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SOF Outright

Step 1 of 2

50%

SOF Serial Number*
Masukkan HPXXXXXX_0001. Ganti XXXXXX dengan nombor ejen 6 angka anda. Tukar nombor siri 0001, 0002, 0003 untuk order seterusnya.
Customer Particulars
Full Name (As Per IC) (Max 35 Characters)*

Pastikan BIN, BINTI, A/L, A/P mengikut Kad Pengenalan. Jika nama customer lebih daripada 35 askara, sambung di sebelah.
Full Name (Barisan Kedua Jika Lebih 35 Character)
New IC Number
Date of Birth (DD/MM/YYYY)
Title / Gender
- Mr / Male
- Mrs / Female
Race
- Malay
- Indian
- Chinese
- Others
Installation Address (With City & State)*
Please adjust address 2 lines only.
Postcode*
Phone Number 1*
Phone Number 2*
Pastikan nombor telefon yang dimasukkan adalah tepat dan boleh dihubungi untuk tujuan pengesahan, pemasangan dan servis. Kesalahan memasukkan nombor telefon boleh menyebabkan pemasangan mengambil masa lebih panjang.

Order & Payment Information
Payment Method
- Outright
- Outright Moto
- Outright IPP
Product Name*
Promotion*
Please choose "NO PROMOTION" for Glaze, Kecil & Lombok 3.
Outright Price (RM)
RM 0.00
Ombak Jom Tukar: Old Filter Brand
Ombak Jom Tukar: Old Filter Model
Ombak Accessories
- Mineral Filter (RM100/6 Months)
- Faucet (RM120)
Hidden
Product Quantity Count*
Special Remarks
Please specify special remarks, Eg: Require aluminium casing, install in the morning at 10AM, etc.
Customer Signature*
Installment
Name on Card*
Card Number*
Card Type*
- Visa
- Master
Bank Name*
Card Expiry Date (MMYY)
Bank Name*
Installment Period
HP Particulars
Agent Name*
Agent Code*
Agent Mobile No*
Agent IC Number*
Agent Email
Declaration Forms
Date*
DD slash MM slash YYYY
HP Signature*

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