ownership

Personal Information

Applicant's Name (required)

Correspondence (required)

NRIC No. (required)

Address (required)

City (required)

State (required)

Postal Code (required)

Country (required)

Phone No. (required)

Mobile No. (required)

Marital Status (required)

Spouse Name (required)

Spouse Occupation (required)

Total No. Of Dependants (required)

Employment/Business Experience

Position(required)

Company (required)

Address(required)

City (required)

State (required)

Postcode (required)

Annual Income (required)

Position(required)

Company (required)

Address(required)

City (required)

State (required)

Postcode (required)

Annual Income (required)

Location Preferences

Independent Shop Lot/ Shopping Mall (Name the Shopping Mall) 1 (required)

State (required)

City (required)

Independent Shop Lot/ Shopping Mall (Name the Shopping Mall) 2 (required)

State (required)

City (required)

Independent Shop Lot/ Shopping Mall (Name the Shopping Mall) 3 (required)

State (required)

City (required)

Do you plan to have equity partners? (required)
YesNo

If YES, complete the following:

Name of Partner

Relationship

Address

City

State

Postal Code

Country

Phone No.

Mobile No.

Name of Partner

Relationship

Address

City

State

Postal Code

Country

Phone No.

Mobile No.

Name of Partner

Relationship

Address

City

State

Postal Code

Country

Phone No.

Mobile No.

Name of Partner

Relationship

Address

City

State

Postal Code

Country

Phone No.

Mobile No.

Schedule A - Financial (Cash On Hand And In Bank)
*Kindly attached the documents

Name Of Bank/ Financial Institute (required)

Country (required)

Amount (required)

Name Of Bank/ Financial Institute

Country

Amount

Name Of Bank/ Financial Institute

Country

Amount

Schedule B - Cash Value of Life Insurance

Name of Insurance Company (required)

Face Amount (required)

Cash Value (required)

Name of Insurance Company

Face Amount

Cash Value

Name of Insurance Company

Face Amount

Cash Value

Name of Insurance Company

Face Amount

Cash Value

Schedule C - Real Estate Owned

Description of Property (required)

Name on Title (required)

Cost (required)

Market Value (required)

Balance Owed (required)

Mortgage Holder (required)

Description of Property

Name on Title

Cost

Market Value

Balance Owed

Mortgage Holder

Description of Property

Name on Title

Cost

Market Value

Balance Owed

Mortgage Holder

Description of Property

Name on Title

Cost

Market Value

Balance Owed

Mortgage Holder

Schedule D - Liabilities

Description of Liabilities (required)

Total Amount (required)

Years Left to Service (required)

Monthly Amount to Service (required)

Joint Guarantee with Others? (Yes/No) (required)

Description of Liabilities

Total Amount

Years Left to Service

Monthly Amount to Service

Joint Guarantee with Others? (Yes/No)

Description of Liabilities

Total Amount

Years Left to Service

Monthly Amount to Service

Joint Guarantee with Others? (Yes/No)

Description of Liabilities

Total Amount

Years Left to Service

Monthly Amount to Service

Joint Guarantee with Others? (Yes/No)

References

List three (3) Professional References you have known at least 5 years (Do not include relatives).

Name (required)

Address (required)

Relationship (required)

Contact No. (required)

Name (required)

Address (required)

Relationship (required)

Contact No. (required)

Name (required)

Address (required)

Relationship (required)

Contact No. (required)

I understand that the granting of franchise is at the sole discretion of Crab Hut (Bangga Raya Sdn Bhd)

I understand that I and/or representatives will have to be successfully complete Crab Hut's training program and competent to operate prior to the start of business operations.

I have read this application and everything I have stated in it is true. I understand that Crab Hut, in granting me as a licensee, will rely upon the information provided by me.

Authorised Signature (required)

Please fill up your Identification Number (I.C) No. for the Authorised Signature Portion

Print Name (required)

Your Email (required)

Date (required)

I hereby authorise Crab Hut, its agent and all credit agencies, educational institutions, corporations, current and former employers, law enforcement and government agencies, city state, country and federal courts, military services and persons to release any information they may have about me to the company with which this has been field, or their agent.

I release Crab Hut and/or its agents and any person or entity which provided information pursuant to this information, from any and all liabilities, claims or lawsuits in regards to the information obtained from any and all referenced sources used.

Applicant Signature (required)

Please fill up your Identification Number (I.C) No. for the Applicant Signature Portion

Authorised Signature (required)

Date (required)

Print Name (required)