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Secure Application
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Are you a principal citi credit card holder?

Annual Income (RM)

Note: Excluding commission and bonus

Title

Full name as in Passport/NRIC

Name to appear on card

The card can only fit max 19 letters due to its sheer size. If your name on card is different from NRIC, we might take a little longer to verify your application

Date of Birth

Nationality

Are you a Bumiputra?

Passport No.

New/Old NRIC No.

Old NRIC No.(Optional)

Marital status

Your current bank

The name of the main bank you have relationship with in Malaysia.

Intended use of credit card

Type of account

Next

Home Telephone No.

If you don’t have a home number then please enter your mobile number.

Handphone No.

E-mail address

Note: By providing your email id, you will be automatically enrolled for
e-statement/e-advice.

Address 1(Unit No)

Address 2

City

State

Postcode

Residence Type

Number of years in residence

Next

Employer Name

Work Tel. No.

Extension No.(Optional)

Work Address

Please provide your complete address.

City

State

Postcode

Type of Business

Please specify the field of your work such as Banking, Telecommunication, Retail, Insurance etc.

Job Title

Tell us the position of your occupation such as doctors, system analyst, manager as per your name card.

Month joined / Business established

Month and year when you started working for the current company.

Preferential mailing address

Gift sending address

Next

Do you want the flexibility to spend beyond your credit limit?

1. Not applicable if your annual income is RM36,000 per annum or less.

2. A fee of RM26.50 (including 6% GST, levied effective 1 April 2015) will be charged when your total outstanding balance exceeds your credit limit.

3. Overlimit transactions are subject to the bank's approval and discretion as we deem fit.

Transaction Notifications

Note: Option selected above will apply to all credit card(s) applied for above and for any existing credit card(s) you may have with Citibank.

Next

Do you have a non-bank debt obligation to declare?

Note: Any non-disclosure of complete and accurate information may impact the Bank's decision on your application, including the approval of your application is at the Bank's discretion.

Type of debt obligations

Monthly loan repayment obligations from non-banks. ie. PTPTN

Amount of each monthly instalment/payment (RM)

Outstanding balance (RM)

Type of Guarantee

Name of Non-Bank

Public Figure Declaration For Primary Card (e.g. Ministerial/diplomatic positions)

Are you or your family members holding or have held senior public office?

e.g. Heads of States or of government, senior politicians, senior government, judicial or military officials, senior executives of state-owned corporations and important political party officials.

GENERAL DECLARATION FOR CITIBANK CREDIT CARD

I/We hereby declare, acknowledge, agree and confirm as follows:

