MB eVibes MGM AF_Internet.ai - Maybank

my personal details
my family details
my declaration
Full Name as in NRIC (please underline surname) Mr Ms Mdm Mrs
Name to Appear on Credit Card (19 characters only)
Date of Birth
(DD/MM/YY)
Gender
Male Female
ID Type Singapore Pink Singapore Blue
NRIC No.
Nationality Singaporean Others
Ethnic Group Chinese Malay Indian Others
Marital Status Single Married Divorced Others
Residential Address
Postal Code
Residential Ownership
Fully Owned Mortgaged Parents’ Rented Others
Residential Type HDB Condo Apt Landed Others
Mother’s Maiden Name (for security verification)
Spouse’s Name
Name of Relative or Friend not living with you
Relationship to Card Applicant
Contact No. (Residence/Office/Mobile)
my parent’s/legal guardian’s details
(Compulsory if applicant is below 21 years of age)
Relation to Card Applicant Father Mother Legal Guardian
(Please attach a copy of the legal
documentation of guardianship)
Salutation Mr Ms Mdm Mrs Dr
Full Name as in NRIC
Date of Birth
ID Type
NRIC No.
Residential Address
Singapore Pink
(DD/MM/YY)
Singapore Blue
By submitting this application, I hereby:
• Agree that the operation of the Maybank Credit Card Account to be opened in my name will be
subject to the Terms and Conditions governing Maybank eVibes Agreement which are available
at Maybank’s Branches in Singapore and www.maybank2u.com.sg and which I acknowledge
that I have read and understood • Agree that I will be responsible for all liabilities (including
annual fees and any other charges) which may be incurred in respect to the Card(s) issued
• Agree that the Card(s) may be sent to me, at my risk, by mail to my billing address • Agree to
abide by the prevailing Terms and Conditions governing accounts and the relevant services
linked to my Card(s) and/or account(s) which have been furnished to me and any amendment
as the Bank may from time to time impose • Agree that the electronic operation of the Maybank
eVibes by me shall also be subject to the Electronic Services Terms and Conditions governing
the operation of cards or accounts using electronic services • Acknowledge that I have read,
understood and agree to be bound by the Terms and Conditions governing Short Message
Service (“SMS”) Transaction Alerts (as amended by Maybank from time to time) which is
available at www.maybank2u.com.sg • Warrant that all information and documents provided by
me are true, accurate and complete and may be retained by you indefinitely • Authorize you to
conduct credit checks and to obtain and/or verify any information about me as you may in your
absolute discretion deem fit • Authorize you, at your discretion, at any time, from time to time, to
disclose any information and/or data relating to myself and my account(s) and/or credit cards
with you, or any other information as you may deem necessary:- to any of your head office,
representative and branch offices and to any of your related company or associated company,
in any jurisdiction; to any government or regulatory agency or authority; to any of your potential
assignee or transferee or to any person who has or may enter into contractual relations with you
in relation to the Maybank Credit Card; to any credit bureau (including, without limitation, Credit
Bureau (Singapore) Pte Ltd), as well as the members of such credit bureau; to my parents/
guardian (if I am below 21 years old); and to any other third parties (including, without limitation,
credit reference or evaluation agencies) wherever situated for any purpose whatsoever
• Confirm that:- there are no legal proceedings commenced against me; I have not been
declared bankrupt; and no Statutory Demand has been served on me • Acknowledge that you
reserve the absolute discretion to reject my application without giving any reason • eVibes Lucky
Draw – I understand that if my eVibes Card is approved during the Qualifying Period stated in
the Terms and Conditions for Maybank eVibes Lucky Draw 2010 my name will be entered into
the Lucky Draw and I will be bound by the said terms and conditions.
my correspondence details
Contact No. (Residence)
Postal Code
Company Name
Designation Annual Income S$
x
Card Applicant’s Signature & Date
(Office)
(Mobile^)
(Mandatory field)
Contact No. (Residence)
parent’s /legal guardian’s consent
Email #
^ Mandatory for all applications to receive Transaction Alerts. Please refer to Maybank’s
website at www.maybank2u.com.sg for details.
# Mandatory for eVibes Application
For new users accessing eVibes statements online via Maybank2u.com.sg, you will receive
your OTP (One-Time-Password) via SMS on your registered mobile phone number. If you
are a current user of 2FA (2-Factor Authentication), you can continue to use your existing
method of receiving your OTP. All existing mobile numbers in our records for Personal
Banking Services will be updated.
my education details
(Mandatory field)
Educational Institution
NUS NTU SMU SIM NYP NP SP TP RP
Full-Time Course
Part-Time Course
(Office)
my referrer details
Name
NRIC No.
(Mobile)
Contact No. *
*Contact no. provided will be used solely for the referral programme.
Thank you for taking the time to fill up this form.
Remember to send us all the mandatory items,
including the required signature(s).
Congrats, you’re now one step away from
getting your eVibes Card!
By signing below, I, the Applicant’s Parent/Legal Guardian, hereby:
• On behalf of the Applicant, apply for, consent and agree to the Bank opening the Credit Card
Account (“Card Account”) and issuing a Credit Card to the Applicant thereunder until the Card
Account is terminated subject to the terms of application herein and to the Bank’s eVibes Terms
and Conditions • Warrant that all information and documents provided by me are true and
accurate • Authorize you to conduct credit checks and to obtain and/or verify any information
about me as you may in your absolute discretion deem fit • Authorize you, at your discretion, at
any time, from time to time, to disclose any information and/or data relating to myself and my
account(s) and/or credit cards with you, or any other information as you may deem necessary:-
to any of your head office, representative and branch offices and to any of your related company
or associated company, in any jurisdiction; to any government or regulatory agency or authority;
to any of your potential assignee or transferee or to any person who has or may enter into
contractual relations with you in relation to the Maybank Credit Card; to any credit bureau
(including, without limitation, Credit Bureau (Singapore) Pte Ltd), as well as the members of
such credit bureau; and to any other third parties (including, without limitation, credit reference
or evaluation agencies) wherever situated for any purpose whatsoever • Confirm that:- there are
no legal proceedings commenced against me; I have not been declared bankrupt; and no
Statutory Demand has been served on me • In consideration of the Bank agreeing to open the
Card Account for and issue the Credit Card to the Applicant, at my request and at the request of
the Applicant hereby confirm and agree to be bound by the terms of this application and the
Terms and Conditions governing Maybank eVibes Agreement and undertake to execute such
document(s) in such form and substance satisfactory to the Bank, as the Bank may require.
Expected Graduating Date
(MM/YYYY)
my employment details (if applicable)
for bank use
Issued by Maybank, which is incorporated in Malaysia with limited liability
Company Name
Annual Income S$
Remarks/Recommendations
Source Code: 361104 Scheme Type: 122
x
Applicant’s Parent’s/Legal Guardian’s Signature & Date