uob visa vox credit card application form - United Overseas Bank ...

Mail to : UOB Card Centre, P.O. Box 10253, 50708 Kuala LumpurExisting UOB Credit Card No.UOB VISA VOX CREDIT CARD APPLICATION FORM(FOR EXISTING BASIC, SUPPLEMENTARY UOB CARDMEMBERS ONLY)Note : FREE Annual Fees on your UOB Visa Vox Credit Card with a minimum monthly charge of RM50 to your card account.If the monthly charge is below RM50, a RM6 administrative fee will be levied for that particular month.MY PERSONAL DETAILSName (as in NRIC / Passport, underline surname)Mr Ms Mdm OthersName to appear on Card (Not more than 19 characters) Sex MaleNRIC / Passport NoOld :New :Home Tel NoHandphone NoDate of BirthNationalityFemaleAnnual Gross IncomeRM18,000 - RM24,000RM60,001 - RM100,000Sources of Other IncomeRM24,001 - RM48,000RM100,001 - RM200,000RM48,001 - RM60,000Above RM200,001INFORMATION UPDATES(Please complete the following portion if there is a change in your personal and contact information)Marital StatusNo. of Dependent(s)Home AddressSingleMarriedPostcodeTown / CityEmail AddressBill to Home OfficeNote : The UOB Credit Cards will be sent by courier to the billing address.My Work Place DetailsName of CompanySelf-EmployedNature of BusinessOffice AddressPostcodeTown / City

Tel NoFax NoPosition HeldYears of ServiceName of Previous EmployerPosition HeldYears of ServiceDECLARATION"I/We, the Principal Applicant and/or Supplementary Applicant(s) hereby request United Overseas Bank (Malaysia) Bhd ("the Bank") to issue UOB VisaCard(s) to me/us. I/We agree to be jointly and severally bound by the terms and conditions of the respective UOB Visa/MasterCard CardmemberAgreement(s) upon issuance or use of the credit card(s). I/We further agree that I/we are jointly and severally liable for all amounts incurred by theSupplementary cardholder of the Visa Card.""I/We warrant that all information given in this application is true, accurate and correct and I/We authorise the Bank to verify the information provided andto obtain from any financial institution and the Director General of Inland Revenue and any other sources the Bank shall deem necessary any informationwhich the Bank may require.""I/We acknowledge that the credit card(s) remain the property of the Bank and must be returned upon the Bank's request. I/We consent to the linking ofthe UOB Visa Card(s) to the UOB121 phonebanking services". Conditions apply.(FOR NON-MALAYSIANS ONLY. "I/We confirm that my/our borrowings from sources within Malaysia do not exceed in aggregate RM200,000")Note :The provision of this form does not automatically indicate that the Bank will accept the contents and issue a UOB Credit Card to the PrincipalApplicant and/or the Supplementary Applicant(s). The bank reserves the right to reject any application without assigning any reason whatsoever.Annual fees for the UOB Vox Card is waived provided that no less than RM50 is transacted each month. In the event the monthly charge is less thanRM50, a RM6 service charge will be imposed and shall be debited to the credit card account payable in accordance with the UOB Visa/MasterCardAgreement. For the purpose of computation of the RM50, it shall not be taken into account interest charges, carry forward balances and settlement ofany outstanding balances or charges imposed by UOB.Principal Applicant's SignatureDate :Supplementary Applicant's SignatureDate :FOR BANK USE ONLYFor BranchFor Card CentreRemarks CLV MIntroduced ByBranchTel NoExt.BS1TSource CodeStaff IDDIV / DeptRecommended ByApproved By