  1. I/We warrant that all information furnished here is true, accurate and not misleading and I/We shall promptly notify the Bank if it ceases to be so and/or if there is any change to the information. I/We also understand that any non-disclosure of complete and accurate information may impact the Bank's decision on my/our application including the financing rate.
  2. I/We authorise Citibank Berhad ("the Bank"), at any time and from time to time to process including but not limited to access, obtain, verify and/or use, any data or information from any source (including credit reference agencies, credit reporting agencies, Bank Negara Malaysia ("BNM"), any credit bureau and/or the Central Credit Reference Information System ("CCRIS") and such relevant authorities) for the purposes of evaluating my/our credit standing in connection to me/us, this application, the Card(s) and any facility, service or accommodation I/We have or may have (whether or not with the Bank) as the Bank deems fit. I/We understand that this application, the opening, operation and conduct of my/our Card account and any future facility, service or accommodation applied by me/us or granted by you (whether in my/our sole name or jointly with another or others, person(s) designated by the Company to be Cardmember(s), presently or subsequently opened) may be reported to the Dishonoured Cheques Information System ("DCHEQS") maintained by BNM, CCRIS and such relevant authorities (as the case may be) as the Bank deems fit.
  3. I/We authorise the Bank to disclose, store, utilise and/or transfer my/our personal data such as my/our name, address(es), contact numbers, information obtained from credit reference agencies, credit reporting agencies, BNM, any credit bureau, CCRIS and such relevant authorities pertaining to this application, the Card(s) and/or any facility, service or accommodation applied by me/us or granted by the Bank (whether in my/our sole name(s) or jointly with another or others, presently or subsequently opened) and whether within or outside Malaysia ("Data") to/with Citibank Berhad, Citibank N.A., Citigroup Inc. or any of your/their offices, affiliates or subsidiaries (collectively "Citigroup"), merchants, VISA International Services Association, MasterCard International Incorporated, American Express Limited, the principal account holder/Cardmember (including its affiliates and subsidiaries), any security party(ies) (including but not limited to any guarantor or indemnifier), any vendors and/or third party service providers engaged by the Bank and/or Citigroup, including any person to whom the Bank and/or Citigroup has outsourced the performance of its/their operational functions (whether within or outside Malaysia), in connection with this application, the Card(s) or any products, service and accommodation I/We have or may have with the Bank, for confidential use, processing this application, data processing, credit evaluation, meeting legal and regulatory requirements, for provision of goods or services, marketing and promotion of any products, service and/or accommodation to me/us, provision of services such as protection plans or insurance policies where applicable (including assessing, processing and investigating any risks or claims), fulfillment and delivery of gifts to me/us in connection with thin application, my/our Card(s), the Citibank Business Signature Card Terms and Conditions and all other purposes incidental and associated with any of the above.
  4. Unless I/We have declared in writing to the contrary, I/We declare that I/We am/are not a connected party(ies) of Citibank Berhad as set out in Bank Negara Malaysia's Guidelines on Credit Transactions and Exposures with Connected Parties [including any amendments and/or substitutions thereafter (if any)] ("the Connected Party Guidelines"). I/We undertake to declare to the Bank immediately in writing if I/We am/are a connected party of Citibank Berhad. I/We understand that if I/We am/are a connected party of Citibank Berhad, Citibank Berhad may not be able to grant or continue with credit facilities, banking facilities or accommodation to me/us. A person is a connected party of Citibank Berhad if, among others, the person –
    1. is a director (or alternate director) of Citibank Berhad or is a close relative of a director (or alternate director) of Citibank Berhad;
    2. is a controlling shareholder of Citibank Berhad or is a close relative of a controlling shareholder of Citibank Berhad;
    3. is an executive officer of Citibank Berhad or is a close relative of an executive officer of Citibank Berhad;
    4. is an officer of Citibank Berhad who is responsible for or has authority to appraise and/or approve credit transactions or review the status of existing credit transactions (a "Credit Office") or is a close relative of a Credit Officer;
    5. is a firm, partnership, company or any legal entity which control, or are controlled by, any person listed in (a) to (d) above;
    6. is a firm, partnership, company or legal entity in which any person listed in (a) to (d) above is interested as a director, partner, executive office, agent or guarantor or is a subsidiary or an entity controlled by any such firm, partnership company or legal entity; or
    7. is a person for whom any person listed in (a) to (d) is a guarantor. A close relative of an individual includes the individual's:-

      (g.i) spouse and the dependents of the spouse;

      (g.ii) child (including step children and adopted children) and the spouse of the child;

      (g.iii) parent; or

      (g.iv) brother or sister and their spouses.

  5. I/We fully understand that the approval of my application is at the discretion as the Bank deems fit and you may at any time terminate my/our Citibank Credit Card(s), Ready Credit and/or Instalment Loan facility with notice.
  6. I/We will keep you fully indemnified against any claims, actions, proceedings, losses, damages, costs and charges as a result of using and/or in connection with the Data, Card(s), Citibank Card Terms and Conditions and all relevant agreements, covenants and undertakings by me/us.
  7. I/We expressly consent to the mailing of my/our Card(s), Debit & ATM Card, the Citibank Card Terms and Conditions, the relevant Terms and Conditions for specific Card-type (if applicable), and/or Citibank Ready Credit Customer's Terms and Conditions to my/our address(es) provided here if my/our application is successfully approved.

