ATTACHMENT 1 for PAYMENT FORM TO FAH-AP TE

(for more than one item/entry)

Name of Supplier / Staff (as per I/C)

2 KHOO YEW BENG

Invoice Number

112

Supplier / Staff

Contact

Staff ID

Supplier / Staff

Email Address

Number

Number

Account Number

Currency Code

yewbeng.khoo@cimb.com

`03-56317934

8002602110

MYR

Invoice Date
Company

GL Code Block (compulsory)

24/2/2015

Branch

Payment to Non-Resident Supplier (for Services ONLY)

Bank Name & Branch

Responsibility Centre

CIMB BANK BERHAD

Account

Requested

Sub Account

Services Rendered in Malaysia

Optional 1

1
0
0
0
0
0
0B
9
Services Rendered Outside Malaysia

B.2 GST Information (Compulsory)

Type of Supplies
Primary Intended Use

Consumed in Malaysia?
(Compulsory for Foreign Vendor)
Product Fiscal Classification

Good or Services?
Product Type

Capital goods, non-capital goods, or nontaxable purchase?

Product Category

MX Mixed Supplies

Yes Consumed in Malaysia

Services

Non Taxable Purchases

B.4 Inter-Company Charge Out GL Accounts & Amount (Applicable if GL code block above is charged to GL 1720726 & GL 1720729)
GL Account

(Please fill up eg. 1111-0000-7051-5300056-0000)

Amount

(Please fill up eg. RM 200.00)

Name of Supplier / Staff (as per I/C)

3 KHOO YEW BENG

Invoice Number

Supplier / Staff

Contact

Staff ID

Supplier / Staff

Email Address

Number

Number

Account Number

Currency Code

yewbeng.khoo@cimb.com

`03-56317934

8002602110

MYR

Invoice Date
Company

GL Code Block (compulsory)

Branch

Payment to Non-Resident Supplier (for Services ONLY)

B.2 GST Information (Compulsory)

31/3/2015

Bank Name & Branch

Responsibility Centre

CIMB BANK BERHAD

Account

Services Rendered in Malaysia

Requested

Sub Account

Optional 1

1
0
0
0
0
0
0B
9
Services Rendered Outside Malaysia

Type of Supplies
Primary Intended Use

Consumed in Malaysia?
(Compulsory for Foreign Vendor)
Product Fiscal Classification

Good or Services?
Product Type

Capital goods, non-capital goods, or nontaxable purchase?

Product Category

MX Mixed Supplies

Yes Consumed in Malaysia

Services

Non Taxable Purchases

B.4 Inter-Company Charge Out GL Accounts & Amount (Applicable if GL code block above is charged to GL 1720726 & GL 1720729)
GL Account

(Please fill up eg. 1111-0000-7051-5300056-0000)

Amount

(Please fill up eg. RM 200.00)

Name of Supplier / Staff (as per I/C)

4 JMB EMPIRE SUBANG - TOWER

Invoice Number

10212

Supplier / Staff

Contact

Staff ID

Supplier / Staff

Email Address

Number

Number

Account Number

Currency Code

empire.soho.tower@gmail.com

`03-56317934

8002622380

MYR

Invoice Date

Company

GL Code Block (compulsory)

20/4/2015

Branch

Payment to Non-Resident Supplier (for Services ONLY)

Bank Name & Branch

Responsibility Centre

CIMB BANK BERHAD

Account

Requested

Services Rendered in Malaysia

Sub Account

Optional 1

2
0
0
0
0
0
1
9
Services Rendered Outside Malaysia

B.2 GST Information (Compulsory)

Type of Supplies
Primary Intended Use

Consumed in Malaysia?
(Compulsory for Foreign Vendor)
Product Fiscal Classification

Good or Services?
Product Type

Capital goods, non-capital goods, or nontaxable purchase?

