my personal details/butir-butir peribadi saya principal card ...

Mail your application form to/Kirimkan borang permohonan ini ke:UOB Card Centre, P.O. Box 10253, 50708 Kuala Lumpur.To speed up the processing of your application, please enclose the following documents (non-returnable):• Photocopy of your NRIC/Passport (both sides) on one side of an A4 paper (For supplementary cardapplicants also, if applicable)• Latest Income Tax Returns (Form J) / Latest Salary Slip• F9, 24, 49 & Latest Income Tax Returns (Form J) (For self- employed)• Latest Copy of Credit/Charge Card(s)/ Bank StatementIf regular income is less, please state source(s) and amount(s) of any other income and attach supporting documents.Untuk memudahkan pemprosesan permohonan anda, sila lampirkan dokumen-dokumen berikut (tidak dipulangkan)• Salinan Kad Pengenalan/Pasport (kedua-dua belah) pada sekeping kertas A4 (Untuk kad tambahan juga,jika berkenaan)• Penyata Cukai Pendapatan Terkini (Borang J)/Slip pendapatan terkini• F9, 24, 49 & Borang J (Untuk Pendaftaran Perniagaan)• Salinan terkini penyata bank/kad(kad) kredit/cajJika pendapatan biasa adalah kurang, sila nyatakan sumber(-sumber) dan jumlah(-jumlah) pendapatan lain danlampirkan dokumen-dokumen berkenaan.PRINCIPAL CARD APPLICATION/PERMOHONAN KAD UTAMAI wish to apply for/Saya ingin memohon (please tick/sila tandakan '✓')Visa VOX(No Annual Fee)(Tiada yuran tahunan)MY PERSONAL DETAILS/BUTIR-BUTIR PERIBADI SAYAName (as in NRIC/Passport, underline surname) Mr Ms Mdm OthersNama (seperti di KP/Pasport, gariskan nama keluarga) Encik Cik Puan Lain-lainName To Appear On Card/Nama Tertera Pada Kad(Not more than 19 characters/tidak melebihi 19 huruf)NRIC/Passport No/No. Kad Pengenalan/PaspotOld/LamaMasterCard Classic(Annual Fee RM88)(RM88 yuran tahunan)MasterCard Gold(Annual Fee RM168)(RM168 yuran tahunan)MasterCard Platinum(Annual Fee RM388)(RM388 yuran tahunan)If the monthly charge for your UOB VOX Card is less than RM50, a RM6 administrative fee will be levied onyour UOB VOX Card account for the said month. First year annual fee waived for all other cards./Jika cajbulanan kepada UOB VOX Card anda kurang daripada RM50, caj pentadbiran RM6 akan dikenakan pada akaunanda bagi bulan tersebut. Yuran tahunan untuk tahun pertama adalah percuma untuk semua kad lain.Minimum requirement is RM18,000 p.a. for UOB VOX Card/MasterCard Classic, RM48,000 p.a. forMasterCard Gold and RM120,000 p.a. for MasterCard Platinum./Syarat kelayakan minimum ialah RM18,000setahun untuk UOB VOX Card/MasterCard Classic, RM48,000 setahun untuk MasterCard Gold danRM120,000 setahun untuk MasterCard Platinum.MY WORK PLACE/BUTIR-BUTIR PEKERJAAN SAYAName of Company/Nama SyarikatNature of Business/Jenis PerniagaanOffice Address/Alamat Tempat BekerjaPostcode/PoskodTel/No TelTown/City/Bandar/WilayahFax/No Faks Self-Employed/Majikan SendiriPosition HeldYears of ServiceJawatan DipegangJumlah Tahun BerkhidmatName of Previous Employer/Nama Majikan Sebelum IniPosition HeldJawatan DipegangYears of ServiceJumlah Tahun BerkhidmatMY INCOME DETAILS/BUTIR-BUTIR PENDAPATAN SAYAAnnual Gross Income (RM)Pendapatan TahunanSources of Other Income(RM)Sumber Pendapatan LainYOUR EMERGENCY CONTACT/RUJUKAN SEMASA KECEMASANName of Relative Not Staying with Me/Nama Saudara yang Tidak Tinggal Bersama SayaRelationship/PerhubunganHome Address/Alamat RumahMY SECURITY CODE/KOD SEKURITI SAYAMother’s Maiden Name/Nama Penuh Ibu(For verification purposes/Untuk tujuan pengesahan)New/BaruDate of Birth/Tarikh Lahir Sex/Jantina Male/LelakiFemale/PerempuanDay/Hari Mth/Bulan Yr/TahunMarital Status Single/Bujang Married/BerkahwinTaraf PerkahwinanNo. of Dependent(s)NationalityBilangan TanggunganWarganegaraHighest Educational Qualification/Taraf PendidikanPrimary/Sekolah Rendah Secondary/Sekolah MenengahCollege*/Kolej* Ter tiary*/Universiti* *Home Address/Alamat Rumah(Please specify qualification/Sila nyatakan)Postcode/Poskod Town/City/Bandar/WilayahHome Tel/No Tel RumahHandphone/Telefon BimbitOffice Tel/No Tel PejabatE-mail Address/Alamat E-melPostcode/PoskodTown/City/Bandar/WilayahMY BANKING REFERENCES/RUJUKAN PERBANKAN SAYAOther Credit / Charge Card(s)/Kad(-kad) Kredit / Caj Lain-lainName of Issuer/Nama Bank Pengeluar Card No/No Kad1Home Tel No/No Tel RumahHandphone/Tel Bimbit2E-mail Address/Alamat E-melBill to/Bil Ke Home/Rumah Office/PejabatNote: The UOB Credit Cards will be sent by courier to your billing addressNota: Kad UOB akan dihantar melalui kurier ke alamat bil anda.Bank/Finance Co Type of Account Account NoBank/Syarikat Kewangan Jenis Akaun No. Akaun12