Notification Request Form

Please complete this form, print and mail to us at OCBC Bank (M) Bhd P.O. Box 10418, 50712 Kuala Lumpur, Malaysia

Full Name NRIC  -   -      Card No.    -   -   -  Expiry       Card No.    -   -   -  Expiry

REQUEST TO UPDATE CHANGE OF PERSONAL PARTICULARS

Preferred billing address (Applicable to Principal Cardmember only)::   Home   Office

Change of home address Change of office address Postcode Postcode

Request for new PIN to be sent to new billing address Change of contact nos.   Home  -    Mobile  -    Office  -

CARD RELATED MATTERS

Card replacememt Reason:   Damaged Faulty Lost/Stolen Others   Others:   Card cancellation Reason:   Others High service fee Low credit limit Too many cards   Others:       * Replacement fee applicable Change of name on credit card

REQUEST FOR LINE INCREASE

Request for Line Increase :

RM  -

REQUEST FOR ADDITIONAL CARD(S)

Request for additional card(s)

Choice of card(s) : Visa Gold Titanium Platinum MasterCard Great Eastern Titanium Great Eastern Platinum

Principal Cardmember declaration I/We agree to be bound by the terms and conditions contained in the OCBC Cardmember Agreement (and to such amendments which the Bank may at its absolute discretion make at any time from time to time and agree to be bound by them upon issuance or use of the Card), a copy of which will be sent to me/us. I/We understand that the OCBC Card(s) shall remain(s) the property of OCBC Bank (Malaysia) Berhad and must be returned to the Bank upon request.

_____________________________________ Principal cardmember Name Date