RHB ISLAMIC BANK CREDIT CARD APPLICATION FORM / BORANG PERMOHONAN KAD KREDIT RHB ISLAMIC BANK CARDS / KAD-KAD

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1 RHB ISLAMIC BANK CREDIT CARD APPLICATION FORM / BORANG PERMOHONAN KAD KREDIT RHB ISLAMIC BANK Please send completed form to: / Sila lengkapkan borang dan hantar ke: RHB BANK BERHAD CARDS & UNSECURED BUSINESS CREDIT CARD APPLICATION UNIT, Level 4, No. 75, Jalan Tun H. S. Lee, Kuala Lumpur Referral ID No./ No. ID Perujuk Region/ Daerah Branch/ Cawangan Channel/ Saluran Please tick ( ) 1 (one) option below / Sila tanda ( ) 1 (satu) pilihan di bawah WORLD CARD-i / KAD-i WORLD Staff ID No./ No. ID Pekerja MASTERCARD Programme Code / Kod Program: C Z A 3 6 No annual fee for all of the above Principal and Supplementary cards / Tiada yuran tahunan untuk semua kad Utama dan Sampingan di atas Purpose of Application / Tujuan Permohonan: CARDS / KAD-KAD Source Code/ Kod Rujukan I wish to apply for the following card / Saya ingin memohon kad berikut: PLATINUM CARD-i / KAD-i PLATINUM Barcode Area RHBI CCI VISA Programme Code / Kod Program: B Z A 1 6 SMART VALUE CARD-i / KAD-i SMART VALUE VISA Programme Code / Kod Program: C Z A 3 7 All of the above cards will enjoy 1st year waiver for Principal Card and for life waiver for Supplementary Card on annual fees / Semua kad di atas akan menikmati pengecualian yuran tahunan untuk tahun pertama bagi Kad Utama dan seumur hidup bagi Kad Sampingan Card Delivery to / Penghantaran Kad ke Billing Address / Alamat Bil Branch, Please specify / Cawangan, Sila nyatakan PERSONAL DETAILS / BUTIRAN PERIBADI MyKad No. / No. MyKad Passport No. / No. Pasport (Non-Civilian No.) Title / Gelaran Mr. / Encik Ms. / Cik Name per MyKad / Passport / Nama seperti MyKad / Pasport Residence is / Rumah Milik Own / Sendiri Rented / Sewa Parents / Ibubapa Company / Syarikat Years resided / Tahun menetap mm / bb yy / tt Permanent Home Address (If P.O. Box is rented or employer-owned, please complete this portion) / Alamat Rumah Tetap (Sila lengkapkan bahagian ini jika Peti Surat disewa atau milik majikan) Name on Card / Nama pada Kad Sex / Jantina Male / Lelaki Female / Perempuan Date of Birth / Tarikh Lahir Nationality / Warganegara Race / Bangsa Single / Bujang Bumiputera / Bumiputera Widowed / Janda / Duda Spouse s Name / Nama Pasangan Chinese / Cina Academic Qualification / Kelayakan Akademik Primary / Secondary / Sekolah Rendah Sekolah Menengah Marital Status / Taraf Perkahwinan dd / hh mm / bb yy / tt Married / Kahwin Diploma Indian / India Degree / Ijazah No. of Children / Bilangan Anak Masters/ Phd Divorced / Bercerai EMPLOYMENT DETAILS / BUTIRAN PEKERJAAN Sector of Employment / Sektor Pekerjaan Employer / Government Employee / Majikan Kakitangan Kerajaan Self-employed/Own Account Worker / Bekerja Sendiri/Pekerja Akaun Sendiri Type of Income / Jenis Pendapatan Postcode / Poskod Private Employee / Kakitangan Swasta Semi Government Employee / Kakitangan Semi Kerajaan Salaried / Gaji Bulanan Self-Employed / Bekerja Sendiri Occupational Field / Bidang Pekerjaan Employer / Majikan Spouse Working / Pasangan Bekerja Spouse s Employer / Majikan Pasangan Office Address / Alamat Pejabat Spouse s Contact No. / No. Tel. Pasangan Address / Alamat E-mel Office Tel. No. / No. Tel. Pejabat Position / Jawatan Postcode / Poskod RESIDENTIAL DETAILS / BUTIRAN KEDIAMAN Current Home Address / Alamat Rumah Type of Business / Jenis Perniagaan Annual Income / Pendapatan Tahunan Home Tel. / No. Tel. Rumah Mobile Tel. No. / No. Tel. Bimbit Postcode / Poskod Years employed / Tahun bekerja mm / bb yy / tt Billing Address / Alamat Bil Home / Rumah Office / Pejabat

2 STATEMENT DELIVERY / PENGHANTARAN PENYATA View my e-statement via / / e-mel Meneliti e-penyata saya melalui address / Alamat e-mel : Please note that there will be no hardcopy statement issued to you should you choose to view your statement via e-statement. If you like to view your e-statement via please proceed to register your online banking at the nearest RHB branches. I/We agree to be bound by RHB Islamic Bank terms and conditions for e-statement delivery available at RHB Islamic Bank website - Sila ambil perhatian bahawa salinan penyata tidak akan diserahkan kepada anda sekiranya anda memilih untuk meneliti penyata melalui melalui e-penyata. Jika anda ingin meneliti e-penyata anda melalui sila daftarkan perbankan dalam talian anda di cawangan RHB