BDM/R039 (R10-11/01/2018) 股份偿还基金申请表格 APPLICATION FOR REDEMPTION OF SHARES 者之个人资料 FOR OFFICE USED ONLY 申请者之个人资料供本社填写 PERSONAL INFORMATION A. APPLICANT'

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1 BDM/R039 (R10-11/01/2018) 股份偿还基金申请表格 APPLICATION FOR REDEMPTION OF SHARES 者之个人资料 FOR OFFICE USED ONLY 申请者之个人资料供本社填写 PERSONAL INFORMATION A. APPLICANT'S PERSONAL INFORMATION 申请者之申请者之个人资料 Name as appeared in Identity Card 英文姓名 ( 与身份证相同 ) Name In Chinese 中文姓名 Application No. R F Membership No. 社员号码 NRIC No. 身份证号码 R F (New 新 ) Previous SRF No. Age 年龄 (Old 旧 ) Tick " " if checked : - Tel. No. 电话号码 - (H) Name - (H/P) I/C No. Address 住址 Age Address No. of shares Document(s) COA B. PARTICULARS OF DECEASED MEMBER ( IN CASE THE APPLICATION IS MADE BY THE NOMINEE / NEXT OF KIN) 逝世社员详情 ( 若申请由继承人 / 亲属提呈 ) Name as appeared in Identity Card 英文名字 ( 与身份证相同 ) Name In Chinese 中文姓名 LR NO : LR NO : Membership No. 社员号码 NRIC No. 身份证号码 - - (New 新 ) (Old 旧 ) 与申请者之关系 Relationship With Applicant : Checked by : C. REASONS FOR REDEMPTION 申请股份偿还原因申请股份偿还原因 Please tick " " in the box against applicable circumstances 请在下列适当方格划 " " (1) Urgent financial need 经济拮据... (2) Attainment of age 70 years or above with membership duration of more than 10 years 年龄达到 70 岁或以上而社龄超过 10 年... Remarks : (3) Permanent disablement / prolonged illness with total loss of earning power 终身残废 / 长久疾病而完全失去工作能力... (4) Death of member 社员逝世... (5) Other reason(s) 其他原因 :... D. DECLARATION 声明事项 I hereby declare that 声明事项兹声明 1. I wish to redeem ALL my shares (inclusive of membership shares) 本人欲申请偿还全部合作社股份 ( 包括社员股金 ) 2. I have fully understood and will abide by the By-Laws of Koperasi Jayadiri Malaysia Berhad (KOJADI) and the Rules of KOJADI Share Redemption Fund 本人已充分了解, 并将遵守自立合作社之章程及自立合作社股份偿还基金细则 Date Received: 3. All the information given in this application are true and correct and the documents submitted are true copies. 所有在此申请表格填写之资料及所有呈交之文件乃完整且正确无讹 Date Received : 4. I understand that the Board of KOJADI has the absolute discretion to approve or reject my application and I shall accept the Board's decision as final. 本人了解自立合作社董事会有绝对的权力批准或拒绝本人的申请, 同时也接受董事会对本人的申请所作之决定乃属最终者 5. KOJADI will not be held responsible for any loss or delay in mail pertaining to my application. 自立合作社将无须对本人之申请书因邮失或邮误负责 Applicant's Signature 申请者签名 Date 日期 Nyc\chung\exceldata\mem\forms\SRF 请阅读背页之申请注意事项 Please Turn Over To The Next Page For Other Information