Specific Declaration For Principal Card Applicants

The Bank has informed me and I fully understand that in accordance with prevailing Bank Negara Malaysia Guidelines, if my annual income is RM36,000 or less, I can only hold credit cards as a Principal Cardmember from a maximum of two (2) credit card issuers ("Maximum Issuer Restriction"). Upon the issuance by the Bank of the credit card(s) applied for under this application, I declare that so long as the Maximum Issuer Restriction applies to me:

  1. I will be holding credit cards from a maximum of two (2) credit card issuers (including the Bank as an issuer); and
  2. If I am an existing Citibank Principal Cardmember holding credit cards from more than two (2) credit card issuers (including the Bank as an issuer), I undertake to comply with the Maximum Issuer Restriction effective 1 January 2012.

DECLARATION FOR CREDIT CARD

Terms and Conditions

IMPORTANT: You are deemed to have accepted Citibank Card Terms and Conditions and are bound by them once you start using your Citibank Berhad American Express Card, VISA Card or MasterCard or any other card associations ("Card"). As such, you should read these terms and conditions and the relevant terms and conditions for specific Card-type, whichever is applicable, available online at www.citibank.com.my prior to usage of the Card. If you require a printed copy, kindly contact us to request a copy or call Citibank Phone Banking at 03-2383 0000. (1) Usage of the card is governed by the Citibank Card Terms and Conditions and the relevant terms and conditions for specific Card-type, whichever is applicable, and is binding on the Principal Cardmember(s) and the Supplementary Cardmembers). (2) The Principal Cardmember shall be responsible for all liabilities and obligations of the Principal Cardmember as well as the Supplementary Cardmember(s). The Principal Cardmember is jointly and severally liable to us for all amounts and charges due and owing to us form the use by the Supplementary Cardmember(s) of his/her own Supplementary Card(s). (3) Any Card(s) issued to me/us, including Supplementary Card(s) must not be used by me/us for any unlawful activity or purpose (including without limitation online gambling), whether in whole or part. (4) For principal card applications, I understand that if I am submitting this application for more than one or multiple Citibank credit cards, I may be participating in more than one Citibank credit card promotion in which gifts are given for successfully approved applicants. In such event, I hereby CONFIRM that I am the only one entitled to receive the gift from only ONE of such promotions, regardless of the number of Citibank credit cards that are successfully approved. For this purpose, and subject to Citibank's approval of my applications, my preference of the gift is as indicated on page 1.

By signing on the income document(s), I confirm that (1) I have read and agree to abide by the provisions contained in GENERAL DECLARATION FOR CITIBANK CREDIT CARD and DECLARATION FOR CREDIT CARD. (2) My minimum income is RM24,000 per annum or more. (3) For CitiBusiness Card application, my business sales turnover is RM120,000 per annum or more (N/A if Business Platinum card applicant is salaried). (4) My signature constitutes a request for Citibank VISA credit card if I already have a Citibank MasterCard and vice versa, if applicable. (5) My signature constitutes a request for Gold/Classic Card if I do not qualify for Platinum/Gold Card. (6) The Principal and Supplementary Cardmember(s) will be jointly and severally liable to the Bank for all amounts and charges due and owing however arising from the use by the Supplementary Cardmember(s) of his/her own Supplementary Card(s). (7) The Bank may allow the Principal Cardmember(s) to exceed the credit limit/total credit limit and/or the Supplementary Cardmember(s) to exceed the Supplementary Card(s) limit (if a separate credit limit is assigned) at the Bank's discretion as we deem fit. (8) The Principal Cardmember(s) and the Supplementary Cardmember(s) will be bound by the Citibank Card Terms and Conditions. (9) I have received, read and understood the contents of the Product Disclosure Sheet.

Citibank's Privacy Notice

Keeping personal data of individuals secure is a top priority for all of us at Citibank. Please visit us at www.citibank.com.my/privacyENG to view our Notice and Choice Principle Statement where we seek to outline how we intend to deliver all the rights and protections that you are entitled to in respect of your personal data. In addition, in the course of your banking relationships with Citibank, personal data of individual third parties such as your mandates, authorised signatories, shareholders, directors, guarantors and parties that have provided security to secure your obligations to Citibank, may have been provided to us as well. Please inform all such third parties to visit us at the above web link to view our Notice and Choice Principle Statement.

By clicking the SUBMIT button, you agree to be borne by the Declarations and Terms of this online application.

Your card details

Existing Citibank Credit Card Number

Experience FAST TRACK since you are a Citibank privileged customer.

Tell Us About Youself

Title

Full name as in NRIC or Passport

New NRIC No. or Passport No.

Old NRIC No.(Optional)

Intended use of credit card

Handphone No.

E-mail address

Note: By providing your email id, you will be automatically enrolled for
e-statement/e-advice.

Tell us which bank do you have a relationship with in Malaysia?

Let Us Serve You Better

Want the flexibility to spend beyond your credit limit

Transaction Notifications

Note: Option selected above will apply to all credit card(s) applied for above and for any existing credit card(s) you may have with Citibank.

Declaration

Do you have a non-bank debt obligation to declare?

Note: Any non-disclosure of complete and accurate information may impact the Bank's decision on your application, including the approval of your application is at the Bank's discretion.

Type of debt obligations

Monthly loan repayment obligations from non-banks. ie. PTPTN

Amount of each monthly installment/payment (RM)

Outstanding balance (RM)

Type of Guarantee

Name of Non-Bank

Type of debt obligations

Amount of each monthly instalment/payment (RM)

Outstanding balance (RM)

Type of Guarantee

Name of Non-Bank

Type of debt obligations

Amount of each monthly instalment/payment (RM)

Outstanding balance (RM)

Type of Guarantee

Name of Non-Bank

Type of debt obligations

Amount of each monthly instalment/payment (RM)

Outstanding balance (RM)

Type of Guarantee

Name of Non-Bank

Type of debt obligations

Amount of each monthly instalment/payment (RM)

Outstanding balance (RM)

Type of Guarantee

Name of Non-Bank

Public Figure Declaration For Primary Card (e.g. Ministerial/diplomatic positions)

Are you or your family members holding or have held senior public office?

e.g. Heads of States or of government, senior politicians, senior government, judicial or military officials, senior executives of state-owned corporations and important political party officials

Senior public office

Position held

Position held from (MM/YYYY)

GENERAL DECLARATION FOR CITIBANK CREDIT CARD

I/We hereby declare, acknowledge, agree and confirm as follows:

  1. I/We warrant that all information furnished here is true, accurate and not misleading and I/We shall promptly notify the Bank if it ceases to be so and/or if there is any change to the information. I/We also understand that any non-disclosure of complete and accurate information may impact the Bank's decision on my/our application including the financing rate.
  2. I/We authorise Citibank Berhad ("the Bank"), at any time and from time to time to process including but not limited to access, obtain, verify and/or use, any data or information from any source (including credit reference agencies, credit reporting agencies, Bank Negara Malaysia ("BNM"), any credit bureau and/or the Central Credit Reference Information System ("CCRIS") and such relevant authorities) for the purposes of evaluating my/our credit standing in connection to me/us, this application, the Card(s) and any facility, service or accommodation I/We have or may have (whether or not with the Bank) as the Bank deems fit. I/We understand that this application, the opening, operation and conduct of my/our Card account and any future facility, service or accommodation applied by me/us or granted by you (whether in my/our sole name or jointly with another or others, person(s) designated by the Company to be Cardmember(s), presently or subsequently opened) may be reported to the Dishonoured Cheques Information System ("DCHEQS") maintained by BNM, CCRIS and such relevant authorities (as the case may be) as the Bank deems fit.
  3. I/We authorise the Bank to disclose, store, utilise and/or transfer my/our personal data such as my/our name, address(es), contact numbers, information obtained from credit reference agencies, credit reporting agencies, BNM, any credit bureau, CCRIS and such relevant authorities pertaining to this application, the Card(s) and/or any facility, service or accommodation applied by me/us or granted by the Bank (whether in my/our sole name(s) or jointly with another or others, presently or subsequently opened) and whether within or outside Malaysia ("Data") to/with Citibank Berhad, Citibank N.A., Citigroup Inc. or any of your/their offices, affiliates or subsidiaries (collectively "Citigroup"), merchants, VISA International Services Association, MasterCard International Incorporated, American Express Limited, the principal account holder/Cardmember (including its affiliates and subsidiaries), any security party(ies) (including but not limited to any guarantor or indemnifier), any vendors and/or third party service providers engaged by the Bank and/or Citigroup, including any person to whom the Bank and/or Citigroup has outsourced the performance of its/their operational functions (whether within or outside Malaysia), in connection with this application, the Card(s) or any products, service and accommodation I/We have or may have with the Bank, for confidential use, processing this application, data processing, credit evaluation, meeting legal and regulatory requirements, for provision of goods or services, marketing and promotion of any products, service and/or accommodation to me/us, provision of services such as protection plans or insurance policies where applicable (including assessing, processing and investigating any risks or claims), fulfillment and delivery of gifts to me/us in connection with thin application, my/our Card(s), the Citibank Business Signature Card Terms and Conditions and all other purposes incidental and associated with any of the above.
  4. Unless I/We have declared in writing to the contrary, I/We declare that I/We am/are not a connected party(ies) of Citibank Berhad as set out in Bank Negara Malaysia's Guidelines on Credit Transactions and Exposures with Connected Parties [including any amendments and/or substitutions thereafter (if any)] ("the Connected Party Guidelines"). I/We undertake to declare to the Bank immediately in writing if I/We am/are a connected party of Citibank Berhad. I/We understand that if I/We am/are a connected party of Citibank Berhad, Citibank Berhad may not be able to grant or continue with credit facilities, banking facilities or accommodation to me/us. A person is a connected party of Citibank Berhad if, among others, the person –
    1. is a director (or alternate director) of Citibank Berhad or is a close relative of a director (or alternate director) of Citibank Berhad;
    2. is a controlling shareholder of Citibank Berhad or is a close relative of a controlling shareholder of Citibank Berhad;
    3. is an executive officer of Citibank Berhad or is a close relative of an executive officer of Citibank Berhad;
    4. is an officer of Citibank Berhad who is responsible for or has authority to appraise and/or approve credit transactions or review the status of existing credit transactions (a "Credit Office") or is a close relative of a Credit Officer;
    5. is a firm, partnership, company or any legal entity which control, or are controlled by, any person listed in (a) to (d) above;
    6. is a firm, partnership, company or legal entity in which any person listed in (a) to (d) above is interested as a director, partner, executive office, agent or guarantor or is a subsidiary or an entity controlled by any such firm, partnership company or legal entity; or
    7. is a person for whom any person listed in (a) to (d) is a guarantor. A close relative of an individual includes the individual's:-

      (g.i) spouse and the dependents of the spouse;

      (g.ii) child (including step children and adopted children) and the spouse of the child;

      (g.iii) parent; or

      (g.iv) brother or sister and their spouses.

  5. I/We fully understand that the approval of my application is at the discretion as the Bank deems fit and you may at any time terminate my/our Citibank Credit Card(s), Ready Credit and/or Instalment Loan facility with notice.
  6. I/We will keep you fully indemnified against any claims, actions, proceedings, losses, damages, costs and charges as a result of using and/or in connection with the Data, Card(s), Citibank Card Terms and Conditions and all relevant agreements, covenants and undertakings by me/us.
  7. I/We expressly consent to the mailing of my/our Card(s), Debit & ATM Card, the Citibank Card Terms and Conditions, the relevant Terms and Conditions for specific Card-type (if applicable), and/or Citibank Ready Credit Customer's Terms and Conditions to my/our address(es) provided here if my/our application is successfully approved.

Specific Declaration For Principal Card Applicants

The Bank has informed me and I fully understand that in accordance with prevailing Bank Negara Malaysia Guidelines, if my annual income is RM36,000 or less, I can only hold credit cards as a Principal Cardmember from a maximum of two (2) credit card issuers ("Maximum Issuer Restriction"). Upon the issuance by the Bank of the credit card(s) applied for under this application, I declare that so long as the Maximum Issuer Restriction applies to me:

  1. I will be holding credit cards from a maximum of two (2) credit card issuers (including the Bank as an issuer); and
  2. If I am an existing Citibank Principal Cardmember holding credit cards from more than two (2) credit card issuers (including the Bank as an issuer), I undertake to comply with the Maximum Issuer Restriction effective 1 January 2012.

