Certified to ISO 9001:2008 Cert. No.

: AR 1350

Qualification : Minimum age of 18 years old Documents required : Supplementary applicants I/C (photocopy of both sides)
Certified to ISO 9001:2008 Cert. No. : AR 1350

DECLARATION AND AGREEMENT I/We hereby declare and certify that all the information given by me/us in this application is true, accurate and complete. Notwithstanding the generality of the foregoing, I/we 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/ us and/or any other person, individual and/or entity as the Bank may deem fit, for any purposes which the Bank deems fit. I/We hereby request the Bank to issue, upon approval of this application, the credit card(s) which I/we have indicated. I/ We acknowledge that the use of the credit card(s) issued to me/us shall be subject to CIMB Banks Cardmember agreement (Cardmember Agreement), which will be sent to me/us 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 and/or the Supplementary Applicants request. I/We further understand that the Bank shall not hold the Supplementary Applicant jointly and severally liable for the debts or amounts incurred by the Principal Applicant or other Supplementary Applicant(s). I/We, acknowledge that the Bank reserves the sole and absolute right to decline or reject my/our application(s) without assigning any reasons therefore. I/ We 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. I/We hereby agree and authorise the Bank to disclose to any person(s) in or outside Malaysia including but not limited to companies within the group of the Bank as well as companies within the group of CIMB Group Holdings Berhad, the Banks ultimate holding company (Group Companies) whether such Group Companies are residing, situated, carrying on business, incorporated or constituted within or outside Malaysia any information about or with regard to me/us, my/our affairs and/or banking accounts for such purposes as the Bank deems fit or appropriate. Disclosure to Group Companies which are involved in the promotion, sale, delivery and distribution of financial products and services shall be for facilitating the operations, businesses, cross-selling and other purposes of the Bank and or the Group Companies. Notwithstanding the generality of the foregoing, the Bank acknowledges that (i) it shall not disclose my/ our information to the Group Companies which are residing, situated, carrying on business, incorporated or constituted within Malaysia for purposes of cross-selling if such disclosure is objected to by me/us; (ii) it shall only disclose my/our information (excluding information relating to my/our affairs or account) to third parties, including Group Companies which are residing, situated, carrying on business, incorporated or constituted outside Malaysia, for strategic alliances, marketing and promotional purposes, if I/we have expressly consented to such disclosure. I/We 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/We further agree to accept liability for all amount incurred arising from the use of my/our credit card(s) issued pursuant to this application or at any time thereafter at my/our request. Please tick ( 3 ) I/We hereby give my/our consent for CIMB Bank/CIMB Islamic Bank to share my/our information (excluding information relating to my/our affairs or account) with third parties, such as strategic alliances for marketing and promotional purposes.

I wish to apply for : Please (3)

u WORLD MasterCard u VISA Infinite

SUPPLEMENTARY CARD Full Name as in NRIC :

u MasterCard Platinum u VISA Platinum

Name to appear on Card (Not more than 19 letters) : Date of Birth (DD/MM/YY) : / / Nationality : M A L A Y S New I/C No. : Sex : u Male Home Address : Old I/C No. / Passport : I A N -

u Female

Tel No. :

Mothers Maiden Name (for verification purposes) : Relationship to Principal :

CARD COLLECTION INSTRUCTIONS Please Send My Card To : u Home NOMINATION OF CREDIT LIMIT

u Office

u Yes, I would like to nominate a credit line for this supplementary application of
RM credit line. Reminder : In either of the above instances, the total combined credit lines cannot exceed the principal cardmembers current approved credit line. If no nomination is made specifically, the supplementary card will share the Principal credit line. PRINCIPAL CARDHOLDERS DETAILS Name : u Mr .

u No, I do not wish to nominate. This supplementary applicant will share my current

u Miss

u Mrs

u Dr

New I/C No. : Old I/C No. : Direct Access Credit Card No. : -

Principal Applicants Signature Date:

Supplementary Applicants Signature Date : 2 0 1 8

SMSA Branch Code Employee No.

FEES AND CHARGES

Annual Fee Direct Access WAIVED FOR LIFE WORLD / Infinite / Platinum Credit Card For Graduates Card Type Supplementary WORLD Infinite Platinum

WAIVED FOR LIFE

Joining Fee Finance Charges

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 Fee

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.

Minimum Monthly Repayment Late Payment Charge

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 the 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.

Interest-Free Period

Conversion For Overseas Transactions

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