terdekat. Saya/Kami bersetuju untuk terikat dengan terma dan syarat RHB Islamic Bank untuk penghantaran e-penyata yang boleh didapati di laman web RHB Islamic Bank - FINANCIAL REFERENCE / RUJUKAN KEWANGAN (SELF DEBT DECLARATION) I / We, (name) hereby declare that: Saya / Kami (nama) mengesahkan bahawa: I/We do not have any non-bank organization outstanding debts Saya/Kami tidak mempunyai baki hutang di institusi-institusi bukan kewangan I/We do have non-bank organization outstanding debts as per below details Saya/Kami mempunyai baki hutang di institusi-institusi bukan kewangan seperti di bawah Bank/Finance Type of Facility [Home Financing Outstanding Monthly Company/ Financing / Vehicle Financing / Amount Balance Payment Personal Financing/Others] / (RM) / (RM) / Amount Bank/Syarikat Jenis Kemudahan [Pembiayaan Jumlah Baki (RM) / Kewangan/ Perumahan / Pembiayaan Pembiayaan Belum Jelas Amaun Kenderaan / Pembiayaan Persendirian/] (RM) (RM) Bayaran Balik Bulanan (RM) I/We, the undersigned hereby declare that the above information provided by me/us are true and correct and in the event that the bank subsequently discovered that any of the information provided are found to be false, incorrect or incomplete, the Bank shall have the absolute discretion to cancel or vary the facility approved. Saya/Kami, penandatangan di bawah, dengan ini mengesahkan bahawa maklumat yang disediakan oleh saya/kami di atas adalah benar dan betul dan sekiranya Bank kemudiannya mendapati bahawa sebarang maklumat yang disediakan adalah tidak benar, salah atau tidak lengkap, pihak Bank berhak mengikuti budi bicara muklaknya membatal atau mengubah kemudahan yang telah diluluskan. PERSONAL SECURITY REFERENCE / RUJUKAN KESELAMATAN PERIBADI Mother s Maiden Name / Nama Ibu Sebelum Kahwin EMERGENCY CONTACT PERSON (Family Members Not Staying With You) / JIKA BERLAKU KECEMASAN HUBUNGI (Ahli Keluarga Yang Tidak Tinggal Bersama) Name / Nama Company Name / Nama Syarikat Tel No. / No. Tel Relationship / Hubungan SUPPLEMENTARY CARD APPLICATION/JOINT ACCOUNTHOLDER CARD APPLICATION / PERMOHONAN KAD SAMPINGAN/PERMOHONAN KAD PEMEGANG AKAUN BERSAMA MyKad No. / No. MyKad Passport No. / No. Pasport (Non-Civilian No.) Shared Supplementary Limit? / Had Sampingan Berkongsi? If no, please state assigned limit / Jika tidak, sila nyatakan had Title / Gelaran Mr. / Encik Ms. / Cik Name per MyKad / Passport / Nama seperti MyKad / Pasport RM Name on Card / Nama pada Kad Sex / Jantina Male / Lelaki Female / Perempuan Date Of Birth / Tarikh Lahir Nationality / Warganegara Race / Bangsa Bumiputera / Bumiputera Relationship / Hubungan Current Home Address / Alamat Rumah Home Tel. No. / No. Tel. Rumah Address / Alamat E-mel dd / hh mm / bb yy / tt Chinese / Cina Mother s Maiden Name / Nama Ibu Sebelum Kahwin Mobile Tel. No. / No. Tel. Bimbit Indian / India Postcode / Poskod CONFIRMATION AND DECLARATION BY RHB ISLAMIC BANK BERHAD CREDIT CARD APPLICANT / PENGESAHAN DARI PEMOHON KAD KREDIT RHB ISLAMIC BANK BERHAD I/We have been briefed on the description and benefits pursuant to the Product Disclosure Sheet that has been given to me/us of the RHB Credit Card applied herein. I/We hereby confirm and declare that all the information provided by me/us is complete, true and correct and that I/we authorise RHB Islamic Bank (the Bank) to verify any information provided and to obtain from any source including Inland Revenue as the Bank considers appropriate any information, which the Bank may require. The Bank may, at its sole and absolute discretion, approve or reject my/our application. I/We agree that by signing and/or using the card(s), I/we agree to be bound by and to comply with all terms and conditions of the Bank Cardholder Agreement(s) which will be sent to me/us with the card(s) upon approval of my/our application and any other terms and conditions imposed by the Bank from time to time for credit card facilities and all amendments thereto and agree that the RHB Islamic Bank Visa/ MasterCard Credit Card-i may only be used to such terms and conditions. I/We understand the card(s) when issued remain the property of the Bank and must be returned to the Bank upon request and shall be subjected to cancellation by giving notice of thirty (30) calendar days. I/We hereby confirm that no further permission or consent from me/us is necessary or required in relation to all of the above disclosures and this declaration shall constitute the consent