Please complete this form and mail or fax it to 6532 6318 together with a copy of the relevant documents.                                                                                                                        PAGE 1 of 3

 MY DESIRED CARD                                                                 5                            Residential Status
                                                                                                              1         Rented                    3       Employers’                    5      Others
                                                                                                                                                                                                                   Length of Stay
                                                                                                              2         Parents’                  4       Mortgaged                     6      Owned                                 Months
                                                                    Annual Fee
                                                           Principal               Supplementary              Residential Type
     BOC Healthway Wellness                                S$150 Waive            S$75 Waived                 1         HDB-3Rm/4Rm                        4       Private Apartment/Condominium                         7       Bungalow
     Platinum Card                                                                                            2         HDB-5Rm/Executive Apt              5       Terrace
                                                                                                              3         Executive Condo/HUDC               6       Semi-detached

  Please complete the entire form in ENGLISH. All principal applicants must be at                                 Education Level
  least 21 years old and earn a minimum income of S$30,000 p.a. For foreigners,                                   1   Primary                         4     Tertiary                          7         Others
  a minimum income of S$60,000 p.a. is required. If you do not meet the minimum                                   2   Secondary                       5     Degree
                                                                                                                  3   Pre University                  6     Postgraduate
  income requirement, a minimum Fixed Deposit of S$10,000 is required or such                                                                                                                                 (Please specify)
  other amount as the Bank deems fit.
                                                                                                              MY EMPLOYMENT DETAILS
   Basic Documents Required
     1. Please submit the following identification documents that are applicable to you.                      Name of Company                                                                      Check here if self–employed
        Singapore Citizens and Permanent Residents
        Photocopy of NRIC (front and back)
        Photocopy of your Employment Pass (valid for at least 9 months) and Passport                          Office Address

                                                                                                              Postal Code
     2. Please submit the following income documents that are applicable to you.
        Salaried Employee
                                                                                                              Length of Employment                                                           __ __ Years              __ __ Months
        Latest computerized payslip OR
        Latest income Tax Notice of Assessment OR
                                                                                                                  Industry / Business Type
        CPF Statement for the last 6 months
        Self-Employed & Commission or variable income earners                                                         Banking & Finance                   IT / Communications                       Government
        Income Tax Notice of Assessment for the last 2 years OR                                                       Manufacturing                       Hotel                                     Retail
        CPF Statement for the last 12 months                                                                          Others (Please specify)

  *You can now print your Notice of Assessment at myTax Portal with your SingPass or IRAS PIN. The service    Current Position
  is free. Log on to Insufficient information may cause delays in processing.
                                                                                                              G          GMs / MDs / CEOs                           A        Administrative                          E       Executive
                                                                                                              P          Professional                               D        Commission Earners                      S       Sales
                               Bank of China Limited Singapore Branch
                                            Card Centre                                                       M          Managerial                                 V        Civil Servant                           R       Retired
                   4 Battery Road #06-00 Bank of China Building Singapore 049908
                          24-Hour Customer Service Hotline: 1800 338 5335                                     O          Others (Please specify)
                                           Fax: 6532 6318
                                                                                                              Annual Income                                                   Are you
  MY BANKING RELATIONSHIP                                                                                                                                                         On Contract (Expiry M __ __ Y __ __)
                                                                                                                                                                                  Permanently Employed
    Existing Bank of China            Existing Bank of China               No existing relationship
    credit cardholder                 customer                                                                Name of Previous Employer

 Do you wish to receive informtion on our product and service offers?
                                                                                                              Previous Position                                                                               Years There
     Y              N

                                                                                                                  MY PERSONAL REFERENCES
 Name as in NRIC / Passport                                 Mr       Miss         Mdm          Mrs       Dr       Mother’s Maiden Name
 (Please underline surname)                                                                                       (for security verification)

 Name to appear on Credit Card (19 characters)                                                                    MY REFERENCE FOR BILLING PROCEDURE
                                                                                                              H        To Home Address                         W         To Office Address                    O      To Other Address

   Date of Birth
                                                                      Gender         0     F         0   Y
                              d d     mm     y y                                                              Postal Code
                                                                                                              Administration fee of S$5.00 per month for overseas address applies.

