Date:

MBF Cards (M'sia) Sdn Bhd
Customer Service Department,
Ground Floor, Menara Mbf,
Jalan Sultan Ismail,
50250 Kuala Lumpur.


Dear Sir/Madam,

Request for MBF Visa / MasterCard Card(s)

I/we, the existing MBF MasterCard CardMember(s) with the following details:
Principal CardMember: _________________________________ (Name as in NRIC)
NRIC No: ___________________________ (New) / _____________________ (Old)
Existing Card No: _____________________________________________________
Existing Line of Credit Account No: _______________________________________

(Please fill-up if relevant)
1st Supplementary CardMember: ________________________ (Name as in NRIC)
NRIC No: ___________________________ (New) / _____________________ (Old)
Existing Supplementary Card No: _________________________________________

(Please fill-up if relevant)

2nd Supplementary CardMember: ________________________ (Name as in NRIC)
NRIC No: ___________________________ (New) / _____________________ (Old)
Existing Supplementary Card No: _________________________________________

hereby request that, in addition to the existing MBF card(s) that I/we hold above, MBFC to issue me/us, subject to the approval of the Line of Credit Provider and/or MBFC, the following card(s) that would share the same Line of Credit Account / Charge Account aforesaid:

I/We request for: ______________Visa ____________________________ MasterCard
       
To be sent to:HouseOfficeMBF Cards branch ____________ (to indicate)

I/we hereby agree to be bound by the Terms and Conditions governing the usage of the MBF MasterCard and/or MBF Visa Card and also agree to be bound by the Terms and Conditions of Line of Credit.



_________________________ ________________________________
Signature of Principal CardMember Signature of 1st Supplementary CardMember
Name: Name:
  
  _________________________________
  Signature of 2nd Supplementary CardMember
  Name:
For Office Use

Company I.D.:
4th Line Embossing:





Kindly fill up the Request Form and mail it back to:

MBF Cards (M'sia) Sdn Bhd
Customer Service Department,
Ground Floor, Menara MBf,
Jalan Sultan Ismail,
50250 Kuala Lumpur.

Tel: 03-2167 7600
Fax: 03-2167 7722
Email: customer.service@mbfcards.com

Note:
If you also request for increase in Line of Credit Limit, subject to Line of Credit Provider's approval, please enclose the following for Line of Credit Providers' consideration:
(i) Past 2 years' Income Tax Return (Form J) or last 2 months' salary slips
(ii) If self-employed, last 3 months' bank statements and Business Registration Certificate/Form 9,
Form 24 and Form 49.