required pursuant to Section 146 of the Islamic Financial Services Act 2013 and any other contractual consent for such disclosures. I/We acknowledge that my/our membership will be subjected to the further terms and conditions of the bank which will be given to me/us with my/our approved credit card. I/We shall not dispute the contents of the faxed copy received by the Bank which shall be deemed as the original application and I/we shall produce the original application to the Bank upon request. I/We agree to abide by the Anti-Money Laundering Laws of Malaysia. For Principal Card applicant only: I/We agree to be liable for all transactions charged to my/our Principal Cardmember(s) and any Supplementary Card(s) issued. For Supplementary Card applicant only: I/We agree to be liable for all transactions charged to my Supplementary Card(s) issued. I/We hereby confirm that the preferred language for this transaction which I/we opt for as stated below (Please tick where applicable). Saya/Kami telah diberitahu tentang keterangan dan faedah berhubung dengan Helaian Pendedahan Produk yang telah diberikan kepada saya/kami berkaitan dengan Kad Kredit-i RHB Islamic yang dimohon di sini. Saya/Kami dengan ini mengesahkan dan mengaku kesemua maklumat yang diberikan oleh saya/kami adalah lengkap, benar dan tepat dan saya/kami memberi kebenaran kepada RHB Islamic Bank (Bank) untuk mengesahkan sebarang maklumat dan mendapat daripada mana-mana sumber termasuk Lembaga Hasil Dalam Negeri sebarang maklumat yang dianggap perlu atau diperlukan oleh Bank. Bank berhak atas budi bicara mutlaknya untuk melulus atau menolak permohonan saya/kami. Saya/Kami bersetuju dengan menandatangani dan/atau menggunakan kad, saya/kami bersetuju untuk diikat oleh dan mematuhi kesemua terma-terma dan syarat-syarat Perjanjian Pemegang Kad yang akan dihantar kepada saya/kami bersama kad setelah permohonan ini diluluskan dan kesemua term-terma dan syarat-syarat Perjanjian Kad Kredit Bank dan terma-terma dan syarat-syarat lain yang dikenakan oleh Bank dari semasa ke semasa untuk kemudahan Kad Kredit dan kesemua pindaan dan bersetuju bahawa Kad Kredit-i VISA/MasterCard RHB Islamic Bank hanya boleh digunakan tertakluk kepada terma-terma dan syarat-syarat tersebut. Saya/Kami faham bahawa kad adalah sentiasa hakmilik Bank dan hendaklah diserahkan kepada Bank apabila diminta dan boleh dibatalkan oleh Bank dengan memberi notis tiga puluh (30) hari kalendar. Saya/Kami dengan ini mengesahkan bahawa tiada kebenaran atau kelulusan selanjutnya dari saya/kami adalah perlu berkaitan dengan perkara tersebut di atas dan deklarasi ini adalah kebenaran yang perlu di bawah Seksyen 146 Akta Perkhidmatan Kewangan Islam 2013 dan segala kebenaran berasas kontrak untuk pemberian maklumat tersebut. Saya/Kami mengakui bahawa permohonan saya/kami akan tertakluk kepada terma dan syarat daripada Bank yang akan diberikan kepada saya/kami dengan Kad Kredit saya/kami yang diluluskan. Saya/Kami tidak akan mempertikaikan isi kandungan salinan faks yang diterima oleh Bank yang dikira sebagai permohonan benar dan saya/kami akan mengeluarkan permohonan benar kepada Bank apabila diminta. Saya/Kami bersetuju untuk mematuhi undang-undang Pencegahan Penggubahan Wang Haram dan Pencegahan Pembiayaan Keganasan Malaysia. Untuk pemohon Kad Utama sahaja: Saya/Kami bersetuju

3 untuk menanggung kesemua transaksi yang dicajkan kepada Kad Utama saya/kami dan Kad Tambahan yang dikeluarkan. Untuk pemohon Kad Tambahan sahaja: Saya/Kami bersetuju untuk menanggung kesemua transaksi yang dicajkan kepada Kad Tambahan yang dikeluarkan. Saya/Kami mengesahkan bahawa saya/kami memilih bahasa seperti yang dinyatakan di bawah sebagai bahasa untuk transaksi ini (Sila tanda mana yang berkenaan). I/We understand that RHB Islamic Bank Berhad ("RHB") will use, collect, record, store, share and/or process my/our personal information, including, without limitation, my/our contact details, background information, financial data, tax residency and other information relevant to my/our application for the product and / or service which (a) I/We have provided in this form or through any other contact with RHB Banking Group (which shall include itsolding company, subsidiary(s), and any associated company(s), including any company as a result of any restructuring, merger, sale or acquisition), or (b) has been obtained from analysis of my/our payment and other transactions/ services