note that the Terms and Conditions and this Form submitted to the Bank shall govern our access and/or use of the services. Any other forms and/or the Application
Form previously submitted by us to the Bank shall be deemed to apply to both the existing services obtained by us and the additional services applied for hereunder.
7.
I/We hereby confirm that I/We are authorized to act for and on behalf of the Company/Association/Club/Society/Partnership to apply for the Reflex Cash Management
provided by the Bank.
8.
I/We hereby confirm that all information provided is true and accurate to the best of my/our knowledge as at the date of this application.
9.
I/We hereby confirm that I/We have read, understood and agreed to the terms and conditions of the Reflex Cash Management, this Application Form and the Terms and
Conditions made available on www.rhb.com.my and agree irrevocably and unconditionally to be bound by such terms and conditions.
* FOR REFLEX CASH MANAGEMENT APPLICATION
** FOR TRADE SERVICES IF APPLICABLE
_
Authorized Signatory (ies) * and Company Stamp (Chop) /
Date
Name
:
_
_
Designation :
_
NRIC No :
_
_
_
_
_
_
Authorized Signatory (ies) ** and Company Stamp (Chop) /
Date
Name
:
_
_
Designation :
_
_
NRIC No :
_
_
_
__
__
__
*Authorized Person(s) signature as per Board Resolution (or such other document acceptable to the Bank) for operation of current accounts for banking transactions.
**Authorized Person(s) signature as per Board Resolution (or such other document acceptable to the Bank) for operation of existing trade facilities/services as furnished to the
Bank, if different from * above.
For Bank Use Only
Reflex Registration Centre
Corporate ID:
Signature and
other
particulars
verified
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Officers’
signature &
name stamp
(Chop)
Corporate
Commercial
Trade
Credit Card
Merchant
Financial
Supply Chain
Verified by:
Approved by:
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