Proof of Debt Form (E-Filing)

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AirAsia X Berhad and Its Subsidiaries

E-Filing ID - as stated in notification email *

Insert assigned E-FIlling ID

Name/Company Name *

Insert name of person/ name of company filling up / signing the form.

Outstanding Amount Currency *

Outstanding Amount as at 30 June 2020 *

Insert the gross amount claimed to be owing to you as at 30 June 2020 (in the currency that the amount claimed by you is denominated in)

Do you hold any cash/asset/bank/other security against AirAsia X? *

For suppliers/vendors/business partners who hold any securities in against AirAsia X only

Details/Description of Cash Security (If any) *

For suppliers/vendors/business partners who hold cash deposit or any securities in the form of cash against AirAsia X only

Value of Cash Security (Currency) - If none, please select not applicable *

Value of Cash Security (Amount) - If none, please state 0 *

Details/Description of Bank Security (if any) *

For suppliers/vendors/business partners who hold bank deposit or any securities in the form of bank guarantees against AirAsia X only

Value of Bank Security (Currency) - If none, please select not applicable *

Value of Bank Security (Amount) - If none, please state 0 *

Details/Description of Asset Security (if any) *

For suppliers/vendors/business partners who hold assets or any securities in the form of assets against AirAsia X only

Value of Asset Security (Currency) - If none, please select not applicable *

Value of Asset Security (Amount) - If none, please state 0 *

Details/Description of Other Security (if any) *

For suppliers/vendors/business partners who hold other deposit or any securities in the form of others against AirAsia X only

Value of Other Security (Currency) - If none, please select not applicable *

Value of Other Security (Amount) - If none, please state 0 *

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