AN INVITATION RESERVED FOR GRADUATES & PROFESSIONALS

Certified to ISO 9001:2008 Cert. No. : AR 1350

www.directaccess.com.my 03-6204 7878 REQUIREMENTS Income WORLD MasterCard / VISA Infinite Platinum Card Gold Card Minimum Age Principal

SMSA 8 9 9 1 Branch No. Employee No. Indicator Code

I WISH TO APPLY FOR THE FOLLOWING CARD (PLEASE 3) :

u WORLD MasterCard u VISA Infinite

u Platinum MasterCard u VISA Platinum

Certified to ISO 9001:2008 Cert. No. : AR 1350

u Gold MasterCard

Note : Additional credit cards will share a combined credit line. Documents required, non-returnable : 3 A photocopy of I/C (both sides, enlarge) 3 Business Card 3 Latest Salary Slip / Income Tax Receipt / EA Form 3 Degree Certificate from recognised university / professional body MY PERSONAL DETAILS

: RM200,000 per annum : RM 80,000 per annum : RM 24,000 per annum : 21 years old

OTHER BANKING SERVICES

u Mr

u Miss

u Madam

u Dr

u Others

Yes, I would like to apply for the following services :

Full Name as in NRIC :

u Overdraft Facility (subject to eligibility & minimum income requirement is RM60,000 p.a.) u Credit Card PIN (to access ATM and CIMB Clicks online statement)
MY EMERGENCY CONTACT PERSON (RELATIVE/FRIEND NOT STAYING WITH ME) Name :

New I/C No. :

Old I/C No. :

Relationship :

Name to appear on Card (Not more than 19 letters) : Marital Status : u Single Sex : u Male

u Married u Female

u Widowed u Divorced

Home Tel :

Mobile Tel :

MY PROFESSIONAL QUALIFICATIONS

Office Tel :

u Yes, I am a graduate / member of a professional body u University u Professional Institute

DECLARATION (BY INDIVIDUAL BORROWERS) IN CONNECTION WITH BANK NEGARA GUIDELINES ON CREDIT TRANSACTIONS AND EXPOSURES WITH CONNECTED PARTIES Please complete this declaration section if any of the below is applicable to you. (No declaration from you denotes that it is not applicable). 1. u I am a staff of the CIMB Group1. 2. u To the best of my knowledge, I have close relative(s)2 employed under the CIMB Group or has acted as my guarantor. Particulars of my close relative(s) in CIMB Group : Name I/C No. Relationship

MY HOME ADDRESS Residential Address :

Postcode :

Acted As Guarantor (Indicate Yes or No)

Residence is : u Owned - No loan u Employers Home Tel :

u Owned - With loan u Parents / Relatives

Mobile Tel :

u Rented Years there :

E-Mail :

IMB Group means CIMB Bank Berhad or CIMB Islamic Bank Berhad or CIMB Investment C Bank Berhad or other subsidiaries or companies controlled by the aforesaid respective banking institutions. 2 lose relative(s) include parents / spouse of staff including the spouses dependents C children / spouse of the children / brother and sister / spouse of brother / sister and any other dependents and persons who may influence / be influenced by the staff.
1

MY EMPLOYMENT DETAILS Name of Company : Address :

u Self-employed

Postcode :

Position : u Salaried employee

Office Tel :

Years there : Other Income Per Annum : Gross Annual Salary :

R M
MY PERSONAL SECURITY CODE Mothers Maiden Name :

R M

DECLARATION SECTION I hereby declare and certify that all the information given by me in this application is true, accurate and complete. Notwithstanding the generality of the foregoing, I confirm that CIMB Bank Berhad (the Bank) is authorised to verify and/or make any checks and/or obtain any information and/or confirmation, with or from any credit reference agencies, and/or from any financial institution, on me and/or any other person, individual and/or entity as the Bank may deem fit, for any purposes which the Bank deems fit. I hereby request the Bank to issue, upon approval of this application, the credit card(s) which I have indicated. I acknowledge that the use of the credit card(s) issued to me shall be subject to CIMB Banks Cardmember agreement (Cardmember Agreement), which will be sent to me with the credit card(s) upon the approval of this application, and agree to be bound by the terms and conditions set forth in the Cardmember Agreement upon issuance or use of the credit card(s). I, the principal Applicant further agree to accept joint and several liability for all amounts incurred arising from the use of the principal and/or supplementary credit card(s) issued pursuant to this application or at any time thereafter at my request. I, acknowledge that the Bank reserves the sole and absolute right to decline or reject my application(s) without assigning any reasons therefore. I also acknowledge that it is a requirement by Bank Negara Malaysia (BNM) that all information relating to this application, whether successful or otherwise, must be updated and/or transmitted to the Customer Credit History (CCH), a database maintained by BNM. In addition thereto, CIMB Bank is hereby irrevocably and unconditionally authorised to disclose any information or particulars given by me herein to any person(s) in or out of Malaysia including but not limited to companies within the group of CIMB Bank as well as companies within the group of CIMB Group Holdings Berhad, CIMB Banks ultimate holding company (Group Companies) and for such purpose(s) as CIMB Bank deems fit, proper or necessary at any time including but not limited to the facilitation of operations, businesses, cross-selling, strategic alliances, marketing and promotional purposes of CIMB Bank. I understand that the credit card(s) when issued shall at all times remain the property of the Bank and must be duly returned upon request by the Bank. I further agree liability to accept liability for all amount incurred arising from the use of my credit card(s) issued pursuant to this application or at any time thereafter at my request. Please tick ( 3 ) u I hereby give my consent for CIMB Bank/CIMB Islamic Bank to share my information (excluding information relating to my affairs or account) with third parties, such as strategic alliances for marketing and promotional purposes.

MY BILLING AND CARD DELIVERY INSTRUCTIONS Please Send My Statement To : u Home Please Courier My Card To : u Home

u Office u Office

Principal Applicants Signature : Date :

Please fax or scan the completed application form (together with your I/C (front & back) and business card) to the following:

Fax: 03-2381 5533 or E-mail: mktgda@cimb.com

*All documents submitted are non-returnable.

FEES AND CHARGES

Annual Fee Joining Fee Finance Charges WAIVED FOR LIFE. No joining fee. The charges are : (a) 1.125% per month or 13.5% per annum if you have promptly settled your minimum payment due for 12 consecutive months. (b) 1.333% per month or 16% per annum if you have promptly settled your minimum payment due for at least 10 months in a 12-month cycle. (c) 1.458% per month or 17.5% per annum if your payment record is not within either (a) or (b) above. Finance charge for cash transaction is 1.5% per month or 18% per annum. Government Service Tax Cash Advance Fees RM50 Each Principal Card RM25 Each Supplementary Card The cash advance fee is 5% of the amount advanced or a minimum of RM15, whichever is higher. This is imposed for each cash advance transaction. 5% of the outstanding balance or a minimum of RM50, whichever is higher. 1% of the total outstanding balance as at statement date or a minimum of RM5, whichever is higher, capped to a maximum of RM50 and will only be imposed if the minimum payment due is not paid by the third day after relevant due date. Full payment on previous statement balance. Enjoy an interest-free period of 20 days for all new retail transactions from statement date. Partial or minimum payment on previous statement balance. No interest-free period. A finance charge will be levied on your unpaid outstanding balance and all new transactions from the date the transactions are posted.

Minimum Monthly Repayment Late Payment Charge

Interest-Free Period

Conversion For Overseas Transactions

The conversion rate as determined by MasterCard International plus an administrative cost of 1%.