CITIBANK BERHAD (297089-M) OPTIONAL CARD PRODUCTS CONSENT FOR CITI PRESTIGE GLOBAL CONCIERGE 17 GENERAL DECLARATION FOR

CITIBANK CREDIT CARD & CITIBANK READY CREDIT 15 5 CITIBANK READY CREDIT PAYLITE
CITIBANK CREDIT CARD / CITIBANK READY CREDIT APPLICATION FORM
performance of its/their operational functions (whether within or outside Malaysia), in By signing below, I kontrak hereby (1) authorise Citibank Berhad (the Bank) toas disclose my personal data, such as my name, address(es), contact numbers, e-mail YES! I wish to apply for Citibank Ready Credit PayLite (RC PayLite) per details provided below. Jika anda ingin memasuki dalam Bahasa Malaysia, sila minta borang tersebut daripada kami. Jika anda menandatangani connection with this application or any of products, service or accommodation I/weConcierge have or may 1. I/We warrant and thatini all information furnished hereanda is to true, accurate and not misleading. address(es) information pertaining this application to TEN Lifestyle Bahasa Management Ltd (TEN) for purposes providing Citi Prestige Global Borang Pemohonan dalam Bahasa Inggeris, dianggap telah memilih dan memahami Inggeris sebagai bahasa have with the Bank, for confidential use, processing this application, data processing, credit utama untuk kontrak ini. 2. I/We services to me, (2) understand thatat any personal data provided by the Bank to TEN shall also be subject to the TENs privacy policy of which details can be authorise Citibank Berhad (the Bank), any time and from time to time to process including

FOR BANK USE ONLY CREDIT CARD - BALANCE TRANSFER VIA INSTALMENT PLAN (BTI) 12 I/We hereby declare, acknowledge, agree and conrm as follows:

evaluation, meeting legal and regulatory requirements, for provision of goods or services, YES! I wish to apply for Citibanks Balance Transfer as per(RM) details provided below. Bank Current/Savings Account No. via Instalment Plan (BTI) Amount (Min. RM1,000) Tenure but notat limited to access, obtain, verify and/or use, any data information from any source located http://www.tenlifestyle.com/privacy andor to the full extent permitted by law, the Bank not any be liable forservice any unauthorised disclosure of personal marketing and shall promoting products, and/or accommodation to me/us, provision of services such as protection plans or insurance policies where applicable (including Citi Prestige MasterCard World Elite Cash Back Platinum VISA Choice MasterCard Giant VISA Rewards (including credit reference agencies, credit reporting agencies, Bank Negara Malaysia (BNM), data or breach of confidentiality, and (3) agree to indemnify and hold the Bank harmless against any liability to the full extent permitted by law arising from the Bank Card/Account No. Amount (RM) (Min. RM1,000) Tenure (6, 9, 12, 18, 24, 30 or 36 months) assessing, processing and investigating any risks or claims), fulfillment and delivery of gifts Platinum VISA the credit bureau and/or the Central Credit Reference Information System (CCRIS) and such PremierMiles VISA Signature Cash Back Platinum MasterCard Choice VISA Shell Gold VISA disclosure of my personal data. to me/us in connection with this application, my/our Card(s) and/or CRC Facility, the Card relevant authorities) for purposes of evaluating my/our credit standing in connection to me/us, this Platinum MasterCard Clear MasterCard AirAsia Platinum VISA CitiBusiness Gold VISA Terms and Conditions and/or Citibank Date of application (Mandatory) : Ready Credit Customers Terms and Conditions and all application and any facility, service or accommodation I/we have or may have (whether or not with other purposes incidental and associated with Platinum any of the above. Applicants signature : Platinum VISA Clear that VISA AirAsia Gold VISA Business VISA the Bank) as the Banks discretion deems t. I/We understand this application, the opening, d d declare m m y spouse(s), y y ychildren or parents (if any) is/are not employee(s) or director(s) 4. I/We that my/our ( Sign in black only) of my/our Card Account, CRC Account and any future facility, service or operation andink conduct For Rewards Platinum card only : Please tick your Rewards categories Shopping Driving Home Travel Entertainment Important Note: applied by me/us or granted by you (whether in my sole name or jointly with of the Bank in compliance with the Banking and Financial Institutions Act, 1989 (BAFIA). I/We also accommodation Your first 2 packages are free in the first year declare and understand that my/our application is subject to non-applicability of the restrictions For fresh or applicants, you maythe only apply for RC PayLite or RC BTI and notor both. another others, including Supplementary Cardmember(s), presently subsequently DECLARATION OF DEBT OBLIGATIONS WITH of NON-BANKS 6 found in Section BAFIA and provided that I/we am/are not in breach of or in contravention of Important Note: opened) may be reported to the Dishonoured Cheques System Rate (DCHEQS) The PayLite Amount disbursed will be subject to Information Effective Interest (E.I.R.)maintained ranging between 5.9% to 17.9% 62 per annum from the date of approval and will be computed based on a the laws of Malaysia, failing which, you are entitled to terminate my/our Card(s) and/or repayment CRC Facility. The amount transferred will be subject to Effective Interest Rate of 9.9% of approval and will be computed based on a monthly reducing balance by BNM, CCRIS and such relevant authorities (as the case may be) as(E.I.R) the Bank deemsper t. annum from the date monthly reducing balance repayment method. Citibank Ready Credit (CRC) I3. hereby apply for product(s). Applicants 5. I/We fully understand that the approval ofBy my/our application at the discretion as the Bank method. Applicant may apply to transfer outstanding balances from not more than 3 credit card/charge card accounts held in other Banks. signing below, I is hereby agree to abide by the I/We authorise the Bank to disclose, store, utilise and/or transfer my/our personal data such as my/our Amount of each monthly Outstanding The PayLite amountgoverning will only be transferred toof your Current or Savings account maintained in your deems sole name. Transfers to any joint accounts or third party accounts are notFacility allowed. signature fit and you may at time terminate my/our Cards(s) and/or CRC with notice. terms and conditions BTI, the full set which is available on www.citibank.com.my name, address(es), contact numbers, information obtained from credit reference agencies, credit (RM) as Balance (RM) Type of Debt Obligations Name of actions, Non-Bank Approval of the RC BNM, PayLite isInstalment/Payment subject tosuch Citibanks discretion we deem fit. keep you fully indemnified against any claims, proceedings, losses, 6. I/We will Capacity reporting agencies, the application credit bureau, CCRIS and relevant authorities pertaining to this banks use only damages, costs and charges as a result of using and/or in connection with the Information, Principal Card applicants signature application and/or facility, service or accommodation applied by me/us or granted byRC thePayLite, Bank the full For By signing below, I any hereby agree to abide by: the terms and conditions governing set of which is available at www.citibank.com.my Card Terms and Conditions, CRC Facility, Citibank Ready Credit Customers in ink my only) sole name or jointly another or others, including the Supplementary 1( (whether TELL US with ABOUT YOURSELF 3 Card(s), Citibank MAILING PREFERENCE Sign in black BTI Code Self Joint Guarantor Terms and Conditions and all relevant agreements, covenants and undertakings by me. For banks use only Cardmember(s), presently: or subsequently opened) and whether within or outside Malaysia Applicants signature (Information) Berhad, Citibank N.A., Citigroup Inc. or any Mr of your/their 7. I/We expressly to the mailing of my/our Card(s), Debit & ATM Card, the Citibank Card Mrsofces, Ms ( Sign in black only) RC PayLite Code Full name as ink into/with NRICCitibank or passport (underline surname) : Statement and consent advice will be sent to your email. Services Association, Terms and Conditions, the relevant Terms and Conditions for specific Card-type (if applicable), CREDIT CARD BALANCE TRANSFER (BT) 13 afliates or subsidiaries (collectively Citigroup), merchants, VISA International E-mail address :Ready Credit Self Joint Guarantor MasterCard International Incorporated, any vendors and/or third party service providers engaged by the and/or Citibank Customers Terms and Conditions to my/our address(es) provided Bank and/or Citigroup, including any person to whom the Bank and/or Citigroup has outsourced the here if my/our application is successfully approved. 16 YES! I wish to apply for Citibanks Balance CITIBANK READY CREDIT BALANCE TRANSFER Transfer (BT) as per details provided below. VIA INSTALMENT PLAN Self Joint Guarantor 18 DECLARATION FORNote: CREDIT CARD Former/existing customers enrolled for e-Statements/e-Advice will continue to receive Bank Credit/Charge Card Account No. Transfer via Instalment Amount (RM) (Min. RM1,000) Tenure (6, 9, 12, 18, 24, 30 or 36 months) with YES! I wish to apply for Citibank Ready Credit Balance Plan (RC BTI) as per details below. their statements or advice (new and provided existing) electronically. New-to-Bank customers By signing below, conrm thatfor (1) e-Advice I have read and agree to abide by the provisions contained in Name to appear on card (max. 19 letters) : SPECIFIC DECLARATION FOR PRINCIPAL CARD APPLICANTS email address willI be enrolled automatically. Box 17 above and this Box 18. (2) My minimum income is RM24,000 per annum or more. (3) For The Bank has informed me and I fully understandCard that inAccount accordance with prevailing Bank Negara Bank Credit/Charge No. Amount (RM) (Min. RM1,000) Tenure No, I prefer statement (only applicable New-to-Bank customers) CitiBusiness Cardpaper application, my business sales turnover is for RM120,000 per annum or more (N/A TOTAL Malaysia Guidelines, if my annual income is RM36,000 or less, I can only hold credit cards as a For CRC, Name to appear on card will be as per your NRIC. if Business Platinum card applicant is salaried). (4) My signature below constitutes a request for Principal Cardmember from a maximum of two (2) credit card issuers (Maximum Issuer Restriction). Statement address and Credit Card/CRC delivery address : Citibank VISA credit card if I alreadyWork have aaddress Citibank MasterCard and vice versa, if applicable. (5) Upon the thed Bank ofm the m credit card(s) for under this application, I declare that Important Note: : byd Residential address y yapplied y y Bumiputra Date of issuance birth My list signature a request forrepayment Gold/Classic Card if I do not qualify for Platinum/Gold so long as the Maximum Issuer Restriction to me: we would like to understand you more. Please To better facilitate the processing of yourapplies application, down constitutes all your monthly loan obligations from Non-banks, inclusive Card. of both Important Note: credit cards from a maximum of two (2) credit card issuers Non-bumiputra (6) obligations. The PrincipalUnder and Supplementary will jointly and severally liable to the (1) I willand be holding (including the Bank and joint Nationality : secured unsecured financing. The total amount must include a combination of individual joint capacity, Cardmember(s) you are required to be apportion your monthly commitment 4 SUPPLEMENTARY CREDIT CARD Bank for all amounts and charges due and owing however arising from the use by the BT The Amount Transferred will be subject to a Special Interest Rate (i.e. Effective Interest Rate) for the Special Interest Rate Term and 18% per annum thereafter. an issuer); and monthly amount divided by the number of joint debtors involved e.g. RM3,000 per month with 3 joints debtors, hence RM1,000 per debtor. byas taking the total Supplementary Cardmember(s) of his own Supplementary Card(s). (7) The Bank may allow the New no. orI passport no. NRIC no. : from (2) INRIC am an existing Citibank Principal Cardmember holding credit cards more two (2) Important Note: By If signing below, hereby to: abide by the Old terms and conditions governing BT, the full set of is available at www.citibank.com.my NOTE: Any non-disclosure of agree complete and accurate information may impact thethan Bank's decision onwhich your application, including the financing rate and the approval of your application is at the Principal Cardmember(s) exceed the credit limit/total surname) credit limit and/or the Supplementary Mrs Ms Full name as in NRICto or passport (underline : Mr credit card issuers (including Bank asapply an issuer), I undertake to comply For discretion. fresh applicants, youthe may only for RC PayLite or RC BTI with and the notMaximum both. Issuer Bank's Cardmember(s) to exceed the Supplementary Card(s) limit (if a separate credit limit is assigned) Restriction effective 1 January 2012. Principal Card The RC Amount transferred will be subject Handphone to Effective Interest 5.9% to 9.9% per annum from the of approval and will be computed based on a no. : Rate (E.I.R.) ranging between Home tel BTI no. : applicants at the Banks discretion as we deem fit. (8)date The Principal Cardmember(s) and the Supplementary For banks use CREDIT CARD - OVERLIMIT OPTION 7 monthly reducing balance repayment method. signature for BT : Cardmember(s) will beonly bound by the Citibank Card Terms and Conditions. (9) I have received, Terms and - Conditions ( Sign in black ink only) BT Code Applicant may apply to transfer balances from not thanand 3 credit card/charge card held in other