Product Category

MX Mixed Supplies

Yes Consumed in Malaysia

Services

Non Taxable Purchases

B.4 Inter-Company Charge Out GL Accounts & Amount (Applicable if GL code block above is charged to GL 1720726 & GL 1720729)
GL Account

(Please fill up eg. 1111-0000-7051-5300056-0000)

Amount

(Please fill up eg. RM 200.00)

Name of Supplier / Staff (as per I/C)

Supplier / Staff

Contact

Staff ID

Supplier / Staff

Email Address

Number

Number

Account Number

5
Invoice Number

Invoice Date

Bank Name & Branch

Requested
Currency Code

Company

Branch

Responsibility Centre

Account

Sub Account

Optional 1

GL Code Block (compulsory)

Payment to Non-Resident Supplier (for Services ONLY)

9
Services Rendered Outside Malaysia

Services Rendered in Malaysia

B.2 GST Information (Compulsory)

Type of Supplies
Primary Intended Use

Consumed in Malaysia?
(Compulsory for Foreign Vendor)
Product Fiscal Classification

Good or Services?
Product Type

Capital goods, non-capital goods, or nontaxable purchase?

Product Category

Please Select

Please Select

Please Select

Please Select

B.4 Inter-Company Charge Out GL Accounts & Amount (Applicable if GL code block above is charged to GL 1720726 & GL 1720729)
GL Account
Amount

(Please fill up eg. 1111-0000-7051-5300056-0000)

(Please fill up eg. RM 200.00)

MENT FORM TO FAH-AP TEAM

han one item/entry)

Requested Amount

Additional Information

Currency Code

Amount

MYR

120

Project Code

Vehicle Number

Travelling Date From

Travelling Date To

Tax Code

0 Payment Description REIMBURSEMENT OF PARKING FOR MARCH 2015

B.3 Additional Information (where applicable)

Capital goods, non-capital goods, or nontaxable purchase?
Product Category

R/D Indicator
(Compulsory if charge to Customer)

AR Customer Number

Non Taxable Purchases

R - Reimbursement (Invoice not billed to AR Client)

29)

Requested Amount

Additional Information

Currency Code

Amount

MYR

120

Project Code

Vehicle Number

Travelling Date From

Travelling Date To

Tax Code

Payment Description REIMBURSEMENT OF PARKING FOR APRIL 2015

B.3 Additional Information (where applicable)

Capital goods, non-capital goods, or nontaxable purchase?

Product Category

R/D Indicator
(Compulsory if charge to Customer)

AR Customer Number

Non Taxable Purchases

R - Reimbursement (Invoice not billed to AR Client)

29)

Requested Amount

Additional Information

Currency Code

Amount

MYR

36

Project Code

Vehicle Number

Travelling Date From

Travelling Date To

Tax Code

Payment Description WATER CHARGES FOR MARCH 2015 FOR UNIT A07-01)

B.3 Additional Information (where applicable)

Capital goods, non-capital goods, or nontaxable purchase?
Product Category

R/D Indicator
(Compulsory if charge to Customer)

AR Customer Number

Non Taxable Purchases

R - Reimbursement (Invoice not billed to AR Client)

29)

Requested Amount
Currency Code

Amount

Additional Information
Project Code

Vehicle Number

Travelling Date From

Travelling Date To

Tax Code

Payment Description

B.3 Additional Information (where applicable)

Capital goods, non-capital goods, or nontaxable purchase?
Product Category

29)

AR Customer Number

R/D Indicator
(Compulsory if charge to Customer)
R - Reimbursement (Invoice not billed to AR Client)

Please Select

PURPOSE: Request for new invoice payment

Payment Form and invoices send to:
RFAH AP,
Level 27, Menara Bumiputra Commerce,
11 Jalan Raja Laut,
50350 Kuala Lumpur.

INSTRUCTIONS FOR COMPLETION OF PAYMENT FORM

Please use Attachment 1 for more than one item/entry.
Please use cost allocation template if you wish to allocate costs from the same vendor to different Business Units / Branches.
Please enclose a duly completed Declaration Form for Staff Advance request.
Please ensure the Vendor's Business Registration Number(Non-Individual) /IC Number (Individual) and Email Address are provided in
the Supplier Maintenance Form for new creation and maintenance of vendor details.

