Complaint on Repayment Assistance (RA) Rejections or Unsatisfied Terms
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Company/Customer Name *
Person in-Charge
Name *
Hp Number *
Email Address *
Financial Institution (FI)
Name Of Financial Institution *
Branch *
Facility Type *
Date Applied for Repayment Assistance *
MM
/
DD
/
YYYY
Date Received Repayment Assistance Decision
MM
/
DD
/
YYYY
Decision by Financial Institution *
Issue(s) e.g. unfavourable terms, imposed additional conditions *
Submit
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