banks. read accounts and understood the contents of the Product Disclosure Sheet. IMPORTANT: You are deemed to haveoutstanding accepted Citibank Card Terms and more Conditions are bound by Residential address :BEYOND FLEXIBILITY YOUR CREDIT Approval of TO theSPEND RC BTI application is subject to LIMIT Citibanks discretion as As we deem fit. them once you start using your Citibank Berhad VISA Card or MasterCard (Card). such, you should Citibanks Privacy Notice read these and and the terms conditions for specific Card-type, RC whichever I terms want theI conditions flexibility to spend beyond myand credit limit. By YES! signing below, hereby agree to relevant abide by the terms and conditions governing BTI, the full Name set of which is available at www.citibank.com.my Keeping personal data individuals is a top to appear on of card (max. secure 19 letters) : priority for all of us at Citibank. Please visit 14 CREDIT If YOUR OPTIONAL CREDIT SHIELD PREMIER is applicable, available online at www.citibank.com.my prior to usage of CARD the Card. you require a us at www.citibank.com.my/privacyEng to view our Notice and Choice Principle Statement printed copy, kindly contact us Forwe banks use only Note: where seek to outline how we intend to deliver all the rights and protections that you are Applicants signature : to request a copy or call Citibank Phone Banking at 03-2383 0000. (1) Usage of the card is governed byCitibank the Citibank Card Terms and and the relevant terms and entitled to inRC respect your personal data. of age and in good health and have not been 1. applicable if your annual income is RM36,000 per Conditions annum or less. (Not Sign in Iblack ink only) BTI Code YES! wish to protect my Credit Card Outstanding Balance with Credit Shield Premier. I declare that of I am under 60 years conditions for specific Card-type, whichever is applicable, and is binding on the Principal m m y y y y 2. Asuffering fee of RM25 will be charged when your totalpressure, outstanding balance exceeds yourdisease, credit limit. Date of birth : d d from disease, high blood stroke, hepatitis, kidney Cardmember(s) and any the heart Supplementary Cardmembers). (2) The Principal Cardmember shall be diabetes, cancer or any other serious illness or physical disability. I acknowledge and confirm that I have understood the essential information on the major benefits and exclusions of Credit Shield Nationality : Premier, which have been summarized but are not exhaustive in the responsible for allfully liabilities and obligations of the Principal Cardmember as well as the Supplementary FEES AND CHARGES Applicants signature : me. A Certificate of Insurance with terms and conditions, a Citibank Credit Card Product Disclosure Sheet and/or any Credit Shield Product Disclosure Sheet presented to Cardmember(s). The Principal Cardmember is jointly and severally to us for allPremier amounts and State : Postcode :liable 8 TRANSACTION NOTIFICATIONS (FOR CREDIT CARD ONLY) New NRIC no. oronly) passport no. : cover and that Old no. : ( Sign inbe black ink welcome letter and will be sent to me upon my enrolment. I understood that I will entitled to 30 days free if NRIC I am not satisfied with the policy, I charges due and owing tonomination us from the form use by the Supplementary Cardmember(s) of his/her own Please refer to the respective Product Disclosure Sheet (PDS) for Citibank Credit Cards or Citibank Ready Credit. y y Residence : Owned Parents Employers Living forCard(s) : Citibank Supplementary Card(s). (3) Any Card(s) to me/us, including Supplementary mustyears not be can cancel the insurance fromissued its inception by giving written notice to Bhd within 15 days from the delivery date of the Certificate of Insurance. For your security, Citibank will notify you via SMS of certain transactions made on your Citibank credit card(s). used by me/us for any unlawful activity orby purpose (including without limitation online gambling), Rented Mortgaged Handphone no. : Home tel no. : The general information provided Citibank in this Application Form is valid as at 7 March 2013. applications: I understand that if I am submitting whether whole or part. (4)notifications, For principal card Yes, Iin want to receive but please notify me viaDivorced E-mail instead. (Email address to follow details above) - provided Single Married Widowed Marital status : Supplementary card Principal Card : this application for applicants more than one signature or multiple Citibank credit cards, I may be participating in I in do not to receive notification and understand thatgiven detection of potential unauthorized transactions may not be as effective & timely. ( No, Sign black ink only) Applicant : more than onewant Citibank creditany card promotion in Iwhich gifts are for successfully Residential address : Bank name : Type of account : ( Sign in black ink only) approved applications. In such event, I hereby CONFIRM that I am the only one entitled to Note: the gift from only ONE of such promotions, regardless of the number of Citibank credit receive Important Notes: Optionthat selected above will apply to allFor credit applied for above and for any existing credit card(s) you may have with Citibank cards are successfully approved. thiscard(s) purpose, and subject to Citibanks approval d d mought m to know. y y Otherwise y y 1. Pursuant to Section 149(4) of the Insurance Act 1996, you are to disclose in this of application form and faithfully all facts which you know or the Date of fully application (Mandatory) : my applications, my preference of the gift is as indicated on page 1. of Insurance issuedYOUR under the policy may be null void. This insurance plan is limited to principal cardmembers below the age of 60 years. 2 Certificate TELL US ABOUT EMPLOYMENT ORand BUSINESS 2. This application form for Credit Shield Premier ( should be read in conjunction with Credit Shield Premier marketing materials. PUBLIC FIGURE DECLARATION FOR PRINCIPAL CARD AND PUBLIC FIGURE DECLARATION ( FOR SUPPLEMENTARY CARD) FOR BANK USE ONLY 9 10 19 DECLARATION FOR CITIBANK READY CREDIT (CRC FACILITY) 3. Credit Premier is underwritten by ING Insurance Berhad (17007-P) CITIBANK CREDIT) (e.g. ministerial/diplomatic positions) (e.g. ministerial/diplomatic positions) Name of Shield employer :READY Applicants name : (a) This application form is not to be construed as a contract of insurance. The precise terms, conditions and definitions of this plan are specified in the policy contract issued by ING I hereby declare, acknowledge, agree and conrm as are follows: Insurance Berhad. (b) family These insurance products obligation only of the insurance company. They bank deposits or obligations of or currently guaranteed by Citibank State :are not Postcodehold/seeking : Citibank Berhad, currently hold/seeking held have held Yes, I/my immediate Yes, I/my immediate family members (1) I have been informed that I ammembers required to read and understand the Terms and have Conditions N.A., Citigroup Inc. or any of their affiliates or subsidiaries. (c) This document does not constitute the making of any offer or invitation to subscribe for insurance products nor does it . (2) I understand that set out in the Citibank Credit Customers Terms and Conditions Senior public ofceReady : Senior public ofce : I wish to assign monthly spend limit of RM to solicitation by is Citibank Berhad, Citibank N.A., Citigroup Inc. or any of their affiliates YES, or subsidiaries for subscription of insurance products by anyone in any jurisdictions in theamount usage the CRC Facility also Terms Work tel. of no. (general line) : subject to the respective Extension no. and : Conditions applicable the making of suchGIRO offer and or invitation subscribe or the solicitation thereof is not authorised or to any person to whom it is unlawful to make such invitation or solicitation. to which Citibank Online, Citibank Citibankto Rewards Program found at your website Reminder: The total combined spend cannot exceed offer the principal cardmember Applicants NRIC no. : - document also (www.citibank.com.my) or made available at any Citibank branches nationwide or any (d) This does not constitute the distribution of any information byother any one incurrent any jurisdiction such distribution is notVISA authorised or to any person to whom it Position held : Position held :in which approved credit line. CitiBusiness Requirement For employees means, as the case may be, and I agree to read, understand and be bound by such Terms and Nature of Business : of RM24,000 per annum and minimum age of 21. is unlawful to: distribute such a document. Work address only: minimum income Conditions. By signing below, I conrm that (i) I have read and agree to abide by the provisions contained in Box 17 above and this Box 19. (ii) My minimum income is RM24,000 per annum or FOR d I acknowledge d use only m m:that Iyhave y received, m m m m y y BANK d ONLY m m y y From to d dread and From d d to d USE more. (iii) understood the the For banks 8 A y 0y 0contents 0 0of 4 Salaried Self-Employed CSP source codeCredit Product Disclosure Sheet. (iv) Please note that this signature will be Citibank Ready PV B06 B33 B35 B55 B44 my authorised signature for the opening and operation of my Citibank Ready Credit account. Position Held :FOR EXISTING AZPRINCIPAL PP RJ___ D___ OPTIONAL CREDIT CARD LINE TRANSFER TO CITIBANK READY CREDIT (CRC FACILITY) CITIBANK CREDIT CARDMEMBERS 11 State : Privacy Notice Postcode : Citibanks Source of Funds/Wealth: RM per annum Keeping personalacknowledge, data of individuals is a top I hereby declare, agreesecure and conrm as priority follows:for all of us at Citibank. Please Nature of business : Payroll Biz Income Other : (please specify) visit us an atexisting www.citibank.com.my/privacyEng to a view our Notice and Choice (1) I am principal credit cardmember of valid Citibank credit card(s) and IPrinciple wish to request for Credit Card Line Transfer to accommodate my application for CRC Facility, only if deemed Statement where on weyour seek to outline how we intend deliver all the rights and protections necessary: based credit evaluation of my CRC to Facility application. (2) By signing below, I agree and consent to your reducing and transferring the unutilised portion of the total credit limit Position that you are entitled in respect of your data. of my Citibank creditto card(s) (which mustpersonal not be less than RM3,000, but up to the maximum amount assigned in the box below) to accommodate my application for CRC Facility, if applicable, Agent code source code card(s)) may affect my CRC Account subject always credit evaluation and your discretion (Transfer Amount). (3) I acknowledge that transactions onno. my :Citibank credit cards (includingCard Supplementary Date joined / to Date business established : application for CRC Facility, the Transfer Amount and/or future transactions on my credit cards due to utilisation of the Transfer Amount and I will not hold you liable if the transactions on my no. : Citibanksalary credit signature card(s) are declined (including auto-billing services) or if my credit card(s) goes overCustomer limit when the Credit Card Line Transfer has been effected. (4) I also acknowledge that once Annual or income Applicants :: the Transfer Amount is effected via Credit Card Line Transfer on my principal Credit Card(s), the credit limit of Supplementary Card(s) may have to be reduced and it is my sole responsibility to ( Sign in black ink only) RC source code Loc/Gift code assign a fresh credit limit for my Supplementary Cardmember(s) (if applicable) and to inform my Supplementary Cardmember(s) accordingly. Signature updated by : Form Filled Up By Staff Applicant Date of application (Mandatory) : d signature d m m y y y y Date of application (Mandatory) : Applicants : d d m m y y y y RM ( Sign in black ink only) The general information provided by Citibank in this Application Form is Signature authorised by : valid as at 7 March 2013.

NON-FTF (March 2013)

17 15 5

OPTIONAL CARD PRODUCTS CONSENT FOR CITI PRESTIGE GLOBAL CONCIERGE GENERAL DECLARATION FOR CITIBANK CREDIT CARD & CITIBANK READY CREDIT CITIBANK READY CREDIT PAYLITE

CREDIT CARD -Bank) BALANCE TRANSFER VIA INSTALMENT PLAN (BTI) 12 I/Wesigning herebyIdeclare, acknowledge, and conrm as follows: performance of its/their operational functions (whether within or outside Malaysia), in By below, I hereby (1) authorise Citibank Berhad (the toas disclose my personal data, such as my name, address(es), contact numbers, e-mail YES! wish to apply foragree Citibank Ready Credit PayLite (RC PayLite) per details provided below. connection with this application or any of products, service or accommodation I/weConcierge have or may 1. I/We warrant and that all information furnished here is to true, accurate and not misleading. address(es) information pertaining this application to TEN Lifestyle Management Ltd (TEN) for purposes providing Citi Prestige Global have with the Bank, for confidential use, processing this application, data processing, credit 2. I/We services to me, (2) understand thatat any personal data provided by the Bank (BTI) to TEN shall also be subject to theTenure TENs privacy policy of which details can be authorise Citibank Berhad (the Bank), any time and from time to time to process including evaluation, meeting legal and regulatory requirements, for provision of goods or services, YES! I wish to apply for Citibanks Balance Transfer via Instalment Plan as per(RM) details provided below. Bank Current/Savings Account No. Amount (Min. RM1,000) but notat limited to access, obtain, verify and/or use, any data information from any source located http://www.tenlifestyle.com/privacy andor to the full extent permitted by law, the Bank not any be liable forservice any unauthorised disclosure of personal marketing and shall promoting products, and/or accommodation to me/us, provision of services such protection plans or insurance policies where applicable (including (including credit of reference agencies, credit reporting agencies, Bank Negara Malaysia data or breach confidentiality, and (3) agree to indemnify and hold (BNM), the Bank harmless against anyas liability to the full extent permitted by law arising from the Bank Card/Account No. Amount (RM) (Min. RM1,000) Tenure 12, 18, 24, 30 or 36 months) assessing, processing and investigating any risks(6, or 9, claims), fulfillment and delivery of gifts the credit of bureau the Central disclosure my and/or personal data. Credit Reference Information System (CCRIS) and such to me/us in connection with this application, my/our Card(s) and/or CRC Facility, the Card relevant authorities) for purposes of evaluating my/our credit standing in connection to me/us, this Terms and Conditions and/or Citibank Date of application (Mandatory) : Ready Credit Customers Terms and Conditions and all application and any facility, service or accommodation I/we have or may have (whether or not with other purposes incidental and associated with any of the above. Applicants signature : the Bank) as the Banks discretion deems t. I/We understand that this application, the opening, d d declare m m y spouse(s), y y ychildren or parents (if any) is/are not employee(s) or director(s) 4. I/We that my/our ( Sign in black only) of my/our Card Account, CRC Account and any future facility, service or operation andink conduct Important Note: applied by me/us or granted by you (whether in my sole name or jointly with of the Bank in compliance with the Banking and Financial Institutions Act, 1989 (BAFIA). I/We also accommodation declare and understand that my/our application is subject to non-applicability of the restrictions For fresh or applicants, you maythe only apply for RC PayLite or RC BTI and notor both. another others, including Supplementary Cardmember(s), presently subsequently DECLARATION OF DEBT OBLIGATIONS WITH of NON-BANKS 6 found in Section BAFIA and provided that I/we am/are not in breach of or in contravention of Important Note: opened) may be reported to the Dishonoured Cheques System Rate (DCHEQS) The PayLite Amount disbursed will be subject to Information Effective Interest (E.I.R.)maintained ranging between 5.9% to 17.9% 62 per annum from the date of approval and will be computed based on a the laws of Malaysia, failing which, you are entitled to terminate my/our Card(s) and/or repayment CRC Facility. The amount transferred will be subject to Effective Interest Rate of 9.9% of approval and will be computed based on a monthly reducing balance by BNM, CCRIS and such relevant authorities (as the case may be) as(E.I.R) the Bank deemsper t. annum from the date monthly reducing balance repayment method. 5. I/We fully understand that the approval ofBy my/our application at the agree discretion as the Bank method. Applicant may apply to transfer outstanding balances from not more than 3 credit card/charge card accounts held in other Banks. signing below, I is hereby to abide by the I/We authorise the Bank to disclose, store, utilise and/or transfer my/our personal data such as my/our 3. Amount of each monthly Outstanding The PayLite amountgoverning will only be transferred toof your Current or Savings account maintained in your deems sole name. Transfers to any joint accounts or third party accounts are notFacility allowed. fit and you may at time terminate my/our Cards(s) and/or CRC with notice. terms and conditions BTI, the full set which is available on www.citibank.com.my name, address(es), contact numbers, information obtained from credit reference agencies, credit (RM) as Balance (RM) Type of Debt Obligations Name of actions, Non-Bank Approval of the RC BNM, PayLite isInstalment/Payment subject tosuch Citibanks discretion we deem fit. keep you fully indemnified against any claims, proceedings, losses, 6. I/We will Capacity reporting agencies, the application credit bureau, CCRIS and relevant authorities pertaining to this banks use only damages, costs and charges as a result of using and/or in connection with the Information, Principal Card applicants signature application and/or facility, service or accommodation applied by me/us or granted byRC thePayLite, Bank the full For By signing below, I any hereby agree to abide by: the terms and conditions governing set of which is available at www.citibank.com.my Card(s), Citibank Card Terms and Conditions, CRC Facility, Citibank Ready Credit Customers in ink my only) sole name or jointly with another or others, including the Supplementary ( (whether Sign in black BTI Code Self Joint Guarantor Terms and Conditions and all relevant agreements, covenants and undertakings by me. For banks use only Cardmember(s), presently: or subsequently opened) and whether within or outside Malaysia Applicants signature (Information) to/with Citibank Berhad, Citibank N.A., Citigroup Inc. or any of your/their ofces, 7. I/We expressly consent to the mailing of my/our Card(s), Debit & ATM Card, the Citibank Card ( Sign in black ink only) RC PayLite Code Services Association, Terms and Conditions, the relevant Terms and Conditions for specific Card-type (if applicable), CREDIT CARD BALANCE TRANSFER (BT) 13 afliates or subsidiaries (collectively Citigroup), merchants, VISA International Self Joint Guarantor MasterCard International Incorporated, any vendors and/or third party service providers engaged by the and/or Citibank Ready Credit Customers Terms and Conditions to my/our address(es) provided Bank and/or Citigroup, including any person to whom the Bank and/or Citigroup has outsourced the here if my/our application is successfully approved. 16 YES! I wish to apply for Citibanks Balance CITIBANK READY CREDIT BALANCE TRANSFER Transfer (BT) as per details provided below. VIA INSTALMENT PLAN Self Joint Guarantor 18 DECLARATION FOR CREDIT CARD Bank Credit/Charge Card Account No. Transfer via Instalment Amount (RM) (Min. RM1,000) Tenure (6, 9, 12, 18, 24, 30 or 36 months) YES! I wish to apply for Citibank Ready Credit Balance Plan (RC BTI) as per details provided below. By signing below, I conrm that (1) I have read and agree to abide by the provisions contained in SPECIFIC DECLARATION FOR PRINCIPAL CARD APPLICANTS Box 17 above and this Box 18. (2) My minimum The Bank has informed me and I fully understandCard that inAccount accordance with prevailing Bank Negara Bank Credit/Charge No. Amount (RM) (Min. RM1,000) Tenureincome is RM24,000 per annum or more. (3) For CitiBusiness Card application, my business sales turnover is RM120,000 per annum or more (N/A TOTAL Malaysia Guidelines, if my annual income is RM36,000 or less, I can only hold credit cards as a if Business Platinum card applicant is salaried). (4) My signature below constitutes a request for Principal Cardmember from a maximum of two (2) credit card issuers (Maximum Issuer Restriction). Citibank VISA credit card if I already have a Citibank MasterCard and vice versa, if applicable. (5) Upon the issuance Important Note: by the Bank of the credit card(s) applied for under this application, I declare that My list signature a request forrepayment Gold/Classic Card if I do not qualify for Platinum/Gold so long as the Maximum Issuer Restriction to me: we would like to understand you more. Please To better facilitate the processing of yourapplies application, down constitutes all your monthly loan obligations from Non-banks, inclusive Card. of both Important Note: credit cards from a maximum of two (2) credit card issuers (including the Bank (6) obligations. The PrincipalUnder and Supplementary will jointly and severally liable to the (1) I willand be holding secured unsecured financing. The total amount must include a combination of individual and joint joint capacity, Cardmember(s) you are required to be apportion your monthly commitment Bank for all amounts and charges due and owing however arising from the use by the BT The Amount Transferred will be subject to a Special Interest Rate (i.e. Effective Interest Rate) for the Special Interest Rate Term and 18% per annum thereafter. an issuer); and monthly amount divided by the number of joint debtors involved e.g. RM3,000 per month with 3 joints debtors, hence RM1,000 per debtor. byas taking the total Supplementary Cardmember(s) of his own Supplementary Card(s). (7) The Bank may allow the (2) IAny am an existing Citibank Principal Cardmember holding credit cards from more two (2) Important Note: By If signing below, I hereby to abide by the terms and conditions governing BT, the full set of is available at www.citibank.com.my NOTE: non-disclosure of agree complete and accurate information may impact thethan Bank's decision onwhich your application, including the financing rate and the approval of your application is at the Principal Cardmember(s) to exceed the credit limit/total credit limit and/or the Supplementary credit card issuers (including Bank asapply an issuer), I undertake to comply For discretion. fresh applicants, youthe may only for RC PayLite or RC BTI with and the notMaximum both. Issuer Bank's Cardmember(s) to exceed the Supplementary Card(s) limit (if a separate credit limit is assigned) Restriction effective 1 January 2012. Principal Card applicants The RC BTI Amount transferred will be subject to Effective Interest Rate (E.I.R.) ranging between 5.9% to 9.9% per annum from the of approval and will be computed based on a at the Banks discretion as we deem fit. (8)date The Principal Cardmember(s) and the Supplementary For banks use CREDIT CARD - OVERLIMIT OPTION 7 monthly reducing balance repayment method. signature for BT : Cardmember(s) will beonly bound by the Citibank Card Terms and Conditions. (9) I have received, Terms and Conditions ( Sign in black ink only) BT Code Applicant may apply to transfer balances from not thanand 3 credit card/charge card held in other banks. read accounts and understood the contents of the Product Disclosure Sheet. IMPORTANT: You are deemed to haveoutstanding accepted Citibank Card Terms and more Conditions are bound by FLEXIBILITY BEYOND YOUR CREDIT Approval of TO theSPEND RC BTI application is subject to LIMIT Citibanks discretion as As we deem fit. them once you start using your Citibank Berhad VISA Card or MasterCard (Card). such, you should Citibanks Privacy Notice read these and and the terms conditions for specific Card-type, RC whichever I terms want theI conditions flexibility to spend beyond myand credit limit. By YES! signing below, hereby agree to relevant abide by the terms and conditions governing BTI, the full set of which is available www.citibank.com.my Keeping personal data ofat individuals secure is a top priority for all of us at Citibank. Please visit 14 CREDIT If YOUR OPTIONAL CREDIT SHIELD PREMIER is applicable, available online at www.citibank.com.my prior to usage of CARD the Card. you require a us at www.citibank.com.my/privacyEng to view our Notice and Choice Principle Statement printed copy, kindly contact us Forwe banks use only Note: where seek to outline how we intend to deliver all the rights and protections that you are Applicants signature : to request a copy or call Citibank Phone Banking at 03-2383 0000. (1) Usage of the card is governed byCitibank the Citibank Card Terms and and the relevant terms and entitled to inRC respect your personal data. of age and in good health and have not been 1. applicable if your annual income is RM36,000 per Conditions annum or less. (Not Sign in Iblack ink only) BTI Code YES! wish to protect my Credit Card Outstanding Balance with Credit Shield Premier. I declare that of I am under 60 years conditions for specific Card-type, whichever is applicable, and is binding on the Principal 2. Asuffering fee of RM25 will be charged when your totalpressure, outstanding balance exceeds yourdisease, credit limit. from any heart disease, high blood stroke, hepatitis, kidney Cardmember(s) and the Supplementary Cardmembers). (2) The Principal Cardmember shall be diabetes, cancer or any other serious illness or physical disability. I acknowledge and confirm that I have understood the essential information on the major benefits and exclusions of Credit Shield Premier, which have been summarized but are not exhaustive in the responsible for allfully liabilities and obligations of the Principal Cardmember as well as the Supplementary FEES AND CHARGES Applicants signature : me. A Certificate of Insurance with terms and conditions, a Citibank Credit Card Product Disclosure Sheet any Credit Shield Product Disclosure Sheet presented to Cardmember(s). The Principal Cardmember is jointly andand/or severally liable to us for allPremier amounts and 8 TRANSACTION NOTIFICATIONS (FOR CREDIT CARD ONLY) ( Sign inbe black ink only) welcome letter and nomination form will be sent to me upon my enrolment. I understood that I will entitled to 30 days free cover and that if I am not satisfied with the policy, I charges due and owing to us from the use by the Supplementary Cardmember(s) of his/her own Please refer to the respective Product Disclosure Sheet (PDS) for Citibank Credit Cards or Citibank Ready Credit. Supplementary Card(s). (3) Any Card(s) to me/us, including Supplementary must not be can cancel the insurance fromissued its inception by giving written noticeCard(s) to Citibank Bhd within 15 days from the delivery date of the Certificate of Insurance. For your security, will activity notify you via SMS of certain transactions made on your Citibank credit card(s). used by me/us for Citibank any unlawful orby purpose (including without limitation online gambling), The general information provided Citibank in this Application Form is valid as at 7 March 2013. applications: I understand that if I am submitting whether whole or part. (4)notifications, For principal card Yes, Iinwant to receive but please notify me via E-mail instead. (Email address to follow details provided above) Supplementary card Principal Card : this application for applicants more than one signature or multiple Citibank credit cards, I may be participating in No, I do not want to receive any notification and I understand that detection of potential unauthorized transactions may not be as effective & timely. ( Sign in black only) credit card promotion in which gifts are given for successfully Applicant : more than one ink Citibank
( Sign in black ink only) approved applications. In such event, I hereby CONFIRM that I am the only one entitled to Note: the gift from only ONE of such promotions, regardless of the number of Citibank credit receive Important Notes: Optionthat selected above will apply to allFor credit applied for above and for any existing credit card(s) you may have with Citibank cards are successfully approved. thiscard(s) purpose, and subject to Citibanks approval d d mought m to know. y y Otherwise y y 1. Pursuant to Section 149(4) of the Insurance Act 1996, you are to disclose in this of application form and faithfully all facts which you know or the Date of fully application (Mandatory) : my applications, my preference of the gift is as indicated on page 1. Certificate of Insurance issued under the policy may be null and void. This insurance plan is limited to principal cardmembers below the age of 60 years. 2. This application form for Credit Shield Premier ( should be read in conjunction with Credit Shield Premier marketing materials. PUBLIC FIGURE DECLARATION FOR PRINCIPAL CARD AND PUBLIC FIGURE DECLARATION ( FOR SUPPLEMENTARY CARD) FOR BANK USE ONLY 9 10 19 DECLARATION FOR CITIBANK READY CREDIT (CRC FACILITY) 3. Credit Shield Premier is underwritten by ING Insurance Berhad (17007-P) CITIBANK READY CREDIT) (e.g. ministerial/diplomatic positions) (e.g. ministerial/diplomatic positions) Applicants name : (a) This application form is not to be construed as a contract of insurance. The precise terms, conditions and definitions of this plan are specified in the policy contract issued by ING I hereby declare, acknowledge, agree and conrm as are follows: Insurance Berhad. (b) family These insurance products obligation only of the insurance company. They are not bank deposits or obligations of or currently guaranteedhold/seeking by Citibank Berhad, Citibank currently hold/seeking held have held Yes, I/my immediate Yes, I/my immediate family members (1) I have been informed that I ammembers required to read and understand the Terms and have Conditions N.A., Citigroup Inc. or any of their affiliates or subsidiaries. (c) This document does not constitute the making of any offer or invitation to subscribe for insurance products nor does it . (2) I understand that set out in the Citibank Credit Customers Terms and Conditions Senior public ofceReady : Senior public ofce : to solicitation by is Citibank Berhad, Citibank N.A., Citigroup Inc. or any of their affiliates or subsidiaries for subscription of insurance products by anyone in any jurisdictions in theamount usage of the CRC Facility also subject to the respective Terms and Conditions applicable the making of suchGIRO offer and or invitation subscribe or the solicitation thereof is not authorised or to any person to whom it is unlawful to make such offer invitation or solicitation. to which Citibank Online, Citibank Citibankto Rewards Program found at your website Applicants NRIC no. : (www.citibank.com.my) or made available at any Citibank branches nationwide or any (d) This document also does not constitute the distribution of any information byother any one in Position any jurisdiction Position held : held :in which such distribution is not authorised or to any person to whom it means, as the case may be, and I agree to read, understand and be bound by such Terms and Nature of Business : is unlawful to distribute such a document. Conditions. By signing below, I conrm that (i) I have read and agree to abide by the provisions contained in Box 17 above and this Box 19. (ii) My minimum income is RM24,000 per annum or d I acknowledge d use only m m:that Iyhave y received, m m m m y y to d d m m y y From to d dread and From d d more. (iii) understood the the For banks 8 A y 0y 0contents 0 0of 4 Salaried Self-Employed CSP source codeCredit Product Disclosure Sheet. (iv) Please note that this signature will be Citibank Ready my authorised signature for the opening and operation of my Citibank Ready Credit account. Position Held :FOR EXISTING PRINCIPAL CITIBANK CREDIT CARDMEMBERS OPTIONAL CREDIT CARD LINE TRANSFER TO CITIBANK READY CREDIT (CRC FACILITY) 11 Citibanks Privacy Notice Source of Funds/Wealth: RM per annum Keeping personalacknowledge, data of individuals is a top I hereby declare, agreesecure and conrm as priority follows:for all of us at Citibank. Please Payroll Biz Income Other : (please specify) visit us an atexisting www.citibank.com.my/privacyEng to a view our Notice and Choice (1) I am principal credit cardmember of valid Citibank credit card(s) and IPrinciple wish to request for Credit Card Line Transfer to accommodate my application for CRC Facility, only if deemed Statement where on weyour seek to outline how we intend deliver all the rights and protections necessary based credit evaluation of my CRC to Facility application. (2) By signing below, I agree and consent to your reducing and transferring the unutilised portion of the total credit limit that you are entitled in respect of your data. of my Citibank creditto card(s) (which mustpersonal not be less than RM3,000, but up to the maximum amount assigned in the box below) to accommodate my application for CRC Facility, if applicable, CRC Account subject always to credit evaluation and your discretion (Transfer Amount). (3) I acknowledge that transactions onno. my :Citibank credit cards (including Supplementary card(s)) may affect my application for CRC Facility, the Transfer Amount and/or future transactions on my credit cards due to utilisation of the Transfer Amount and I will not hold you liable if the transactions on my no. : Citibank credit signature card(s) are declined (including auto-billing services) or if my credit card(s) goes overCustomer limit when the Credit Card Line Transfer has been effected. (4) I also acknowledge that once Applicants : the Transfer Amount is effected via Credit Card Line Transfer on my principal Credit Card(s), the credit limit of Supplementary Card(s) may have to be reduced and it is my sole responsibility to ( Sign in black ink only) assign a fresh credit limit for my Supplementary Cardmember(s) (if applicable) and to inform my Supplementary Cardmember(s) accordingly. Signature updated by : Date of application (Mandatory) : d signature d m m y y y y Date of application (Mandatory) : Applicants : d d m m y y y y RM ( Sign in black ink only) The general information provided by Citibank in this Application Form is Signature authorised by : valid as at 7 March 2013.

NON-FTF (March 2013)

17 15

OPTIONAL CARD PRODUCTS GENERAL DECLARATION FOR CITIBANK CREDIT CARD & CITIBANK READY CREDIT CITIBANK READY CREDIT PAYLITE

CREDIT CARD - PayLite) BALANCE TRANSFER VIA INSTALMENT (BTI) 12 I/We YES! herebyIdeclare, acknowledge, and conrm as follows: performance of its/their PLAN operational functions (whether within or outside Malaysia), in wish to apply foragree Citibank Ready Credit PayLite (RC as per details provided below. connection with this application or any products, service or accommodation I/we have or may 1. I/We warrant that all information furnished here is true, accurate and not misleading. have with the Bank, for confidential use, processing this application, data processing, credit 2. I/We authorise Citibank Berhad (the Bank), at any time and from time to time to process including evaluation, meeting legal and regulatory requirements, for provision of goods or services, YES! I wish to apply for Citibanks Balance Transfer via Instalment Plan (BTI) as per(RM) details provided below. Bank Current/Savings Account No. Amount (Min. RM1,000) Tenure but not limited to access, obtain, verify and/or use, any data or information from any source marketing and promoting any products, service and/or accommodation to me/us, provision of services such as protection plans or insurance policies where applicable (including (including credit reference agencies, credit reporting agencies, Bank Negara Malaysia (BNM), Bank Card/Account No. Information System (CCRIS) and such Amount (RM) (Min. RM1,000) Tenure 12, 18, 24, 30 or 36 months) assessing, processing and investigating any risks(6, or 9, claims), fulfillment and delivery of gifts the credit bureau and/or the Central Credit Reference to me/us in connection with this application, my/our Card(s) and/or CRC Facility, the Card relevant authorities) for purposes of evaluating my/our credit standing in connection to me/us, this Terms and Conditions and/or Citibank Ready Credit Customers Terms and Conditions and all application and any facility, service or accommodation I/we have or may have (whether or not with other purposes incidental and associated with any of the above. the Bank) as the Banks discretion deems t. I/We understand that this application, the opening, 4. I/We declare that my/our spouse(s), children or parents (if any) is/are not employee(s) or director(s) operation and conduct of my/our Card Account, CRC Account and any future facility, service or Important Note: applied by me/us or granted by you (whether in my sole name or jointly with of the Bank in compliance with the Banking and Financial Institutions Act, 1989 (BAFIA). I/We also accommodation declare and understand that my/our application is subject to non-applicability of the restrictions For fresh or applicants, you maythe only apply for RC PayLite or RC BTI and notor both. another others, including Supplementary Cardmember(s), presently subsequently found in Section 62 of BAFIA and provided that I/we am/are not in breach of or in contravention of Important Note: opened) may be reported to the Dishonoured Cheques System Rate (DCHEQS) The PayLite Amount disbursed will be subject to Information Effective Interest (E.I.R.)maintained ranging between 5.9% to 17.9% per annum from the date of approval and will be computed based on a the laws of Malaysia, failing which, you are entitled to terminate my/our Card(s) and/or repayment CRC Facility. The amount transferred will be subject to Effective Interest Rate of 9.9% of approval and will be computed based on a monthly reducing balance by BNM, CCRIS and such relevant authorities (as the case may be) as(E.I.R) the Bank deemsper t. annum from the date monthly reducing balance repayment method. 5. I/We fully understand that approval ofBy my/our application at the agree discretion as the Bank method. Applicant may apply to transfer outstanding balances from not more than 3 credit card/charge card accounts held inthe other Banks. signing below, I is hereby to abide by the I/We authorise the Bank to disclose, store, utilise and/or transfer my/our personal data such as my/our 3. The PayLite amountgoverning will only be transferred toof your Current or Savings account maintained in your deems sole name. Transfers to any joint accounts or third party accounts are notFacility allowed. fit and you may at time terminate my/our Cards(s) and/or CRC with notice. terms and conditions BTI, the full set which is available on www.citibank.com.my name, address(es), contact numbers, information obtained from credit reference agencies, credit Approval the RC BNM, PayLite is CCRIS subject tosuch Citibanks discretion we deem fit. 6. I/We will keep you fully indemnified against any claims, actions, proceedings, losses, reporting of agencies, the application credit bureau, and relevant authorities as pertaining to this banks use only damages, costs and charges as a result of using and/or in connection with the Information, Principal Card applicants signature application and/or facility, service or accommodation applied by me/us or granted byRC thePayLite, Bank the full For By signing below, I any hereby agree to abide by: the terms and conditions governing set of which is available at www.citibank.com.my Card(s), Citibank Card Terms and Conditions, CRC Facility, Citibank Ready Credit Customers in ink my only) sole name or jointly with another or others, including the Supplementary ( (whether Sign in black BTI Code Terms and Conditions and all relevant agreements, covenants and undertakings by me. For banks use only Cardmember(s), presently: or subsequently opened) and whether within or outside Malaysia Applicants signature (Information) to/with Citibank Berhad, Citibank N.A., Citigroup Inc. or any of your/their ofces, 7. I/We expressly consent to the mailing of my/our Card(s), Debit & ATM Card, the Citibank Card ( Sign in black ink only) RC PayLite Code Services Association, Terms and Conditions, the relevant Terms and Conditions for specific Card-type (if applicable), CREDIT CARD BALANCE TRANSFER (BT) 13 afliates or subsidiaries (collectively Citigroup), merchants, VISA International MasterCard International Incorporated, any vendors and/or third party service providers engaged by the and/or Citibank Ready Credit Customers Terms and Conditions to my/our address(es) provided Bank and/or Citigroup, including any person to whom the Bank and/or Citigroup has outsourced the here if my/our application is successfully approved. 16 YES! I wish to apply for Citibanks Balance CITIBANK READY CREDIT BALANCE TRANSFER Transfer (BT) as per details provided below. VIA INSTALMENT PLAN 18 DECLARATION FOR CREDIT CARD Bank Credit/Charge Card Account No. Transfer via Instalment Amount (RM) (Min. RM1,000) Tenure (6, 9, 12, 18, 24, 30 or 36 months) YES! I wish to apply for Citibank Ready Credit Balance Plan (RC BTI) as per details provided below. By signing below, I conrm that (1) I have read and agree to abide by the provisions contained in SPECIFIC DECLARATION FOR PRINCIPAL CARD APPLICANTS Box 17 above and this Box 18. (2) My minimum The Bank has informed me and I fully understandCard that inAccount accordance with prevailing Bank Negara Bank Credit/Charge No. Amount (RM) (Min. RM1,000) Tenureincome is RM24,000 per annum or more. (3) For CitiBusiness Card application, my business sales turnover is RM120,000 per annum or more (N/A Malaysia Guidelines, if my annual income is RM36,000 or less, I can only hold credit cards as a if Business Platinum card applicant is salaried). (4) My signature below constitutes a request for Principal Cardmember from a maximum of two (2) credit card issuers (Maximum Issuer Restriction). Citibank VISA credit card if I already have a Citibank MasterCard and vice versa, if applicable. (5) Upon the issuance by the Bank of the credit card(s) applied for under this application, I declare that My signature constitutes a request for Gold/Classic Card if I do not qualify for Platinum/Gold Card. so long as the Maximum Issuer Restriction applies to me: Important Note: credit cards from a maximum of two (2) credit card issuers (including the Bank (6) The Principal and Supplementary Cardmember(s) will be jointly and severally liable to the (1) I will be holding Bank forSpecial all amounts and charges due 18% and per owing however arising from the use by the BTan The Amount for the Interest Rate Term and annum thereafter. as issuer); and Transferred will be subject to a Special Interest Rate (i.e. Effective Interest Rate) Supplementary Cardmember(s) of his own Supplementary Card(s). (7) The Bank may allow the (2) I am anbelow, existing Citibankagree Principal Cardmember holding credit cards from more than two Important Note: By If signing I hereby to abide by the terms and conditions governing BT, the(2) full set of which is available at www.citibank.com.my Principal Cardmember(s) to exceed the credit limit/total credit limit and/or the Supplementary credit issuers (including Bank asapply an issuer), I undertake to comply For card fresh applicants, youthe may only for RC PayLite or RC BTI with and the notMaximum both. Issuer Cardmember(s) to exceed the Supplementary Card(s) limit (if a separate credit limit is assigned) Restriction effective 1 January 2012. Principal Card applicants The RC BTI Amount transferred will be subject to Effective Interest Rate (E.I.R.) ranging between 5.9% to 9.9% per annum from the of approval and will be computed based on a at the Banks discretion as we deem fit. (8)date The Principal Cardmember(s) and the Supplementary For bankswill use monthly reducing balance repayment method. signature for BT : Cardmember(s) beonly bound by the Citibank Card Terms and Conditions. (9) I have received, Terms and Conditions ( Sign in black ink only) BT Code Applicant may apply to transfer balances from not thanand 3 credit card/charge card held in other banks. read accounts and understood the contents of the Product Disclosure Sheet. IMPORTANT: You are deemed to haveoutstanding accepted Citibank Card Terms and more Conditions are bound by Approval of start the RC BTI application is subject to Citibanks discretion as As we deem fit. them once you using your Citibank Berhad VISA Card or MasterCard (Card). such, you should Citibanks Privacy Notice read these terms andI conditions and the terms conditions for specific Card-type, RC whichever By signing below, hereby agree to relevant abide by the and terms and conditions governing BTI, the full set of which is available www.citibank.com.my Keeping personal data ofat individuals secure is a top priority for all of us at Citibank. Please visit 14 CREDIT If YOUR OPTIONAL CREDIT SHIELD PREMIER is applicable, available online at www.citibank.com.my prior to usage of CARD the Card. you require a us at www.citibank.com.my/privacyEng to view our Notice and Choice Principle Statement printed copy, kindly contact us Forwe banks use only where seek to outline how we intend to deliver all the rights and protections that you are Applicants signature : to request a copy or call Citibank Phone Banking at 03-2383 0000. (1) Usage of the card is governed byCitibank the Citibank Card Terms and ConditionsBalance and the relevant terms and entitled to inRC respect your personal data. of age and in good health and have not been ( Sign in Iblack ink BTI Code YES! wish toonly) protect my Credit Card Outstanding with Credit Shield Premier. I declare that of I am under 60 years conditions for specific Card-type, whichever is applicable, and is binding on the Principal suffering from any heart disease, high blood pressure, stroke, hepatitis, kidney disease, Cardmember(s) and the Supplementary Cardmembers). (2) The Principal Cardmember shall be diabetes, cancer or any other serious illness or physical disability. I acknowledge and confirm that I have understood the essential information on the major benefits and exclusions of Credit Shield Premier, which have been summarized but are not exhaustive in the responsible for allfully liabilities and obligations of the Principal Cardmember as well as the Supplementary FEES AND CHARGES Applicants : me. A Certificate of Insurance with terms and conditions, a Citibank Credit Card Product Disclosure Sheet any Credit Shield Disclosure Sheet signature presented to Cardmember(s). The Principal Cardmember is jointly andand/or severally liable to us for allPremier amountsProduct and ( Sign inbe black ink only) welcome letter and will be sent to me upon my enrolment. I understood that I will entitled to 30 days free cover and that if I am not satisfied with the policy, I charges due and owing tonomination us from the form use by the Supplementary Cardmember(s) of his/her own Please referCard(s). to respective Product Disclosure Sheetnotice (PDS) for Citibank Credit Cards Citibank Ready Credit. Supplementary (3) Any Card(s) to me/us, including Supplementary Card(s) must not be can cancel thethe insurance fromissued its inception by giving written to Citibank Bhd within 15 daysor from the delivery date of the Certificate of Insurance. used by me/us for any unlawful activity or purpose (including without limitation online gambling), The general information provided by Citibank in this Application Form is valid as at 7 March 2013. whether in whole or part. (4) For principal card applications: I understand that if I am submitting Supplementary card Principal Card : this application for applicants more than one signature or multiple Citibank credit cards, I may be participating in ( Sign in black only) credit card promotion in which gifts are given for successfully Applicant : more than one ink Citibank ( Sign in black ink only) approved applications. In such event, I hereby CONFIRM that I am the only one entitled to receive the gift from only ONE of such promotions, regardless of the number of Citibank credit Important Notes: cards that are successfully approved. For this purpose, and subject to Citibanks approval of d d mought m to know. y y Otherwise y y 1. Pursuant to Section 149(4) of the Insurance Act 1996, you are to disclose in this application form and faithfully all facts which you know or the Date of fully application (Mandatory) : my applications, my preference of the gift is as indicated on page 1. Certificate of Insurance issued under the policy may be null and void. This insurance plan is limited to principal cardmembers below the age of 60 years. 2. This application form for Credit Shield Premier should be read in conjunction with Credit Shield Premier marketing materials. FOR BANK USE ONLY 19 DECLARATION FOR CITIBANK READY CREDIT (CRC FACILITY) 3. Credit Shield Premier is underwritten by ING Insurance Berhad (17007-P) Applicants name : (a) This application form is not to be construed as a contract of insurance. The precise terms, conditions and definitions of this plan are specified in the policy contract issued by ING I hereby declare, acknowledge, agree and conrm as are follows: Insurance Berhad. (b) These insurance products obligation only of the insurance company. They are not bank deposits or obligations of or guaranteed by Citibank Berhad, Citibank (1) I have been informed that I am required to read and understand the Terms and Conditions N.A., Citigroup Inc. or any of their affiliates or subsidiaries. (c) This document does not constitute the making of any offer or invitation to subscribe for insurance products nor does it . (2) I understand that set out in the Citibank Ready Credit Customers Terms and Conditions to solicitation by is Citibank Berhad, Citibank N.A., Citigroup Inc. or any of their affiliates or subsidiaries for subscription of insurance products by anyone in any jurisdictions in theamount usage of the CRC Facility also subject to the respective Terms and Conditions applicable the making of suchGIRO offer and or invitation subscribe or the solicitation thereof is not authorised or to any person to whom it is unlawful to make such offer invitation or solicitation. to which Citibank Online, Citibank Citibankto Rewards Program found at your website Applicants NRIC no. : (www.citibank.com.my) or made available at any Citibank branches nationwide or any (d) This document also does not constitute the distribution of any information byother any one in any jurisdiction in which such distribution is not authorised or to any person to whom it means, as the case may be, and I agree to read, understand and be bound by such Terms and Nature of Business : is unlawful to distribute such a document. Conditions. By signing below, I conrm that (i) I have read and agree to abide by the provisions contained in Box 17 above and this Box 19. (ii) My minimum income is RM24,000 per annum or more. (iii) I acknowledge the For banks use only :that I have received, read and understood 8 A 0 the 0contents 0 0of 4 Salaried Self-Employed CSP source codeCredit Product Disclosure Sheet. (iv) Please note that this signature will be Citibank Ready my authorised signature for the opening and operation of my Citibank Ready Credit account. Position Held :
Citibanks Privacy Notice Keeping personal data of individuals secure is a top priority for all of us at Citibank. Please visit us at www.citibank.com.my/privacyEng to view our Notice and Choice Principle Statement where we seek to outline how we intend to deliver all the rights and protections that you are entitled to in respect of your personal data.

Source of Funds/Wealth: RM Payroll Biz Income Other : (please specify)

per annum

CRC Account no. : Applicants signature :

( Sign in black ink only)

Customer no. : Signature updated by :

Date of application (Mandatory) :

d d

m m

y y y y Signature authorised by : NON-FTF (March 2013)

The general information provided by Citibank in this Application Form is valid as at 7 March 2013.

17 15

GENERAL DECLARATION FOR CITIBANK CREDIT CARD & CITIBANK READY CREDIT CITIBANK READY CREDIT PAYLITE

I/We YES! herebyIdeclare, acknowledge, and conrm as follows: performance its/their operational functions (whether within or outside Malaysia), in wish to apply foragree Citibank Ready Credit PayLite (RC PayLite) as per details providedof below. connection with this application or any products, service or accommodation I/we have or may 1. I/We warrant that all information furnished here is true, accurate and not misleading. have with the Bank, for confidential use, processing this application, data processing, credit 2. I/We authorise Citibank Berhad (the Bank), at any time and from time to time to process including evaluation, meeting legal and regulatory requirements, for provision of goods or services, Bank Current/Savings Account No. Amount (RM) (Min. RM1,000) Tenure but not limited to access, obtain, verify and/or use, any data or information from any source marketing and promoting any products, service and/or accommodation to me/us, provision of services such as protection plans or insurance policies where applicable (including (including credit reference agencies, credit reporting agencies, Bank Negara Malaysia (BNM), assessing, processing and investigating any risks or claims), fulfillment and delivery of gifts the credit bureau and/or the Central Credit Reference Information System (CCRIS) and such to me/us in connection with this application, my/our Card(s) and/or CRC Facility, the Card relevant authorities) for purposes of evaluating my/our credit standing in connection to me/us, this Terms and Conditions and/or Citibank Ready Credit Customers Terms and Conditions and all application and any facility, service or accommodation I/we have or may have (whether or not with other purposes incidental and associated with any of the above. the Bank) as the Banks discretion deems t. I/We understand that this application, the opening, 4. I/We declare that my/our spouse(s), children or parents (if any) is/are not employee(s) or director(s) operation and conduct of my/our Card Account, CRC Account and any future facility, service or Important Note: applied by me/us or granted by you (whether in my sole name or jointly with of the Bank in compliance with the Banking and Financial Institutions Act, 1989 (BAFIA). I/We also accommodation declare and understand that my/our application is subject to non-applicability of the restrictions For fresh or applicants, you maythe only apply for RC PayLite or RC BTI and notor both. another others, including Supplementary Cardmember(s), presently subsequently found in Section 62 of BAFIA and provided that I/we am/are not in breach of or in contravention of opened) mayAmount be reported to the Dishonoured Cheques System Rate (DCHEQS) The PayLite disbursed will be subject to Information Effective Interest (E.I.R.)maintained ranging between 5.9% to 17.9% per annum from the date of approval and will be computed based on a the laws of Malaysia, failing which, you are entitled to terminate my/our Card(s) and/or CRC Facility. by BNM, CCRIS and such relevant authorities (as the case may be) as the Bank deems t. monthly reducing balance repayment method. 5. I/We fully understand that the approval of my/our application is at the discretion as the Bank I/We authorise the Bank to disclose, utilise and/or transfer my/our such as my/our in your sole name. 3. The PayLite amount will only be store, transferred to your Current or personal Savingsdata account maintained Transfers to any joint accounts or third party accounts are notFacility allowed. deems fit and you may at time terminate my/our Cards(s) and/or CRC with notice. name, address(es), contact numbers, information obtained from credit reference agencies, credit Approval the RC BNM, PayLite is CCRIS subject tosuch Citibanks discretion we deem fit. 6. I/We will keep you fully indemnified against any claims, actions, proceedings, losses, reporting of agencies, the application credit bureau, and relevant authorities as pertaining to this costs and charges as a result of using and/or in connection with the Information, application and/or facility, service or accommodation applied by me/us or granted byRC thePayLite, Bank the full damages, By signing below, I any hereby agree to abide by the terms and conditions governing set of which is available at www.citibank.com.my Card(s), Citibank Card Terms and Conditions, CRC Facility, Citibank Ready Credit Customers (whether in my sole name or jointly with another or others, including the Supplementary Terms and Conditions and all relevant agreements, covenants and undertakings by me. For banks use only Cardmember(s), presently: or subsequently opened) and whether within or outside Malaysia Applicants signature (Information) to/with Citibank Berhad, Citibank N.A., Citigroup Inc. or any of your/their ofces, 7. I/We expressly consent to the mailing of my/our Card(s), Debit & ATM Card, the Citibank Card ( Sign in black ink only) RC PayLite Code afliates or subsidiaries (collectively Citigroup), merchants, VISA International Services Association, Terms and Conditions, the relevant Terms and Conditions for specific Card-type (if applicable), MasterCard International Incorporated, any vendors and/or third party service providers engaged by the and/or Citibank Ready Credit Customers Terms and Conditions to my/our address(es) provided Bank and/or Citigroup, including any person to whom the Bank and/or Citigroup has outsourced the here if my/our application is successfully approved. 16 CITIBANK READY CREDIT BALANCE TRANSFER VIA INSTALMENT PLAN

18

DECLARATION FOR CREDIT CARD YES! I wish to apply for Citibank Ready Credit Balance Transfer via Instalment Plan (RC BTI) as per details provided below. By signing below, I conrm that (1) I have read and agree to abide by the provisions contained in SPECIFIC DECLARATION FOR PRINCIPAL CARD APPLICANTS Box 17 above and this Box 18. (2) My minimum The Bank has informed me and I fully understandCard that inAccount accordance with prevailing Bank Negara Bank Credit/Charge No. Amount (RM) (Min. RM1,000) Tenureincome is RM24,000 per annum or more. (3) For CitiBusiness Card application, my business sales turnover is RM120,000 per annum or more (N/A Malaysia Guidelines, if my annual income is RM36,000 or less, I can only hold credit cards as a if Business Platinum card applicant is salaried). (4) My signature below constitutes a request for Principal Cardmember from a maximum of two (2) credit card issuers (Maximum Issuer Restriction). Citibank VISA credit card if I already have a Citibank MasterCard and vice versa, if applicable. (5) Upon the issuance by the Bank of the credit card(s) applied for under this application, I declare that My signature constitutes a request for Gold/Classic Card if I do not qualify for Platinum/Gold Card. so long as the Maximum Issuer Restriction applies to me: (6) The Principal and Supplementary Cardmember(s) will be jointly and severally liable to the (1) I will be holding credit cards from a maximum of two (2) credit card issuers (including the Bank Bank for all amounts and charges due and owing however arising from the use by the as an issuer); and Supplementary Cardmember(s) of his own Supplementary Card(s). (7) The Bank may allow the (2) If I am anNote: existing Citibank Principal Cardmember holding credit cards from more than two (2) Important Principal Cardmember(s) to exceed the credit limit/total credit limit and/or the Supplementary credit issuers (including Bank asapply an issuer), I undertake to comply For card fresh applicants, youthe may only for RC PayLite or RC BTI with and the notMaximum both. Issuer Cardmember(s) to exceed the Supplementary Card(s) limit (if a separate credit limit is assigned) Restriction effective 1 January 2012. The RC BTI Amount transferred will be subject to Effective Interest Rate (E.I.R.) ranging between 5.9% to 9.9% per annum from the of approval and will be computed based on a at the Banks discretion as we deem fit. (8)date The Principal Cardmember(s) and the Supplementary monthly reducing balance repayment method. Cardmember(s) will be bound by the Citibank Card Terms and Conditions. (9) I have received, Terms and Conditions Applicant may apply to transfer balances from not thanand 3 credit card/charge card held in other banks. read accounts and understood the contents of the Product Disclosure Sheet. IMPORTANT: You are deemed to haveoutstanding accepted Citibank Card Terms and more Conditions are bound by Approval of start the RC BTI application is subject to Citibanks discretion as As we deem fit. them once you using your Citibank Berhad VISA Card or MasterCard (Card). such, you should Citibanks Privacy Notice read these terms andI conditions and the terms conditions for specific Card-type, RC whichever By signing below, hereby agree to relevant abide by the and terms and conditions governing BTI, the full set of which is available www.citibank.com.my Keeping personal data ofat individuals secure is a top priority for all of us at Citibank. Please visit is applicable, available online at www.citibank.com.my prior to usage of the Card. If you require a us at www.citibank.com.my/privacyEng to view our Notice and Choice Principle Statement printed copy, kindly contact us Forwe banks use only where seek to outline how we intend to deliver all the rights and protections that you are Applicants signature : to request a copy or call Citibank Phone Banking at 03-2383 0000. (1) Usage of the card is governed by the Citibank Card Terms and Conditions and the relevant terms and entitled to inRC respect your personal data. ( Sign in black ink only) BTI of Code conditions for specific Card-type, whichever is applicable, and is binding on the Principal Cardmember(s) and the Supplementary Cardmembers). (2) The Principal Cardmember shall be responsible for all liabilities and obligations of the Principal Cardmember as well as the Supplementary FEES AND CHARGES Applicants signature : Cardmember(s). The Principal Cardmember is jointly and severally liable to us for all amounts and ( Sign in black ink only) charges due and owing to us from the use by the Supplementary Cardmember(s) of his/her own Please referCard(s). to the respective Product Disclosure Sheet (PDS) for Citibank Credit Cards or Citibank Ready Credit. Supplementary (3) Any Card(s) issued to me/us, including Supplementary Card(s) must not be usedgeneral by me/us information for any unlawful activity orby purpose (including without limitation online gambling), The provided Citibank in this Application Form is valid as at 7 March 2013. whether in whole or part. (4) For principal card applications: I understand that if I am submitting Supplementary card this application for more than one or multiple Citibank credit cards, I may be participating in Applicant : more than one Citibank credit card promotion in which gifts are given for successfully ( Sign in black ink only) approved applications. In such event, I hereby CONFIRM that I am the only one entitled to receive the gift from only ONE of such promotions, regardless of the number of Citibank credit cards that are successfully approved. For this purpose, and subject to Citibanks approval of d d m m y y y y Date of application (Mandatory) : my applications, my preference of the gift is as indicated on page 1. DECLARATION FOR CITIBANK READY CREDIT (CRC FACILITY) Applicants name :
I hereby declare, acknowledge, agree and conrm as follows: (1) I have been informed that I am required to read and understand the Terms and Conditions set out in the Citibank Ready Credit Customers Terms and Conditions. (2) I understand that the usage of the CRC Facility is also subject to the respective Terms and Conditions applicable to Citibank Online, Citibank GIRO and Citibank Rewards Program found at your website (www.citibank.com.my) or made available at any Citibank branches nationwide or any other means, as the case may be, and I agree to read, understand and be bound by such Terms and Conditions. By signing below, I conrm that (i) I have read and agree to abide by the provisions contained in Box 17 above and this Box 19. (ii) My minimum income is RM24,000 per annum or more. (iii) I acknowledge that I have received, read and understood the contents of the Citibank Ready Credit Product Disclosure Sheet. (iv) Please note that this signature will be my authorised signature for the opening and operation of my Citibank Ready Credit account. Citibanks Privacy Notice Keeping personal data of individuals secure is a top priority for all of us at Citibank. Please visit us at www.citibank.com.my/privacyEng to view our Notice and Choice Principle Statement where we seek to outline how we intend to deliver all the rights and protections that you are entitled to in respect of your personal data.

