Citibank信用卡電子月結單提示服務登記表格
Citibank Credit Card e-Statement Reminder Service Enrollment Form
請填妥下列表格及傳真至2866 1764或郵寄至郵政信箱3463號。 Please fax completed form to 2866 1764 or mail to GPO Box 3463. 持卡人姓名 Cardholder's Name: 身份証/護照號碼 HKID/Passport No: (頭3位數字 The first 3 digits)
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Citibank信用卡/大來信用証號碼 Citibank Credit Card / Diners Club Card Number:
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(如閣下持有其他 Citibank信用卡/大來信用証，只須填寫其中一張之號碼，名下之所有賬戶即可全部轉用電子月結單。 Should you have other Citibank Credit Cards/Diners Club Cards, just provide one and all of your existing Credit Card Account will be enrolled.) 電郵地址 Email Address:
(日後之電子通訊將以此為準，並取替本行以往之紀錄。 You'll receive your e-Communication via this email address, superseding our existing record. )
致:花旗銀行(香港)有限公司及大來信用証國際(香港)有限公司 本人/吾等同意登記使用 Citibank 網上理財電子月結單提示服務並同意每月截數日後在本人/ 吾等提供之電郵地址收取電郵通知。此電郵應被視為電子月結單已發出及提示本人/吾等可登入Citibank 網上理財 戶口查閱月結單。登記使用 Citibank 網上理財電子月結單提示服務後，月結單將停止印發。Citibank 網上理財電子月結單發出後可保留十二個月。本人/吾等接受並同意遵守管轄列於Citibank網頁 www.citibank.com.hk之Citibank 網上理財電子月結單提示服務的所有一般規則及條款，並同意若本人/吾等未能收到電子月結單或收取電子月結單有任何延誤,將立即致電及通知Citibank。本人/吾等確認 Citibank 網上理財若其中部份或全部服務可能於某段時段內由於維修及/或故障的原因而未能提供予本人/吾等使用, Citibank 無需因為本人/吾等未能不時使用而負任何責任。Citibank 保留權利取消或拒絕本 人/吾等 Citibank 網上理財電子月結單提示服務的登記。在 Citibank 取消本人/吾等 Citibank 網上理財電子月結單提示服務的登記後，Citibank 應自動印發本人/吾等的月結單。若本人/吾等欲取消本人/吾等 Citibank 網上理財電子月結單提示服務的登記，本人/吾等應向 Citibank事先給予最少兩個工作天通知生效。本人/吾等同意登記使用 Citibank 網上理財電子月結單提示服務後,所有Citibank信用卡，大來信用 証及私人儲蓄戶口均不獲發郵寄月結單。
To: Citibank (Hong Kong) Limited, Diners Club International (Hong Kong) Limited I/We agree that by enrolling to e-Statement Reminder Service, I/We will receive an email each month, the day after my statement date to the email address(es) I/We provided to you. This email will be considered as issuing my statement and is a reminder that my full billing statement can be viewed by logging into Citibank Online. My paper statements will be suppressed accordingly. Each e-Statement will be available for 12 months after the statement date. I/We accept and agree to be bound by the Citibank e-Statement User Agreement that states at Citibank Online, www.citibank.com.hk. If I do not receive the monthly email for any reason, I/We agree to notify Citibank in a timely manner. I/We acknowledge that Citibank Online may on rare occasions, be unavailable due to technical issues or maintenance, and I shall not hold Citibank liable for this. Citibank may at its discretion, reject my application for, or cancel my e-Statement Reminder Service enrollment, at which point paper statements will resume. If at any time I/We wish to revert to receiving paper statements, I/We should provide at least 2 working days notice to Citibank for this to be effective. I/We agree that once e-Statement Reminder Service is enrolled, all paper statements of Citibank Credit Card, Diners Club Card and Ready Cash/Ready Credit account will be suppressed.
以下的簽名證明本人/吾等同意所有印在此表格上的Citibank電子月結單之條款及細則。 By signing below, I/We agree to the Terms and Conditions of Citibank e-Statement Service on this enrollment form. 簽名 Signature:
日期 Date:
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重要事項 Important Notice!
須以您的Citibank信用卡/大來信用証號碼及私人密碼設立Citibank Online 「用戶登入賬戶」及「密碼」，如忘記或遺失了私人密碼，請填上以下部份，私人密碼 將寄上您的郵寄地址。 To set up your Citibank Online’s User ID & Password, you'll need your Citibank Credit Card/Diners Club Card No.(s) & ATM PIN(s). If you don’t have your ATM PIN(s), please fill in the below and your ATM PIN(s) will be mailed to your correspondent address. 申請Citibank信用卡/大來信用証私人密碼 ATM PIN(s) Request 第 1 張Citibank信用卡/大來信用証號碼 1st Citibank Credit Card/Diners Club Card No: 第 2張Citibank信用卡/大來信用証號碼 2nd Citibank Credit Card/Diners Club Card No: 第 3 張Citibank信用卡/大來信用証號碼 3rd Citibank Credit Card/Diners Club Card No: