FIT AND PROPER DECLARATION
As we are a financial institution, we require the following questions to be answered.
1) Have you been suspended, dismissed or terminated with cause from the service of your previous employers? Yes / No
Have you ever been dismissed or asked to resign from office, employment, a position of trust or a fiduciary
2) Yes / No
appointment or similar position whether in Singapore or elsewhere?
3) Have you ever been
- charged, convicted in any Court of Law; or Yes / No
- detained under the provisions of any written law; or Yes / No
- charged with any offence in a Court of Law in any country for which the outcome is not yet known? Yes / No
4) Have you been
- declared a bankrupt; or Yes / No
- are you a discharged bankrupt; or Yes / No
- a person in respect of whom a bankruptcy proceeding is pending in Court? Yes / No
5) Have you ever been convicted of any of the offence?
- under the Insurance Act (Chapter 142) or any regulations made thereunder; Yes / No
- involving fraud, misrepresentation or dishonesty; Yes / No
- under the Penal Code (Chapter 224); Yes / No
- under the Monetary Authority of Singapore Act (Chapter 186) or any regulations made thereunder; Yes / No
- under any Act or regulations administered by the Monetary Authority of Singapore Yes / No
6) Are you a subject of any criminal proceeding which is pending in Court? Yes / No
Do you have any share in any business undertaking other than that in a public-listed company, or are you
7) Yes / No
holding directorship or other appointment(s) in any Company?
Have you been reported to the MAS pursuant to Notice on Reporting of Misconduct of Representatives by
8)
Financial Advisers 1 Jul 05 (Notice No. FAA-N09), or equivalent provisions under Securities & Futures Act Yes / No
(SFA), or any other Financial Services, Securities, Insurance or Banking Regulations?
9) Have you signed a promissory note or have any unsecured debts for which the outstanding amount has not
been fully repaid? (This excludes overdrafts approved by a recognized bank, hire purchases agreements,
Yes / No
sums borrowed from Insurance companies, sums borrowed from Statutory Boards or Co-operative Societies,
sums borrowed on security of land charged or mortgaged, and pawn shop payments.)
If your answer is YES to any of the questions, please provide details in the space provided.
DECLARATION
1) I declare that the information given by me in this application for employment is true and correct to the best of my knowledge and that I have not
withheld any relevant particulars.
2) I understand that if any of the information given by me is intentionally falsified or misrepresented, the Company should have the right to dismiss
me without notice if I have been employed.
3) I give my consent to the Company to obtain and verify information from or with any source, as you deem appropriate for the assessment of my
application for employment.
4) I give my consent to the Group/Company, Government agencies, its agents and service providers for collecting, using, disclosing and
processing my personal data, as you deem appropriate for the assessment of my application for employment.
HAFIZ HAIQAL BIN AMIR_________________ Page 1 of 1
__________________________________ ___4/10/2025____________
Name of Job Applicant Signature Date