Column

Details/Example

1 Operating Unit

For Payment to Supplier: Requestor to tick on the box for appropriate category of which entity the
Branch/Division belongs to

2 Invoice Information
(a) Name of Supplier/Staff (as per IC)

Requestor to tick for appropriate category:

Supplier's name who provides the products and services to the requestor
Staff's name who requests for the claims or advances

(b) Supplier / Staff Email Address

Supplier / Staff Email Address

(c) Contact Number

Supplier's / Staff's contact number

(d) Supplier / Staff Account Number

Supplier / Staff Bank Account number for the payment to be credited to

(e) Bank Name & Branch

Supplier / Staff Bank Name & Branch for the payment to be credited to

(f) Staff ID Number

Staff ID number

(g) Requested Amount

Amount needs to pay for suppliers, staff claims or staff advances

(i) Currency code - Select from the drop box for Currency code for the amount requested
(ii) Total amount - Total payment/claims/advances made to supplier or staff

(h) Invoice Number

Invoice number
e.g. Inv 5678

(i) Invoice Date

Issuing date of the invoice

e.g. 27-06-09

(j) Payment Description

Description for the payment

e.g. Purchase of Stationery

(k) Payment to Non-Resident Supplier To select on Services Rendered in Malaysia or Services Rendered Outside Malaysia. Services Rendered
(for Services ONLY)
in Malaysia means the non-resident supplier has to be physically present in Malaysia to provide the
service.
(l) Justification for Cheque Request

Justification is required for all cheque request i.e Payment for Company Income Tax Installment

(m) Pay Alone

Click on the Pay Alone Box if you have more than 1 invoice from the same supplier and you want to pay
the supplier using one cheque.
Instruction to collect cheque by Business Units from RFAH. Only Business Units are allowed to collect
cheques from RFAH. No external party eg no vendor will be allowed to collect directly from RFAH

(n) Collect

3 Accounting Information

(a) GL Code Block (compulsory) Please refer to the Chart of Account in C.I.M.B Net under Workguide
Page,
Forms,Code
Regional
Financiallegal
Accounting
Section,
Chart ofaccounting
Accout, COA
1
(i)
Company
representing
entities,Hub
as well
as separate
entities
within company (funds, Islamic windows, overseas branches)
(ii) Branch Code used for branches & selected HO monoline
(iii) RC Code used for Profit & Cost Centre
(iv) GL Code identifies each type of asset, liability, shareholder equity, income and expense
(v) Sub Account is dependent segment to Account to allow detailed analysis
(vi) Optional 1 provide flexibility for company to obtain further analysis as required
(d) Additional Information (where applicable)
(i) Customer Number : to be fill in for expenses chargable to client
(ii) Vehicle Number : Vehicle Plate Number
e.g. BKJ 9668
(iii) Travelling Date From - Starting date of travelling in DD-MM-YY format
e.g. 01-07-09
(iv) Travelling Date To - Ending date of travelling in DD-MM-YY format
e.g. 10-07-09

4 Type of Expenditure (as per Delegated

Authority)
For requestor to tick on Budgeted or Non-Budgeted, Recurring or Non-Recurring for the following category:
(i) Capex (IT)
(ii) Capex (other than IT Capex)
(iii) Non Capex Mandatory
(iv) Non Capex Non Mandatory

5 Expenditure Details
(a) Approved Budget for the Year
(b) Utilised To Date

This section is applicable for Supplier Payment under Budgeted Expenditure

Budget approved for the year
Total amount utilised up-to-date

(in MYR)

(c) Utilised/Payment Amount

Utilised/usage that need to pay to supplier in Ringgit Malaysia

(in MYR)

(d) Balance Carried Forward

Balance available after deduction of utilisation from approved budget for the year in Ringgit Malaysia

(in MYR)

6 Prepared by
- Signature
- Name Stamp

Signature of Requestor
Requestor official Name Stamp

7 Reviewed /Recommended by
- Signature
- Name Stamp

The completed form must be verified by Officer/Supervisor

Signature of Officer/Supervisor
The Officer/Supervisor official Name Stamp

8 Approved by as per DA
- Signature
- Name Stamp

The completed form must be approved by HOD or as per DA

Signature of HOD / as per DA
The HOD / as per DA official Name Stamp

PAYMENT FORM TO FAH-AP TEAM

ORIGINATING BRANCH / DIVISION :