   Nationality                                                        PR               0   Y             N
                                                                                                                  SUPPLEMENTARY CARD APPLICANT’S
  NRIC / Passport No.
                                                                                                              Name as in NRIC / Passport (Please underline surname)
                                                                                                                                                                                                                                                 Bank Of China Limited (Incorporated in China) Wellness Platinum Appform 11/2011

  Home Address                                                                                                Name to appear on Credit Card (19 characters)

  Postal Code
                                                                                                              Date of Birth
                                                                                                                                                d d       mm       y y            Gender            0     F              1       M
  Overseas Permanent Address (If non-Singaporean)

                                                                                                              Nationality                                                         PR                      Y              1       N
  Postal Code

                                                                                                              NRIC / Passport No.
                                                                     Marital Status
   Expiry Date of Employment Pass                                    0       Single            2   Divorced       Home Address (If different from Principal Card applicant’s)
                                          d d       mm     y y       1       Married           3   Widowed

                                                                                                                  Postal Code
   Home Country ID No.                                               No. of Dependants
                                                                                                                  Name of Company                                                                         Annual Income

   Tel (H)                                Tel (M)                             Tel (O)
                                                                                                                  Tel (H)                                                     Relationship with Principal Card Applicant
  E-mail                                                                                                          Tel (M)
                                                                                                                  Tel (O)
   Language Preferred                            1       English         2      Chinese                       All applications are subject to approval. Supplementary Card applicant must be at least 18 years of age. Please also attach a
                                                                                                              copy of NRIC (front and back). If applicant’s age is below 18, a letter of acceptance from the overseas institution is required.
                                                                                                                                                                                                                 PAGE 2 of 3
 BOC CREDIT CARD FUND TRANSFER                                                                                            DECLARATION AND AGREEMENT
                                                                                                                          BOC CREDIT CARD, MONEYPLUS & FUND TRANSFER
     Yes! I wish to make additional Fund Transfer(s) and enjoy greater savings.                                           (Important : please read before signing)

     (Please tick accordingly)

                                                                                                                          BOC Credit Card: By signing below, I/we request that a Card Account be opened for me/us
               % interest rate for 3 months with 1.8% processing fee                                                      and for the Card(s) to be issued, renewed and replaced until the Card Account is terminated.
                                                                                                                          I/We acknowledge and agree that my/our use of the Cards shall be subjected to the terms

     Account Name
                    interest rate for 6 months with 3% processing fee                                                     and conditions of the BOC Cardmember Agreement (as may be amended, supplemented and
                                                                                                                          replaced from time to time) and agree to be bound thereby, a copy of which will be sent to me/
                                                                                                                          us by mail with the Card(s) at my/our own risk.

     (as shown in your credit card/credit line/bank account)                                                              MoneyPlus (applicable only if you choose to apply for MoneyPlus): I, as principle applicant,
                                                                                                                          understand that, subject to the discretion of BOC, a MoneyPlus Account may be opened
     Name of Bank                                                                                                         for me upon my successful application of the Card. Where a MoneyPlus Account is made
                                                                                                                          available to me, l agree to be bound by the BOC MoneyPlus Terms and Conditions, (a copy
     Credit Card/ Credit Line / Bank Account No                                                                           will be made available to me upon the MoneyPlus Account being made available to me) and
                                                                                                                          any amendments and additions made thereto from time to time.