2 E. ATTENTION 注意事项 1. All parts of this form must be completed in block letters 此申请表格必须以正楷清晰填写 2. Kindly attach with this application a photostat copy of the Applicant's identity card (both sides). 请申请者在此表格符夹身份证双面影印本 3. Under Item C - 'Circumtances For Redemption' : - 在 C 项 [ 申请股份偿还原因 ] 一栏 : - (a) If the applicant has ticked " " in box (1), a photostat copies of evidence of circumstances justifying the urgent financial need. 若申请者在方格 (1) 划, 则需附夹有关文件副本 (b) If the applicant has ticked " " in box (3), a photostat copy of report by a medical practitioner confirming the permanent disablement or prolonged illness and total loss of earning power. 若申请者在方格 (3) 划, 则需附夹有关终身残废 / 长久疾病而完全失去工作能力之医药报告书副本 (c) If the applicant has ticked " " in box (4), a photostat copy of the deceased member's certified death certificate ( may be certified by Member of Parliament / State Assembly, Doctor, Justice of Peace, Penghulu, Police Officer, Advocate & Solicitor, Commissioner for Oath, KOJADI's Manager or any other person acceptable to the Board). 若申请者在方格 (4) 划, 则需附夹经签证的经签证的逝世社员死亡证书副本 ( 可由国州议员医生太平局绅村长警长律师宣誓官自立合作社经理或董事会接受之其他人士签证 ) 4. The applicant may be required by the Board from time to time to furnish other information. 申请者也需提呈董事会随时需要之其他资料文件 5. The application form duly completed together with the necessary documents shall be submitted or posted to :- 填妥之申请表格及所需文件, 提呈或寄至本社办事处 : - KOPERASI JAYADIRI MALAYSIA BERHAD (KOJADI) 11th Floor Wisma MCA 163 Jalan Ampang Kuala Lumpur Tel : Fax : Homepage : contact@kojadi.com.my / member@kojadi.com.my F. REQUEST FOR CHANGE OF ADDRESS 更换地址申请 I wish to change my address as follows : - 本人欲更换地址如下 : ( 请以国文或英文填写 ) Address 住址电话 Tel: - (H) - (O) - (H/P) 电邮传真 Fax : Nyc\chung\exceldata\srf\2004\form\form1 pg.1

3 自立合作社股份偿还基金问答录 1. 问 : 何谓股份偿还基金? 设立此基金有何目的和用途? 答 : 股份偿还基金是董事会于 1992 年根据章程设立的基金此基金来源是取自合作社的盈余 ; 基金拨款必须由董事会建议及获得代表大会的批准设立此基金的目的是作为社员股份偿还用途, 让有意退股的社员有机会取回股金 2. 问 : 社员如何申请股份偿还基金? 答 : 社员须根据董事会制定之申请表格提出申请, 申请表格可向本社办事处, 即 11th Floor, Wisma MCA, Jalan Ampang, Kuala Lumpur 或本社当地董事代表和联委会委员索取本社也接受影印表格, 惟此表格须以打字或亲笔填写 3. 问 : 社员填写申请股份偿还基金表格时, 有什么事项须特别留意? 答 : 社员在填写申请表格时, 必须特别留意表格中 E 项, 尤其是有关指定的附夹证实文件 4. 问 : 董事会是否有制定任何细则, 以管制股份偿还基金的实行? 答 : 有, 董事会已制订股份偿还基金细则以管制有关基金的实行, 有关基金细则附夹於申请表格, 申请社员在填写表格时请详读有关细则 5. 问 : 董事会应用什么方式进行评估及审核社员的申请? 答 : 为了顺畅公平和系统化的实行有关基金, 董事会将采取积分方式进行评估及审核所有的申请书董事会将根据申请者的年龄社龄或其他相关的情况和退股理由打分所有符合规定分数者将会获准退股一般上, 下列情况的社员都会获得优先考虑和获准退股 a) 社员逝世 ( 由继承人或法定代表提出申请 ) ; b) 社员年龄达到 70 岁或以上, 而社龄超过 10 年 ; c) 社员永久残废或久病缠身而失去工作能力 ; d) 经过审核后由董事会全权决定急需经济援助之社员 6. 问 : 申请书提呈后, 是否表示一定获得批准? 答 : 这要视申请书及基金拨款之多寡而决定如果该年拨出的基金不足应付所有的申请, 则董事会将以上述积分方式审核遴选符合条件的申请书不获批准的申请将会自动纳入下一轮的退股名单以再次进行遴选 7. 问 : 股份偿还基金的偿还偿还数额是否有限制? 答 : 偿还数额无限制, 成功获得批准者, 股金将全数获得偿还 8. 问 : 申请获准获准的社员, 何时获得退股付款? 答 : 申请获准的社员, 一般可在社员寄回退股付款通知函及相关文件 ( 股票证书正本或其他 ) 后一个月内获得退款 Nyc\chung\wordata\mem\q&a\srf pg.1 ( 于 2014 年 1 月 1 日拟备 )