DECLARATION FOR CREDIT CARD

Terms and Conditions

IMPORTANT: You are deemed to have accepted Citibank Card Terms and Conditions and are bound by them once you start using your Citibank Berhad American Express Card, VISA Card or MasterCard or any other card associations ("Card"). As such, you should read these terms and conditions and the relevant terms and conditions for specific Card-type, whichever is applicable, available online at www.citibank.com.my prior to usage of the Card. If you require a printed copy, kindly contact us to request a copy or call Citibank Phone Banking at 03-2383 0000. (1) Usage of the card is governed by the Citibank Card Terms and Conditions and the relevant terms and conditions for specific Card-type, whichever is applicable, and is binding on the Principal Cardmember(s) and the Supplementary Cardmembers). (2) The Principal Cardmember shall be responsible for all liabilities and obligations of the Principal Cardmember as well as the Supplementary Cardmember(s). The Principal Cardmember is jointly and severally liable to us for all amounts and charges due and owing to us form the use by the Supplementary Cardmember(s) of his/her own Supplementary Card(s). (3) Any Card(s) issued to me/us, including Supplementary Card(s) must not be used by me/us for any unlawful activity or purpose (including without limitation online gambling), whether in whole or part. (4) For principal card applications, I understand that if I am submitting this application for more than one or multiple Citibank credit cards, I may be participating in more than one Citibank credit card promotion in which gifts are given for successfully approved applicants. In such event, I hereby CONFIRM that I am the only one entitled to receive the gift from only ONE of such promotions, regardless of the number of Citibank credit cards that are successfully approved. For this purpose, and subject to Citibank's approval of my applications, my preference of the gift is as indicated on page 1.

By signing on the income document(s), I confirm that (1) I have read and agree to abide by the provisions contained in GENERAL DECLARATION FOR CITIBANK CREDIT CARD and DECLARATION FOR CREDIT CARD. (2) My minimum income is RM24,000 per annum or more. (3) For CitiBusiness Card application, my business sales turnover is RM120,000 per annum or more (N/A if Business Platinum card applicant is salaried). (4) My signature constitutes a request for Citibank VISA credit card if I already have a Citibank MasterCard and vice versa, if applicable. (5) My signature constitutes a request for Gold/Classic Card if I do not qualify for Platinum/Gold Card. (6) The Principal and Supplementary Cardmember(s) will be jointly and severally liable to the Bank for all amounts and charges due and owing however arising from the use by the Supplementary Cardmember(s) of his/her own Supplementary Card(s). (7) The Bank may allow the Principal Cardmember(s) to exceed the credit limit/total credit limit and/or the Supplementary Cardmember(s) to exceed the Supplementary Card(s) limit (if a separate credit limit is assigned) at the Bank's discretion as we deem fit. (8) The Principal Cardmember(s) and the Supplementary Cardmember(s) will be bound by the Citibank Card Terms and Conditions. (9) I have received, read and understood the contents of the Product Disclosure Sheet.

Citibank's Privacy Notice

Keeping personal data of individuals secure is a top priority for all of us at Citibank. Please visit us at www.citibank.com.my/privacyENG to view our Notice and Choice Principle Statement where we seek to outline how we intend to deliver all the rights and protections that you are entitled to in respect of your personal data. In addition, in the course of your banking relationships with Citibank, personal data of individual third parties such as your mandates, authorised signatories, shareholders, directors, guarantors and parties that have provided security to secure your obligations to Citibank, may have been provided to us as well. Please inform all such third parties to visit us at the above web link to view our Notice and Choice Principle Statement.

By clicking the SUBMIT button, you agree to be borne by the Declarations and Terms of this online application.

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In accordance with Citibank's privacy policy, your details will not be used for any other purpose or shared with any third parties.