within the RHB Banking Group, or (c) has been obtained from third parties such as employers, joint applicants/ accountholders, guarantors, legal representatives, industry/ financial related associations, government/ regulatory authorities, credit bureaus or credit reporting agencies, retailers, social networks and fraud prevention agencies or other organizations for any and/or all of the following purposes ( Purpose ), if applicable: (i) providing this product and/or service and notifying me/us about important changes or developments to the features; (ii) updating and managing the accuracy of RHB Banking Group's records; (iii) prevention, detection or prosecution of crime, and complying with legal and regulatory obligations; (iv) assessment and analysis including credit/ lending/ insurance risks/ behaviour scoring/ market and product analysis and market research; (v) communications and ensuring customer satisfaction, which may include conducting surveys to improve the quality of RHB products and services, responding to inquiries and complaints and to generally resolve disputes; (vi) determining the amount of my/our indebtedness and recovering debt that I/we owe to RHB; (vii) maintaining my/our credit history for present and future reference; (viii) enabling an actual or proposed assignee of RHB, or participant or sub-participant of RHB to evaluate my/our transactions which are intended to be the subject of the assignment, participation or sub-participation; (ix) cross-selling, marketing and promotions of products and/or services of RHB Banking Group and its strategic alliances; (x) English / Bahasa Inggeris Bahasa Malaysia PRIVACY NOTICE FOR NEW CUSTOMERS / NOTIS PRIVASI UNTUK PELANGGAN-PELANGGAN BARU for RHB s corporate events (including networking events, launching of products, etc)/ contests, of which photographs/ images of me/us may be captured and may be used for RHB s publications; or (xi) protecting RHB Banking Group's interests and other ancillary or related purposes. I/We understand and acknowledge that it is necessary for RHB to process my/our personal information for the Purpose, without which RHB will not be able to provide the product/ service that I/we have requested from RHB and to notify me/us about important changes or developments to the products/ services. Where I/we have provided RHB with sensitive personal information (in particular, information consisting my/our physical/mental health for applications of insurance products/ services), I/we hereby provide RHB with my/our express consent to process the same in the manner described in this Privacy Notice. I/Weu may exercise my/our options in respect of receiving marketing materials (including cross-selling, marketing and promotions as described above) at any time by visiting or contact I/We understand that RHB may disclose my/our personal information (or sensitive personal information, if applicable) to other companies within the RHB Banking Group, service providers, merchants and strategic partners, vendors including debt collection agencies, professional advisers, industry/ financial related associations, credit bureaus or credit reporting agencies and fraud prevention agencies, governmental agencies, other financial institutions and any of their respective agents, servants and/or such persons, whether located within or outside Malaysia for the Purpose, if applicable, subject at all times to any laws (including regulations, standards, guidelines and/or obligations) applicable to RHB. I/We further understand that I/we may request for correction (if my/our personal information is inaccurate, outdated, incomplete, etc), access to (a prescribed fee may be charged), or deletion (if I/we no longer have any existing products/services with RHB Banking Group) of my/our personal information or limit the processing thereof at any time hereafter by submitting such request via post, or fax to the following address: RHB Banking Group Customer Care Centre Level 7 Menara AA, JalanTun Razak, Kuala Lumpur, Malaysia. Facsimile number: / Telephone number: customer.service@rhbgroup.com I/We acknowledge that RHB Banking Group may modify or update its Privacy Notice from time to time, a copy of which is available at and that I/we may channel any complaints or inquiries I/we may have in the manner indicated above. / Saya/Kami faham bahawa RHB Islamic Bank Berhad ("RHB") akan menggunakan, mengumpul, merekod, menyimpan, berkongsi dan/atau memproses maklumat peribadi saya/kami, termasuk, tanpa had, butir-butir pengenalan saya/kami, maklumat latar belakang, data kewangan, penduduk cukai dan maklumat lain yang berkaitan dengan permohonan saya/kami untuk produk dan / atau perkhidmatan yang a) telah saya/kami berikan di dalam borang ini atau melalui sebarang perhubungan lain dengan Kumpulan Perbankan RHB (termasuk syarikat induk, syarikat-syarikat subsidiari dan mana-mana syarikat yang berkenaan, termasuk mana-mana syarikat yang terhasil daripada mana-mana penyusunan semula, penggabungan, jualan atau pengambilalihan) atau b) diperolehi daripada analisis pembayaran saya/kami dan urusniaga/ perkhidmatan yang lain dalam Kumpulan Perbankan RHB, atau c) diperolehi daripada pihak ketiga seperti majikan, pemohon bersama/ pemegang 0pemegang akaun, penjamin-penjamin, wakil-wakil perundangan, persatuan-persatuan berkaitan industri/ kewangan, pihak-pihak berkuasa kerajaan, biro-biro kredit atau agensi-agensi pelaporan kredit, penjual-penjual, rangkaian-rangkaian sosial dan agensi-agensi pencegahan penipuan atau organisasi-organisasi lain, untuk mana-mana dan/atau semua tujuan-tujuan yang berikut ("Tujuan"), jika berkaitan: (i) menyediakan produk dan/atau perkhidmatan ini dan memaklumkan saya/kami tentang sebarang perubahan penting atau perkembangan tentang ciri-ciri produk dan/ atau perkhidmatan tersebut; (ii) mengemaskini dan menguruskan ketepatan rekod Kumpulan Perbankan RHB; (iii) pencegahan, pengesanan atau pendakwaan jenayah, dan pematuhan obligasi-obligasi perundangan dan peraturan; (iv) penilaian dan analisis termasuk pemarkahan kredit/ pinjaman/ risiko insurans/ kelakuan, analisis pasaran dan produk dan penyelidikan pasaran; (v) perhubungan dan memastikan kepuasan pelanggan, yang mungkin termasuk menjalankan kajian-kajian meningkatkan kualiti produk-produk dan perkhidmatan-perkhidmatan RHB, membalas kepada pertanyaan dan aduan serta untuk menyelesaikan percanggahan secara umumnya; (vi) menentukan jumlah hutang saya/kami dan pemungutan hutang yang saya/kami berhutang kepada RHB; (vii) mengekalkan sejarah kredit saya/kami untuk rujukan semasa dan akan datang; (viii) membolehkan pemegang serah hak sebenar atau yang dicadangkan oleh RHB, atau peserta atau sub peserta RHB untuk menilai urus niaga saya/kami yang bertujuan untuk menjadi subjek penyerahhakan, penyertaan atau sub penyertaan; (ix) melindungi kepentingan Kumpulan Perbankan RHB dan tujuan sampingan atau tujuan lain yang berkenaan; (x) penjualan silang, pemasaran dan promosi produk dan/ atau perkhidmatan Kumpulan Perbankan RHB dan rakan-rakan kongsi strategik; atau (xi) bagi acara-acara korporat RHB (termasuk acara rangkaian, pelancaran produk, dan lain-lain)/ pertandingan, di mana gambar/ imej saya/kami mungkin akan ditangkap dan boleh digunakan untuk penerbitan RHB. Saya/kami faham dan mengakui bahawa RHB perlu memproses maklumat peribadi saya/kami untuk Tujuan tersebut, tanpanya RHB tidak akan dapat menyediakan produk/ perkhidmatan yang saya/kami minta daripada RHB dan untuk memaklumkan saya/kami tentang sebarang perubahan penting atau perkembangan tentang produk/ perkhidmatan tersebut. Di mana saya/kami telah memberi RHB maklumat peribadi sensitif (khususnya, maklumat tentang kesihatan fizikal/ mental saya/kami untuk permohonan bagi produk insurans / perkhidmatan), saya/kami dengan ini memberikan RHB persetujuan nyata saya/kami untuk memproses mengikut cara yang dinyatakan dalam Notis Privasi ini. Saya/kami boleh menjalankan pilihan saya/kami berkenaan dengan menerima bahan-bahan pemasaran (termasuk penjualan silang, pemasaran dan promosi seperti yang dinyatakan di atas) pada bila-bila masa dengan melawat atau hubungi Saya/kami faham bahawa RHB mungkin akan mendedahkan maklumat peribadi saya/kami (atau maklumat peribadi sensitif, jika berkenaan) kepada syarikat-syarikat lain di dalam Kumpulan Perbankan RHB, penyedia-penyedia perkhidmatan, peniaga-peniaga dan rakan-rakan kongsi strategik, pembekal-pembekal termasuk agensi-agensi pemungutan hutang, penasihat-penasihat profesional, persatuan-persatuan berkaitan industri/ kewangan, biro-biro kredit atau agensi-agensi pelaporan kredit dan pencegahan penipuan, agensi-agensi kerajaan, institusi-institusi kewangan yang lain dan mana-mana ejen, pekerja, dan/atau mana-mana orang mereka, sama ada bertempat di dalam atau di luar Malaysia untuk Tujuan tersebut, jika berkenaan, tertakluk pada setiap masa kepada mana-mana undang-undang (termasuk peraturan-peraturan, piawaian, garis panduan dan / atau obligasi) yang terpakai kepada RHB. Saya/kami juga faham bahawa saya/kami boleh meminta untuk membuat pembetulan (jika maklumat peribadi saya/kami adalah tidak tepat, ketinggalan zaman, tidak lengkap, dan lain-lain), akses kepada (fi yang ditetapkan mungkin dikenakan), atau untuk menghapuskan (jika saya/kami tidak lagi mempunyai apa-apa produk/perkhidmatan yang sedia ada dengan Kumpulan Perbankan RHB) ke atas maklumat peribadi saya/kami atau mengehadkan pemprosesan itu pada bila-bila masa selepas ini dengan mengemukakan permintaan tersebut melalui pos, e-mel atau faks kepada alamat berikut: RHB Banking Group Customer Care Centre Level 7 Menara AA, JalanTun Razak, Kuala Lumpur, Malaysia. Nombor Faks: / Nombor Telefon: Emel: customer.service@rhbgroup.com Saya/kami mengakui bahawa Kumpulan Perbankan RHB boleh mengubahsuai atau mengemas kini Notis Privasi ini dari masa ke semasa, di mana salinannya boleh didapati di dan saya/kami boleh menyalurkan sebarang aduan atau pertanyaan yang saya/kami mungkin ada dengan cara yang ditunjukkan di atas. ACKNOWLEDGEMENT AND CONSENT/ PENGIKTIRAFAN DAN KEBENARAN By providing my/our personal information and signature, I/we consent to RHB processing my/our personal information for any necessary disclosures and overseas transfers of my/our personal information to relevant third parties, for the Purpose, if applicable. I/we agree to the disclosure and/or transfer of my/our personal information to relevant third parties as a result of any restructuring, sale or acquisition of any company within the RHB Banking Group, provided that the recipient uses my/our personal information for the Purpose, if applicable. I/we also represent and warrant that I/we have sufficiently obtained the consent of third party individual(s) (e.g. family, spouse, related parties, supplementary cardholder and/or emergency contact persons, etc) whose personal information I/we have disclosed to RHB to allow RHB to process the same in relation to the Purpose, if applicable./ Dengan memberikan maklumat peribadi saya/kami berserta tandatangan, saya/kami mengizinkan RHB memproses maklumat peribadi saya/kami untuk mana-mana pendedahan yang diperlukan dan pemindahan maklumat peribadi saya/kami ke luar negara kepada pihak ketiga yang berkaitan, jika berkenaan. Saya/Kami bersetuju dengan pendedahan dan/atau pemindahan maklumat peribadi saya/kami kepada pihak ketiga yang berkaitan akibat daripada apa-apa penyusunan semula, penjualan atau pengambilalihan mana-mana syarikat dalam Kumpulan Perbankan RHB, dengan syarat bahawa penerima menggunakan maklumat peribadi saya/kami untuk Tujuan tersebut sahaja. Saya/Kami juga

4 menyatakan dan menjamin bahawa saya/kami telah cukup memperolehi persetujuan individu-individu pihak ketiga (contohnya keluarga, pasangan, pihak-pihak berkaitan, pemegang kad tambahan dan/atau orang hubungan kecemasan, lain-lain) di mana maklumat peribadi mereka telah saya/kami dedahkan kepada RHB untuk membenarkan RHB membuat pemprosesan yang sama berhubung dengan Tujuan, jika berkenaan. FOR PRINCIPAL CARD / UNTUK PEMOHON KAD UTAMA i. I confirm and agree to the fee payable/waiver and the product benefits explained by the sales agent for my RHB Islamic Credit Card-i application./ Saya mengesahkan dan bersetuju dengan yuran yang kena dibayar/dikecualikan dan faedah produk yang diterangkan oleh ejen jualan untuk permohonan Kad Kredit-i RHB Islamic. For NEW RHB Islamic Credit Card-i Applicant who earns RM36,000 or less per annum (Item ii, iii, iv) / Khusus untuk pemohon-pemohon Kad Kredit-i RHB Islamic Bank berpendapatan tahunan RM36,000 dan ke bawah (Perkara ii, iii, iv) ii. I have been briefed and made to understand by RHB sales staff/representative on the following:/ Saya telah diberi keterangan oleh kakitangan dari bahagian jualan/wakil RHB seperti berikut: (a) Credit Cardholders can only own Credit Cards from a maximum of two (2) credit card issuers./pemegang Kad Kredit hanya boleh memiliki Kad-kad Kredit daripada maksima dua (2) mana-mana pengeluar Kad Kredit. (b) The maximum credit limit extended shall be two times monthly income of new Cardholder./ Had maxima kredit yang diberikan kepada RHB Kad Kredit baru adalah dua (2) kali ganda gaji Pemegang Kad bagi setiap pengeluar kad kredit. iii. I have Credit Card(s) from two (2) or more credit card issuers and I intend to apply for a new RHB Islamic Credit Card-i now./ Saya ingin memohon Kad Kredit-i RHB Islamic dan pada ketika ini saya sudah mempunyai kad-kad kredit dari dua (2) pengeluar kad. If Yes, please proceed to declaration iv. Below / Jika Ya, sila rujuk kepada pengisytiharan iv. di bawah iv. I shall cancel/have cancelled my existing Credit Card(s) with other credit card issuer(s) as follow./ Saya akan/telah membatalkan kad kredit yang sedia ada dengan pengeluar kad-kad kredit seperti berikut: a) Bank: b) Bank: c) Bank: v. Please proceed to submit my RHB Islamic Bank Credit Card-i Application immediately and I understand RHB Islamic Bank may at its sole and absolute direction, approve or reject my application. Sila teruskan permohonan saya dengan segera bagi mendapatkan Kad Kredit-i RHB Islamic Bank dan saya memahami bahawa RHB Islamic Bank berhak atas budi bicara mutlaknya untuk melulus atau menolak permohonan saya. CREDIT RATING AGENCIES (CRA) CONSENT DECLARATION FORM / BORANG AKAUN KEBENARAN AGENSI PELAPORAN KREDIT I/We, authorize and consent RHB Islamic Bank to obtain any credit information from CTOS and/or other registered Credit Reporting Agencies as defined under the Credit Reporting Agencies Act 2010 without further notice to me/us to such extent and for the purpose of the followings (whichever is applicable)/ Saya/Kami, dengan ini memberi kuasa dan memberi kebenaran kepada RHB Islamic Bank untuk mendapatkan apa-apa maklumat kredit daripada CTOS dan/atau mana-mana Agensi Pelaporan Kredit berdaftar seperti yang didefinisikan di bawah Akta Agensi Pelaporan Kredit 2010 tanpa sebarang notis lanjut kepada Saya/Kami bagi tujuan seperti yang berikut (mana-mana yang berkenaan) :-:- Credit application processing/ Pemprosesan permohonan kredit Credit limit review/ Kajian semula had kredit Restructuring/ Penyusunan semula Overlapping/ Pertindihan Upgrading/ Permohonan naik taraf IMPORTANT DISCLOSURES / MAKLUMAT PENTING Minimum age required is 21 years for Principal Card and 18 years for a Supplementary Card. Minimum annual basic income required is RM80,000 for World Card-i, RM48,000 for Platinum Card-i and RM24,000 for Smart Value Card-i. / Para pemohon mesti berusia sekurang-kurangnya 21 tahun untuk Kad Utama dan 18 tahun untuk Kad Tambahan. Pendapatan tahunan minima yang diperlukan adalah sebanyak RM80,000 untuk Kad-i Kredit World, RM48,000 untuk Kad-i Platinum dan RM24,000 untuk Kad-i Smart Value. DOCUMENT REQUIRED / DOKUMEN DIPERLUKAN Copy of MyKad (front and back) / Salinan MyKad (depan dan belakang) Recent 1-month salary slip/ 1 bulan penyata i. Recent 3-month salary slip; AND/ 3 bulan penyata ; DAN ii. Recent 3-month bank statement evidenced by salary crediting/ 3 bulan penyata bank bukti pengkreditan i. Recent 6-month salary/ commission slip; AND/ 6 bulan penyata gaji/ komisen; DAN ii. Recent 6-month bank statement evidenced by salary crediting/ 6 bulan penyata bank bukti pengkreditan Recent 6-months bank statement/ 6 bulan penyata bank bukti pengkreditan Latest EPF Statement/ Penyata KWSP terkini i. Latest Form B / BE; AND/ Borang B/BE terkini ii. Latest Tax Payment Receipt/ Resit sah Pembayaran Cukai terkini i. Latest Notice of Assessment; AND/ Notis Taksiran terkini; DAN ii. Latest tax payment receipt/ Resit sah Pembayaran Cukai (For Singapore only)/ (Untuk warganegara Singapura saja) i. Latest Pension Letter/ Pension Statement; AND/ Surat / penyata pencen terkini; DAN ii. Recent 3-month bank statement showing crediting of pension/ 3 bulan penyata bank bukti pengkreditan Mandatory Documents/ Dokumen Mandatori Letter of Employment/ Appointment (mandatory for employment for < 6 months)/ Surat Tawaran Kerja/ Pelantikan (wajip untuk tempoh pekerjaan < 6 bulan) Form 9, 24, 49 or Business Registration Certificate/ Borang 9, 24, 49 atau Sijil Pendaftaran Perniagaan Note: For any applicants employed outside Malaysia, a valid work permit is required. / Nota: Permit pekerjaan diperlukan untuk pemohon yang bekerja di luar Malaysia. Shariah Compliance Checklist (For Internal Use Only and to be completed by the Sales Person ) 1. Have you explained the Ujrah Contract? Note: Ujrah (Service fee): The customer will be charged a certain fee based on the services provided by the Bank 2. Have you informed the customer about Fees and Charges as in the Product Disclosure Sheet? i.e. Fixed Management Fee Rate / Actual Management Fee Rate / Cash Advance Fee / late Payment Charges / Excess Limit Fee 3. Have you informed the customer that the card usage is prohibited on merchant outlets that conduct non-shariah compliant business activities via barring of selected merchant codes? Note: The merchant codes that have been barred are as follows: MCC Bars, Cocktails MCC Packages Beer, Wine and Liquor MCC Cigar Stores and Stands MCC Gambling Transactions SALARIED / BERGAJI COMMISSION SELF-EMPLOYED / EARNER / MNCs Non-MNCs Govt BEKERJA SENDIRI PENDAPAT KOMISEN Remarks/Notes: - Signature of Principal Applicant / Tandatangan Pemohon Kad Utama Name / Nama: MyKad/Passport No. / No. MyKad/Pasport: Signature of Supplementary Applicant / Tandatangan Pemohon Kad Tambahan Name / Nama: MyKad/Passport No. / No. MyKad/Pasport: Attended by: Name:

5 TAKAFUL MY CREDIT SHIELD-i DECLARATION/ PENGAKUAN TAKAFUL MY CREDIT SHIELD-i YES!/YA!.. I would like to participate in TAKAFUL mycredit SHIELD. I declare that I am in good health and free from any physical impairments / deformities and have never been diagnosed and / or received or shown manifestations / symptoms of any illness or disability 12 month prior to my enrolment to this plan. Saya ingin menyertai TAKAFUL mycredit SHIELD. Saya mengaku bahawa kesihatan saya adalah baik dan bebas daripada sebarang kekurangan / kecacatan fizikal dan tidak pernah didiagnosis dan / atau menerima atau menunjukkan manifestasi / tanda-tanda sebarang penyakit atau ketidakupayaan dalam tempoh 12 bulan sebelum permohonan penyertaan saya untuk pelan ini. I understand that the monthly contribution is RM0.46 per RM100 of the total outstanding balance of my RHB Islamic Credit Card-i accounts including supplementary cards and I authorise RHB Islamic Bank Berhad to debit my contribution due under TAKAFUL mycredit SHIELD from my RHB Islamic credit card-i accounts including supplementary cards./ Saya faham bahawa caruman bulanan adalah RM0.46 untuk setiap RM100 daripada jumlah baki tertunggak di dalam akaun Kredit Kad-i RHB Islamic saya termasuk kad tambahan dan saya memberi kebenaran kepada RHB Islamic Bank Berhad untuk mendebitkan caruman saya yang harus bayar di bawah TAKAFUL mycredit SHIELD daripada akaun Kredit Kad-i RHB Islamic saya termasuk kad tambahan. I acknowledge and agree that the claim proceeds of TAKAFUL mycredit SHIELD shall be first made to RHB Islamic Bank Berhad for the purpose of settling the outstanding balance of my RHB Islamic Credit Card-i accounts including supplementary cards./ Saya mengakui dan bersetuju bahawa tuntutan TAKAFUL mycredit SHIELD akan dibayar kepada RHB Islamic Bank Berhad terlebih dahulu untuk menyelesaikan baki tertunggak akaun Kredit Kad-i RHB Islamic saya termasuk kad tambahan. I agree that all my personal details will be sent to Syarikat Takaful Malaysia Berhad and any selected third party or organizations associated with RHB Islamic Bank Berhad for the administration of my coverage under TAKAFUL mycredit SHIELD./ Saya bersetuju bahawa semua maklumat peribadi saya akan diberikan kepada Syarikat Takaful Malaysia Berhad dan mana-mana pihak ketiga yang dipilih atau organisasi yang berkaitan dengan RHB Islamic Bank Berhad untuk tujuan pemprosesan perlindungan saya di bawah TAKAFUL mycredit SHIELD. I agree to pay the contribution based on tabarru (concept of donation for mutual benefit), and appoint Syarikat Takaful Malaysia Berhad as the operator based on wakalah (concept of agency) to manage the contribution according to the terms and conditions stipulated in the master certificate./ Saya bersetuju untuk membayar caruman berdasarkan tabarru (konsep menderma bagi kebaikan bersama), dan melantik Syarikat Takaful Malaysia Berhad sebagai pengendali berdasarkan wakalah (konsep agensi) untuk menguruskan caruman berdasarkan kepada terma dan syarat seperti yang dinyatakan dalam sijil induk. I declare that all statements made above and any other documents submitted in connection with this application are complete and true to the best of my knowledge and belief./ Saya mengaku bahawa semua penyataan di atas dan sebarang dokumen yang disertakan berhubung dengan permohonan ini adalah lengkap dan benar sepanjang pengetahuan dan kepercayaan saya. Signature of Principal Applicant / Tandatangan Pemohon Kad Utama Date / Tarikh FOR BANK USE ONLY / UNTUK KEGUNAAN BANK SAHAJA Credit Card Number / Nombor Kad Kredit Account Number / Nombor Akaun

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