4 KOPERASI JAYADIRI MALAYSIA BERHAD (KOJADI) SHARE REDEMPTION FUND QUESTIONS & ANSWERS ====================================================== 1. Q : What is Share Redemption Fund and what is the purpose of the Fund? A : Share Redemption Fund is a special fund set up by the Board in 1992 in accordance with the provisions of the By-laws. Allocation to the Fund is apportioned from the annual net profit of KOJADI subject to approval of the AGM on recommendation of the Board. The purpose of setting up the Share Redemption Fund is to cater for the needs of members who wish to redeem their shares in the co-operative. 2. Q : How shall a member apply for the Share Redemption Fund? A : A member shall fill in the form of APPLICATION FOR SHARE REDEMPTION (MEM/R039) prescribed by the Board. The form can be obtained from KOJADI s office at 11th Floor, Wisma MCA, Jalan Ampang, Kuala Lumpur or our local director or our delegate or local Area Liaison Committee. Photostat copy of the form is acceptable, but such form should be clearly written or typed and duly signed by the applicant. 3. Q : Are there any important points to draw attention of a member in filling up of the application form? A : Yes, the member should read Section E carefully and ensure that all relevant document(s) are enclosed when submitting the application form. 4. Q : Are there any rules governing the operation of the Fund? A : Yes, the Board has approved the Rules of KOJADI s Share Redemption Fund governing the operation of the Fund. The Rules are attached together with the application form. Members concerned are required to read the Rules before filling in the application form. 5. Q : Is there any method or system in the evaluation of applications? A : In order to implement the Fund in an orderly and systematic manner and also to be fair as far as possible to the members concerned, a Point System has been adopted by the Board in its evaluation of applications. Specific points will be given to an applicant based on various factors such as duration of membership with KOJADI and age of the applicant etc. Applicants who meet the minimum qualifying points will be approved to redeem their shares. Generally, the major qualifying factors that command high points include : - a) upon the death of the member; (application is to be made by nominee or legal representative) b) upon attaining the age of 70 years or above in the case of a member who has been a member of KOJADI for more than 10 years; c) if the member is suffering from permanent disablement or prolonged / serious illness resulting in his total loss of earning power; or d) if the Board in its sole and absolute discretion decides that the member is in urgent financial need. 6. Q : Will all valid applications be successful? A : This will depend on the number of valid applications and allocation to the Fund. Based on the point-system above, the Board will decide the qualifying points and select successful applicants at its sole discretion. Unsuccessful applicants for the Fund need not re-apply, as their applications will be automatically reconsidered at the next selection process. 7. Q : Is there a ceiling of the amount fixed for the share redemption fund? A : There is no ceiling of the amount of share redemption, all successful applications will receive full redemption amount. 8. Q : How soon can a member get back his redemption sum if he is successful in his application? A : Barring unforeseen circumstances, the successful member-applicant will be able to get back his redemption sum within a month upon receipt of the SRF Payment Advice and relevant document (eg. Original share certificate, etc) by the Society. Nyc\chung\wordata\mem\q&a\srf pg.2 (Prepared on 01/01/2014)

