CARD CONVERSION REQUEST FORM From Citibank Credit Card to CITIBANK SHELL Credit Card
Please complete this form and return to: Date To : : Citibank Berhad FAX: or MAIL: 03 2383 6666 Citibank Berhad Customer Correspondence Unit P.O. Box 11725 50754 Kuala Lumpur
Dear Sir / Madam, RE : Application for Conversion to Citibank-Shell Credit Card
I wish to upgrade my existing Citibank Card (“Existing Card”) to CITIBANK-SHELL credit card (“Citibank-Shell Card”). I confirm that I understand the conversion is subject to the following terms and conditions: 1. The credit limit (CL) for the Citibank-Shell Card will be the same as the current CL of my Existing Card (subject to the maximum amount of RM45,000) or any other amount subject to bank’s approval. Citibank also reserves the right to approve or reject this application based on its sole discretion. Rewards Points from my existing Citibank card cannot be converted to cash back. I will redeem all reward points prior to conversion, failing which my reward points will be forfeited. All cash rebate available in my current cash back card will be redeemed against my current outstanding balances. I will start earning cash back when I start using my Shell Citibank card based on tiers as communicated below All my outstanding balances, including unbilled installment loans (such as Loan-On-Phone, Easy Payment Plan, Flexible Payment Plan), balances of my balance transfer, other fees and charges on my Existing Card will be transferred to my new Citibank-Shell Card accordingly upon issuance of the Citibank-Shell Card. All my Citibank One Bill and Credit Shield Plus services (if any) on my Existing Card are transferable to my new Citibank-Shell Card. However, for Autopay services that I have registered with the participating merchants, I shall assume the full responsibility to inform the respective merchants accordingly of my new Citibank-Shell card number. I acknowledge that Citibank do not have any obligation to inform the merchants of the change in my credit card details and that Citibank is not liable for any interruption of the auto-pay services if I fail to inform merchants of the change in details of my credit card. I am aware that once my card has been processed and converted to Citibank – Shell Card, there will be a one-day interruption on my supplementary card. I confirm that I am fully aware that my Existing Card is still active to be used for a period of 90 days after conversion to the Citibank-Shell Card. Thereafter, Citibank will automatically block my Existing Card from all transactions. The above terms and conditions shall also apply to the supplementary card(s) to my Existing Card.
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Citibank-Shell Card Application (please tick where applicable) Yes, I have read and understood the terms and conditions related to the upgrade of my Existing Card to the Citibank-Shell Card, and hereby authorize Citibank to proceed with the transfer of my Existing Card to the below Citibank-Shell Card. I understand that Citibank have the right to provide me with either of the products below base on my credit evaluation. Citibank-Shell Gold Card – Annual Fee RM 195 (1st year fee waived); first 2 supplementary free Citibank-Shell Silver Card – Annual Fee RM 90 (1st year fee waived); first 2 supplementary free My current Citibank card is a VISA Card No: _________________________________________ Name: ___________________________________ I/C NO. (New/Old): ______________________
Principal Cardmember’s signature * delete where applicable