19

FOR BANK USE ONLY

Applicants NRIC no. : Nature of Business :

Salaried Position Held :

Self-Employed

Source of Funds/Wealth: RM Payroll Biz Income Other : (please specify)

per annum

CRC Account no. : Applicants signature :

( Sign in black ink only)

Customer no. : Signature updated by :

Date of application (Mandatory) :

d d

m m

y y y y Signature authorised by : NON-FTF (March 2013)

The general information provided by Citibank in this Application Form is valid as at 7 March 2013.

17

GENERAL DECLARATION FOR CITIBANK CREDIT CARD & CITIBANK READY CREDIT
performance of its/their operational functions (whether within or outside Malaysia), in connection with this application or any products, service or accommodation I/we have or may have with the Bank, for confidential use, processing this application, data processing, credit evaluation, meeting legal and regulatory requirements, for provision of goods or services, marketing and promoting any products, service and/or accommodation to me/us, provision of services such as protection plans or insurance policies where applicable (including assessing, processing and investigating any risks or claims), fulfillment and delivery of gifts to me/us in connection with this application, my/our Card(s) and/or CRC Facility, the Card Terms and Conditions and/or Citibank Ready Credit Customers Terms and Conditions and all other purposes incidental and associated with any of the above. I/We declare that my/our spouse(s), children or parents (if any) is/are not employee(s) or director(s) of the Bank in compliance with the Banking and Financial Institutions Act, 1989 (BAFIA). I/We also declare and understand that my/our application is subject to non-applicability of the restrictions found in Section 62 of BAFIA and provided that I/we am/are not in breach of or in contravention of the laws of Malaysia, failing which, you are entitled to terminate my/our Card(s) and/or CRC Facility. I/We fully understand that the approval of my/our application is at the discretion as the Bank deems fit and you may at any time terminate my/our Cards(s) and/or CRC Facility with notice. I/We will keep you fully indemnified against any claims, actions, proceedings, losses, damages, costs and charges as a result of using and/or in connection with the Information, Card(s), Citibank Card Terms and Conditions, CRC Facility, Citibank Ready Credit Customers Terms and Conditions and all relevant agreements, covenants and undertakings by me. I/We expressly consent to the mailing of my/our Card(s), Debit & ATM Card, the Citibank Card Terms and Conditions, the relevant Terms and Conditions for specific Card-type (if applicable), and/or Citibank Ready Credit Customers Terms and Conditions to my/our address(es) provided here if my/our application is successfully approved.

I/We hereby declare, acknowledge, agree and conrm as follows: 1. I/We warrant that all information furnished here is true, accurate and not misleading. 2. I/We authorise Citibank Berhad (the Bank), at any time and from time to time to process including but not limited to access, obtain, verify and/or use, any data or information from any source (including credit reference agencies, credit reporting agencies, Bank Negara Malaysia (BNM), the credit bureau and/or the Central Credit Reference Information System (CCRIS) and such relevant authorities) for purposes of evaluating my/our credit standing in connection to me/us, this application and any facility, service or accommodation I/we have or may have (whether or not with the Bank) as the Banks discretion deems t. I/We understand that this application, the opening, operation and conduct of my/our Card Account, CRC Account and any future facility, service or accommodation applied by me/us or granted by you (whether in my sole name or jointly with another or others, including the Supplementary Cardmember(s), presently or subsequently opened) may be reported to the Dishonoured Cheques Information System (DCHEQS) maintained by BNM, CCRIS and such relevant authorities (as the case may be) as the Bank deems t. 3. I/We authorise the Bank to disclose, store, utilise and/or transfer my/our personal data such as my/our name, address(es), contact numbers, information obtained from credit reference agencies, credit reporting agencies, BNM, the credit bureau, CCRIS and such relevant authorities pertaining to this application and/or any facility, service or accommodation applied by me/us or granted by the Bank (whether in my sole name or jointly with another or others, including the Supplementary Cardmember(s), presently or subsequently opened) and whether within or outside Malaysia (Information) to/with Citibank Berhad, Citibank N.A., Citigroup Inc. or any of your/their ofces, afliates or subsidiaries (collectively Citigroup), merchants, VISA International Services Association, MasterCard International Incorporated, any vendors and/or third party service providers engaged by the Bank and/or Citigroup, including any person to whom the Bank and/or Citigroup has outsourced the

4.

5. 6.

7.

18

DECLARATION FOR CREDIT CARD

By signing below, I conrm that (1) I have read and agree to abide by the provisions contained in Box 17 above and this Box 18. (2) My minimum income is RM24,000 per annum or more. (3) For CitiBusiness Card application, my business sales turnover is RM120,000 per annum or more (N/A if Business Platinum card applicant is salaried). (4) My signature below constitutes a request for Citibank VISA credit card if I already have a Citibank MasterCard and vice versa, if applicable. (5) My signature constitutes a request for Gold/Classic Card if I do not qualify for Platinum/Gold Card. (6) The Principal and Supplementary Cardmember(s) will be jointly and severally liable to the Bank for all amounts and charges due and owing however arising from the use by the Supplementary Cardmember(s) of his own Supplementary Card(s). (7) The Bank may allow the Principal Cardmember(s) to exceed the credit limit/total credit limit and/or the Supplementary Cardmember(s) to exceed the Supplementary Card(s) limit (if a separate credit limit is assigned) at the Banks discretion as we deem fit. (8) The Principal Cardmember(s) and the Supplementary Cardmember(s) will be bound by the Citibank Card Terms and Conditions. (9) I have received, read and understood the contents of the Product Disclosure Sheet.

SPECIFIC DECLARATION FOR PRINCIPAL CARD APPLICANTS The Bank has informed me and I fully understand that in accordance with prevailing Bank Negara Malaysia Guidelines, if my annual income is RM36,000 or less, I can only hold credit cards as a Principal Cardmember from a maximum of two (2) credit card issuers (Maximum Issuer Restriction). Upon the issuance by the Bank of the credit card(s) applied for under this application, I declare that so long as the Maximum Issuer Restriction applies to me: (1) I will be holding credit cards from a maximum of two (2) credit card issuers (including the Bank as an issuer); and (2) If I am an existing Citibank Principal Cardmember holding credit cards from more than two (2) credit card issuers (including the Bank as an issuer), I undertake to comply with the Maximum Issuer Restriction effective 1 January 2012. Terms and Conditions IMPORTANT: You are deemed to have accepted Citibank Card Terms and Conditions and are bound by them once you start using your Citibank Berhad VISA Card or MasterCard (Card). As such, you should read these terms and conditions and the relevant terms and conditions for specific Card-type, whichever is applicable, available online at www.citibank.com.my prior to usage of the Card. If you require a printed copy, kindly contact us to request a copy or call Citibank Phone Banking at 03-2383 0000. (1) Usage of the card is governed by the Citibank Card Terms and Conditions and the relevant terms and conditions for specific Card-type, whichever is applicable, and is binding on the Principal Cardmember(s) and the Supplementary Cardmembers). (2) The Principal Cardmember shall be responsible for all liabilities and obligations of the Principal Cardmember as well as the Supplementary Cardmember(s). The Principal Cardmember is jointly and severally liable to us for all amounts and charges due and owing to us from the use by the Supplementary Cardmember(s) of his/her own Supplementary Card(s). (3) Any Card(s) issued to me/us, including Supplementary Card(s) must not be used by me/us for any unlawful activity or purpose (including without limitation online gambling), whether in whole or part. (4) For principal card applications: I understand that if I am submitting this application for more than one or multiple Citibank credit cards, I may be participating in more than one Citibank credit card promotion in which gifts are given for successfully approved applications. In such event, I hereby CONFIRM that I am the only one entitled to receive the gift from only ONE of such promotions, regardless of the number of Citibank credit cards that are successfully approved. For this purpose, and subject to Citibanks approval of my applications, my preference of the gift is as indicated on page 1.

Citibanks Privacy Notice Keeping personal data of individuals secure is a top priority for all of us at Citibank. Please visit us at www.citibank.com.my/privacyEng to view our Notice and Choice Principle Statement where we seek to outline how we intend to deliver all the rights and protections that you are entitled to in respect of your personal data.

Applicants signature :
( Sign in black ink only)

Supplementary card Applicant :

( Sign in black ink only)

Date of application (Mandatory) :

d d

m m

y y y y

19

DECLARATION FOR CITIBANK READY CREDIT (CRC FACILITY) Applicants name :

FOR BANK USE ONLY

I hereby declare, acknowledge, agree and conrm as follows: (1) I have been informed that I am required to read and understand the Terms and Conditions set out in the Citibank Ready Credit Customers Terms and Conditions. (2) I understand that the usage of the CRC Facility is also subject to the respective Terms and Conditions applicable to Citibank Online, Citibank GIRO and Citibank Rewards Program found at your website (www.citibank.com.my) or made available at any Citibank branches nationwide or any other means, as the case may be, and I agree to read, understand and be bound by such Terms and Conditions. By signing below, I conrm that (i) I have read and agree to abide by the provisions contained in Box 17 above and this Box 19. (ii) My minimum income is RM24,000 per annum or more. (iii) I acknowledge that I have received, read and understood the contents of the Citibank Ready Credit Product Disclosure Sheet. (iv) Please note that this signature will be my authorised signature for the opening and operation of my Citibank Ready Credit account. Citibanks Privacy Notice Keeping personal data of individuals secure is a top priority for all of us at Citibank. Please visit us at www.citibank.com.my/privacyEng to view our Notice and Choice Principle Statement where we seek to outline how we intend to deliver all the rights and protections that you are entitled to in respect of your personal data.

Applicants NRIC no. : Nature of Business :

Salaried Position Held :

Self-Employed

Source of Funds/Wealth: RM Payroll Biz Income Other : (please specify)

per annum

CRC Account no. : Applicants signature :

( Sign in black ink only)

Customer no. : Signature updated by :

Date of application (Mandatory) :

d d

m m

y y y y Signature authorised by : NON-FTF (March 2013)

The general information provided by Citibank in this Application Form is valid as at 7 March 2013.