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    AC003315 ApplicationForm

    Uploaded by

    connielia47

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    AC003315 ApplicationForm

    Uploaded by

    connielia47
    29 views1 page

    Original Title

    20240206094601938_AC003315_ApplicationForm(2)(1)

    Copyright

    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
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    Download as pdf or txt
    29 views1 page

    AC003315 ApplicationForm

    Uploaded by

    connielia47

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 1

    V25082023

    Product Application Form

    Customer Details
    Name of Customer : NORAINIE BINTI SEPIRIN

    NRIC/Passport/Company No : 910826125970

    Email : CONNIELIA47@GMAIL.COM

    Contact No : +60-1121608554

    Address : JALAN LANDAK KWN LOT89 TAMAN ABAD 80250 80250 TAMAN ABAD JOHOR MALAYSIA

    Product(s) Details
    Order Date : 2024-02-06

    Order No : AC003315

    Outright Purchase/ Product


    Plan : RENTAL PLAN

    Rental Period : 60 MONTHS

    Warranty Period : 60 MONTHS

    Service & Maintenance Priod : EVERY 6 MONTHS

    HEALTHY LIVING

    Product(s) : AIR CONDITIONING

    CW10V-MB3-IU - CUCKOO VITA-S AC INVERTER (1 HP) & CL10V-MB3-OU - CUCKOO VITA-S AC INVERTER COMPRESSOR (1
    HP)

    Delivery/Installation Address : JALAN LANDAK KWN LOT89 TAMAN ABAD 80250 80250 TAMAN ABAD JOHOR MALAYSIA

    Delivery/Installation Date : The day when the Product is delivered and/or installed at the Delivery/Installation Address

    Outright Purchase Price : -

    Obligatory Period : 1 - 60 MONTHS

    Monthly Rental : Remaining Period : -

    1-12 Months 13-24 Months 25-36 Months 37-48 Months 49-60 Months

    RM 98.00 RM 98.00 RM 98.00 RM 98.00 RM 98.00

    Early Termination Fee : Total Monthly Rental Sum for Obligatory Period - Total Paid Rental

    Total Loss Fee : Total Monthly Rental Sum - Total Paid Rental

    Advanced Fee : RM 98.00

    Processing Fee : -

    Promotion Code : CUCKOO VITA-S AC INVERTER - WAIVE RPF ( VITAS-REN-RPF2023 ) : Waive RM250 Processing Fees

    I/We hereby declare that:

    o I/We wish to outright purchase the Product(s) or subscribe to the Product Plan.

    o The information provided by me/us is true and correct.

    o I/We have read, accepted and agreed to be bound by the terms in https://app.cuckoo.com.my/STCP_GTCP/AC_v2.0.pdf (GTCP & STCP) and the above as well as any
    amendments provided to you via email, SMS or CUCKOO+APP and the same shall be read together and considered as one original and binding agreement between me/us
    o I/We hereby consent to the collection and processing of my/our personal data in accordance with CUCKOO’S Privacy Notice (at https://www.cuckoo.com.my/pdpa-consent ).
    I/ We further agree and accept that the terms and conditions in the CUCKOO’s Privacy Notice form an integral part of the terms and conditions of the outright purchase or
    Product Plan.

    Signed by )
    NORAINIE BINTI SEPIRIN
    )

    910826125970 )

    Signatory Name :
    Signatory NRIC :

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