     Card Expiry Date (If applicable) __ __ / __ __ __ __ (mm/yyyy)                                                       Fund Transfer: I/We understand that, subject to the discretion of BOC, a Fund Transfer may
                                                                                                                          be made available to me/us upon my successful application of the Card. I/We acknowledge
     Transfer Amount S$                                                      .00 (min. S$1,000 per transfer)              that the Fund Transfer may only be used upon approval subject to the Fund Transfer Terms
                                                                                                                          and Conditions. Fund Transfer is applicable in Singapore dollars, subject to a minimum
                                                                                                                          amount specified by BOC, to any credit card/credit line/bank account(s) held with any banks
     Principal Card Applicant’s Signature                                                                                 or financial institutions in Singapore, (other than BOC). I/We agree to be bound by the Fund
                                                                                                                          Transfer Terms and Conditions (a copy will be sent to me/us upon the Fund Transfer being
                                                                                                                          made available to me/us) and any amendments and additions made thereto from time to time.
                                                                                                                          I/We, jointly and severally,
 MONEYPLUS APPLICATION                                                                                                    (i) represent and warrant that all information given in this application and all documents
                                                                                                                              submitted to Bank of China Limited, Singapore Branch (“BOC”) are complete, true
                                                                                                                              and accurate and belong to BOC absolutely. If any of the given information changes or
YES! I wish to apply for                                                                                                      becomes inaccurate in any way, I/we shall promptly notify BOC in writing of any such
       MoneyPlus and enjoy 1 year annual fee waiver                                                                           change or inaccuracy.
       MoneyPlus revolving credit at 16.88% p.a effective interest rate upon
       withdrawal.                                                                                                        (ii) authorise BOC to disclose, obtain and/or verify any information about me/us or the Card
                                                                                                                               Account in any way as BOC deems fit in its absolute discretion (including but not limited
OR                                                                                                                             to checks with any credit bureau of which BOC is a member or subscriber; disclosure
                                                                                                                               of information to the head office of BOC, any branches, sub-branches, subsidiaries,
       MoneyPlus Term Loan to enjoy lower interest rate                                                                        affiliates, related companies or associated companies of the Bank of China Limited Group,
       Please select one of the tenure                                                                                         whether situated in Singapore or elsewhere; disclosure of information to any service
       6.38% p.a. for 12 months                                  7.38% p.a. for 24 months                                      provider, whether situated in Singapore or elsewhere, engaged by BOC or the Bank of
       8.68% p.a. for 36 months                                                                                                China Limited Group and agent or third party selected by such service provider for the
                                                                                                                               purpose of or in connection with providing services/products under or in connection with
                                                                                                                               BOC’s business). This consent or authorization shall be in addition to and shall not be in
In the event that the Account is closed or terminated for whatever reasons within 12 months
from the date of the opening of the Account, I agree that BOC is entitled to claim from me a full
                                                                                                                               any way prejudiced or affected by any other agreement, expressed or implied, between
reimbursement of the cost of any welcome gift that BOC may have given to me upon approval                                      me/us and BOC with regard to disclosure by BOC of any information about me/us nor
of my MoneyPlus application. I hereby authorize BOC to debit the Account for the cost of such                                  shall any other agreement to be in any way prejudiced or affected by this clause. For
gift (as determined by BOC), if any, prior to the closure of the Account.                                                      the avoidance of doubt, information or data herein referred shall include information or
                                                                                                                               data that BOC may obtain from third parties such as any credit bureau recognised by the
                                                                                                                               Monetary Authority of Singapore.

                                                                                                                          (iii) agree that the Principal Card applicant is responsible for all liabilities (including but not
                                                                                                                                limited to annual fees and other charges) which may be incurred in respect of his/her
                                                                                                                                Cards(s) and all Supplementary Card(s) issued at his/her request; each Supplementary
                                                                                                                                Card applicant is responsible only for all liabilities which may be incurred in respect of his/
                                                                                                                                her Supplementary Card(s).

                                                                                                                          (iv) agree and authorise BOC to make payment to any credit card/credit line/bank account(s)
                                                                                                                               held with any banks or financial institutions in Singapore (other than BOC) as stated under
                                                                                                                               Fund Transfer above.