5 App Ref : Date : The Board of Directors Koperasi Jayadiri Malaysia Berhad (KOJADI) 11th Floor, Wisma MCA 163, Jalan Ampang Kuala Lumpur Dear Sirs, SHARE REDEMPTION FUND SRF PAYMENT ADVICE BDM/R041 (R12-11/01/2018) I hereby enclosed:- a) the relevant Share Certificate(s) No. b) photocopy(ies) of identity card of me / the nominee(s)* c) photocopy(ies) of my bank passbook / bank statement for your further action. I further request the Society to credit all payment due to me / nominee(s) into the following bank account: Bank Account Holder Name: Bank Name (tick one) Am Bank CIMB Maybank Public Bank RHB Bank Hong Leong Bank Affin Bank Other: Bank Islam Alliance Bank Citibank Berhad OCBC Bank (M) Berhad HSBC Bank Malaysia UOB Bank Standard Chartered Bank Type Of Account Savings Current Account No. I further agree that KOJADI will not be held responsible for any wrong account number or details provided. Yours faithfully, (Signature) Name : NRIC No : Address : My new mailing address / Tel. No. is changed as follows : Tel : H/P : * Delete whichever is not applicable Nyc\chung\wordata\srf\letter\2015\R041-MAIL MERGE

6 译本 R041 申请编号 : 日期 : 致 : 自立合作社董事会 11TH FLOOR WISMA MCA 163 JALAN AMPANG KUALA LUMPUR 股份偿还基金退股付款通知函本人在此附上 :- ( 一 ) 列号之股票证书 : ( 二 ) 本人 / 继承人 * 身份证影印本 ( 三 ) 本人银行银行存折 / 银行月结单复印件, 敬请查收本人恳请贵社将所有支付予本人 / 继承人的款项存入下列银行账户 : 银行户口持有人名字 : 银行名称 ( 选一 ) Am Bank CIMB Maybank Public Bank RHB Bank Hong Leong Bank Affin Bank Other: Bank Islam Alliance Bank Citibank Berhad OCBC Bank (M) Berhad HSBC Bank Malaysia UOB Bank Standard Chartered Bank 账户种类银行户口储蓄户口号码 : 来往户口本人也同意如提供的银行户口号码或资料有误, 自立合作社将无须承担任何责任 ( 签名 ) 姓名 : ( 社员号码 : ) 身份证号码 : 通讯地址 : 本人已更改上述的通讯地址, 新地址 / 电话列下 : g:\wordata\srf\letter\2012\r041-c-mail merge 电话 : * 删除不适当者

7 BDM/R043 (R5-11/01/2018) RM10.00 Stamp Duty Date : Koperasi Jayadiri Malaysia Berhad (KOJADI) 11th Floor Wisma MCA 163 Jalan Ampang Kuala Lumpur LETTER OF INDEMNITY LOSS OF SHARE CERTIFICATE I, ( please fill in the appropriate column ) (1) a member of membership no : or (2) a nominee / personal representative to the deceased membership no : do solemnly and sincerely declare that the original share certificate(s) numbered of shares issued to me / the deceased on by KOJADI (hereafter the Society) has/have been lost, mislaid by post or damaged. I have searched and caused to be searched for the said share certificate(s) but after a careful and thorough search have been unable to locate the same. I request the Society to issue to me new share certificate(s) for such share as abovementioned and in consideration thereof I hereby undertake to return the said original share certificate(s) to you if the same shall at any time hereafter be recovered and to indemnify and save harmless the Society and Directors from and against all actions, proceedings, loss charges, damages, expenses, claims and demands which may be brought or made against the Society or the Directors in the event of the said share certificate(s) being in any way dealt with now or at any future time. Signature of Member / Nominee / Personal Representative Name : NRIC No : Tel No : Address : ysy\wordata\mem\forms\2005\r043(r5)

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ch_code_infoaccess 地產代理監管局公開資料守則 2014 年 5 月目錄引言第 1 部段數適用範圍 1.1-1.2 監管局部門 1.1 紀律研訊 1.2 提供資料 1.3-1.6 按慣例公布或供查閱的資料 1.3-1.4 應要求提供的資料 1.5 法定義務及限制 1.6 程序 1.7-1.19 公開資