CONTACT PERSON

RETAIL EQUITIES / BRANCH BROKING

: SIVANESVARY SELVARAJAH

DATE : 28/5/2015

EMAIL: sivanesvary.selvarajah@cimb.com

CONTACT NUMBER : 03-56317934

OPERATING UNIT: (please tick one of the following categories)

CIMB Bank [1811]

CIMB Islamic [1871]

iCIMB (M) [1977]

iCIMB (MSC) [0011]

CAPS AP Reference
(via CAPS only)

CIMB Investment [1111]

CIMB Investment Islamic [1121]

Others (pls specify)

A. INVOICE INFORMATION:
Name of Supplier / Staff (as per I/C)

KAM SEE SONG

Staff ID Number

BIV

Supplier / Staff Email Address

seesong.kam@cimb.com

Contact Number

03-56317934

Supplier / Staff Account No. (Compulsory)

Bank & Branch Name

Click here for List of Banks & Account Length

MAYBANK BERHAD

Requested Amount

Currency Code

Total Amount

Payment Description

REIMBURSEMENT OF NEWSPAPER FOR MARCH & APRIL 2015

MYR

56.8

Payment to Non-Resident Supplier (for Services ONLY)

Invoice Number

7084

Invoice Date

30/4/2015

Services Rendered in Malaysia

Paygroup

Travelling Date From

Services Rendered Outside Malaysia

DD-MM-YY

Travelling Date To

DD-MM-YY

B. ACCOUNTING & GST INFORMATION:

B.1 GL Code Block (Compulsory)
Company
1

Tax Code

Branch
1

Responsibility Centre
0

Account

Sub Account
2

Optional 1
0

(compulsory)
V

B.2 GST Information (Compulsory)

Primary Intended Use

Consumed in Malaysia?
(Compulsory for Foreign Vendor)

SR Standard Rated Supplies

Type of Supplies

Product Type

Capital goods, non-capital goods, or nontaxable purchase?

Yes Consumed in Malaysia

Services

Non Taxable Purchases

Vehicle Number

AR Customer Number

R/D Indicator
(Compulsory if charge to Customer)

Good or Services?

Product Fiscal Classification

Product Category

B.3 Additional Information (where applicable)

Project Code

Please Select

B.4 Inter-Company Charge Out GL Accounts & Amount (Applicable if GL code block above is charged to GL 1720726 & GL
1720729)
GL Account

(Please fill up eg. 1111-0000-7051-5300056-0000)

Amount

(Please fill up eg. RM 200.00)

Mandatory Information required for Credit

Note
Original Invoice Number
Original Invoice Date
Original Invoice Amount

C. FIXED ASSET INFORMATION: (use attachment if required)

Depreciation RC

Location

Prepared by

Asset Key (Project Code)

Add-On (Asset No.) if any

Reviewed / Recommended by

Approved by (as per DA)

MICHAEL CHERN

PAUL GUI

SIVANESVARY

FOR GROUP TAX USE ONLY

For Non-GST registered entity

With Holding Tax Verification

Deduct

Borne

No WHT

IMS

Yes

Gross Amount

Pay to IRB

IMS Amount

WHT %

Pay to Vendor

Accounting entry

Remarks

Verified By:

Not Applicable

Name:
Date:

Remarks

FOR FAH-AP USE ONLY

Payment on Hold:

Yes

Data Entry

No

1st Authoriser

2nd Authoriser

Reason
Held By
Date
Released By

Name:

Name:

Name:

Date

Date:

Date:

Date:

BANK NAME
Affin Bank Berhad
Agro Bank
Alliance Bank Malaysia Berhad
AmBank (M) Berhad
Bank Kerjasama Rakyat Malaysia Berhad
CIMB Bank Berhad
EON Bank Berhad
Malayan Banking Berhad (Maybank)
Public Bank Berhad
RHB Bank Ber
HSBC
CITIBANK
JP MORGAN
Bank Islam
Bank Muamalat
Bank of America
BSN
Deutsche Bank
Hong Leong Bank
OCBC
Standard Chartered Bank
Sumitomo Mitsui Banking Corp
Royal Banking of Scotland (RBS)
Kuwait Finance House
UOB
Bank of Tokyo-Mitsubishi
Al Rajhi

Account Length
12
16
15
13
12
14
13
12
10
14
12
10
10
14
14
12
16
10
11
10
12
8
7-10
12
11
XX
XX

ATTACHMENT 1 for PAYMENT FORM TO FAH-AP TEAM

(for more than one item/entry)
Name of Supplier / Staff (as per I/C)

Supplier / Staff

Contact

Staff ID

Supplier / Staff

Email Address

Number

Number

Account Number

Requested Amount
Currency Code

Additional Information

Amount

Project Code

Vehicle Number

Travelling Date From

Travelling Date To

2
Invoice Number

Invoice Date
Company

Branch

Bank Name & Branch

Responsibility Centre

Account

Sub Account

Optional 1

Tax Code

Payment Description

GL Code Block (compulsory)

Payment to Non-Resident Supplier (for Services ONLY)

Services Rendered in Malaysia

9
Services Rendered Outside Malaysia

B.2 GST Information (Compulsory)

B.3 Additional Information (where applicable)

Type of Supplies
Primary Intended Use

Consumed in Malaysia?
(Compulsory for Foreign Vendor)
Product Fiscal Classification

Good or Services?
Product Type

Capital goods, non-capital goods, or nontaxable purchase?

Product Category

Please Select

Please Select

Please Select

Please Select

AR Customer Number

R/D Indicator
(Compulsory if charge to Customer)
R - Reimbursement (Invoice not billed to AR Client)

ATTACHMENT 1- Multiple Invoices

Page 14

Organization Name

Originating Dept Code

Invoice Type

Vendor Name

Invoice Number
Invoice Header

Invoice Date
(DD-MM-YYYY)
Invoice Header

DR Amount

CR Amount

Invoice Currency

Description

Line Number

Distribution DR
Amount

Distribution CR Amount

Invoice Line Description

Company

Branch Number
Invoice Distribution

istribution

Responsibility Center

GL Code

Sub GL Code

Option 1

Option 2

Option 3

Tax Code

Staff No/Staff Name

Customer Number
Charge Back & Reporting Purpose

Client Number

arge Back & Reporting Purpose

Vehicle Number

Organization Name

Originating Dept Code

Invoice Type

CBB OU MYR

7101

STANDARD

CBB OU MYR

7101

STANDARD

Vendor Name
AIRPLUS TRAVEL SERVICES SDN BHD
AIRPLUS TRAVEL SERVICES SDN BHD

Invoice Number
Invoice Header
7587699
7587698

Invoice Date
(DD-MM-YYYY)

DR Amount

CR Amount

Invoice Currency

Invoice Header
6-Jul-09

5600

MYR

6-Jul-09

500

MYR

Description
BP TESTING
BP TESTING

Line Number
1
2
1
2
3

Distribution DR
Amount

Distribution CR Amount
5000.00
600.00
300.00
100.00
100.00

Invoice Line Description

BP TESTING
BP TESTING
BP TESTING
BP TESTING
BP TESTING

Company

Branch Number

Invoice Distribution
1811 0000
1811 0000
1811 0000
1811 0000
1811 0000

Responsibility Center

GL Code

Sub GL Code

Option 1

Option 2

istribution
7101
0123
0124
0125
0126

5210152
5210152
5210152
5210152
5210152

0000
0000
0000
0001
0002

00000
00000
00000

0000
0000
0000

Option 3

Tax Code

Staff No/Staff Name

Customer Number
Charge Back & Reporting Purpose

000
000
000

3000 Rosmaiza
3000
3000
3000
3000

Client Number

arge Back & Reporting Purpose

7UUU

Vehicle Number
HTY3456