                                                                                                                          (v) agree that the Card/ATM Card in relation to MoneyPlus Account and personal identification
BOC MONEYPLUS TERM LOAN TERMS AND CONDITIONS:                                                                                 number may be collected by me/us personally at my/our option or be sent to me/us by
1.     Upon completion of your MoneyPlus Term Loan tenure, the MoneyPlus Account prevailing interest rate of                  ordinary mail at my/our sole risk to my/our billing address.
       16.88% will apply.
2.     MoneyPlus Term Loan interest rate is applicable to the approved MoneyPlus Term Loan amount only.                   (vi) confirm that as at the time of this application, I/we are not an undischarged bankrupt(s)
3.     Disbursed MoneyPlus Term Loan amount will be rounded down to the nearest hundred. The total MoneyPlus                   and there has been no statutory demand served on me/us nor legal proceedings
       Term Loan amount shall not exceed 90% of the available credit limit on the MoneyPlus Account at the time of
                                                                                                                               commenced against me/us.
4.     Interest is calculated on a front end add-on method. MoneyPlus Term Loan interest rates are at 6.38%p.a. for
       12-month loans, 7.38%p.a. for 24-month loans or 8.68%p.a. for 36-month loans. Effective interest rates are         (vii) understand that BOC reserves the right to decline this application at its sole discretion
       at 11.58% p.a. for 12-month loans, 13.58%p.a. for 24-month loans or 15.70%p.a. for 36-month loans.                       without giving any reason and without entering into any correspondence; and to retain all
5.     A non-refundable processing fee of 2% of loan amount or S$75 applies, whichever is higher.                               supporting documents submitted for the processing.
6.     An early repayment fee of 1% on the outstanding MoneyPlus Term Loan amount or S$100, whichever is
       higher, is applicable if the MoneyPlus Term Loan is terminated or if the Customer makes early repayment of the     (viii) agree and consent for BOC to communicate with me/us with regard to any promotion
       MoneyPlus Term Loan before expiry of the MoneyPlus Term Loan tenure.                                                      relating to the Cards/MoneyPlus Account by electronic mail, SMS or any other means
7.     To initiate early repayment before expiry of the MoneyPlus Term Loan tenure, the Customer shall inform BOC                which BOC may deem appropriate at my/our contact details set out in this application or
       of such repayment in writing. Otherwise, monthly instalments will continue to be effected.
                                                                                                                                 which I/we may furnish to BOC from time to time. I/We authorise BOC to accept and act
8.     BOC may vary the interest rate chargeable, the basis of calculation of interest rates, fees, charges at any time
                                                                                                                                                                                                                                  Bank Of China Limited (Incorporated in China) Wellness Platinum Appform 11/2011

                                                                                                                                 upon all communications or instructions from me/us via electronic mail or SMS with regard
       at BOC’s sole discretion and without giving any reason therefore.
                                                                                                                                 to such promotions and BOC shall not be liable if it acts upon such communications in
9.     All information is correct at the time of print.                                                                          good faith.

     Principal Card Applicant’s Signature


                                                                                                                          Please sign as you would for all future transactions.

                                                                                                                            Principal Card Applicant’s Signature

                                                                                                                            Supplementary Card Applicant’s Signature

                                                             Glue or seal here with clear tape

            How to use the Business Reply Envelope (BRE)

                 1. Fold along dotted lines.                2. Insert documents into business            3. Seal along edges of folder with
                                                               reply folder, folding inwards.               clear tape (do not staple).
                                                                                                            Drop sealed folder into post box.

fold here

                                                                                                                                        Postage will
                                                                                                                                         be paid by
                                                                                                                                       For posting in
                                                                                                                                      Singapore only.

                                                  BUSINESS REPLY SERVICE
                                                     PERMIT NO. 04602

                                       BANK OF CHINA LIMITED SINGAPORE BRANCH
                                                    CARD CENTRE
                                                   ROBINSON ROAD
                                                     P.O. BOX 1289
                                                  SINGAPORE 902539

fold here

            ☞ Please note:
            • How you signed the form?
            • Do you remember to submit:
             √ Copy of NRIC / Passport for principal applicant and / or supplementary applicant (if applicable)
             √ Latest 6 months CPF Statement (12 months for self employed) OR
             √ Latest Income Tax Notice of Assessment

                                                             Glue or seal here with clear tape

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