Principal Credit Card Application Form

DMTM
Credit Card*:
Notes:
# Subject to 1 swipe in 45 days from card approval date.
* This application constitutes a request for Gold credit card if I do not qualify for Platinum credit card.
WISE Platinum (Visa) WISE Gold (Visa)
For Hong Leong WISE Credit Card
Book Stores
Departmental Stores
Dining
Entertainment
Groceries
Petrol
Pharmacies
Travel
Utilities
I would like to choose the following categories to enjoy 10% cash back on retail purchases (please select maximum 2):
Yes, I would like to apply for the following Hong Leong Credit Card(s):
1st year Annual Fee waiver
#
Step 1 Complete The Application Form
Step 2 Scan Your Personal Identification Documents & Income Documents
i. Photocopy of NRIC (front and back) *Please cross it with For HLB Use Only
For Salaried with Basic / Variable Income
i. Latest 3 months Pay Slip and Personal Bank Statements showing last 3 months salary credited OR
ii. Latest EPF Statement OR
iii. Latest EA Form or BE with payment receipt / stamped e-Filing Summary Sheet
For Self Employed
i. Latest EPF Statement OR
ii. Latest 6 months Company Bank Statement with Business Registration Certificate OR
iii. Latest Form B or BE with payment receipt / last 2 years stamped e-Filing Summary Sheet OR
iv. Form 9, 24 and 49
Step 3 Email the files to SPEEDAPP@HLBB.HONGLEONG.COM.MY
Nationality
Your Personal Details
Full Name (as per IC/Passport) Mr Madam Ms Others
Gender Male Female
Name to Appear on Card (not more than 19 letters)
New IC/Passport No. Old IC No.
Date of Birth
DD MM YY
No. of dependants
Marital Status Single Married Widowed Divorced
Race Malay Chinese Others Indian
Educational Level Secondary/Primary Diploma Bachelor Degree Master/PhD
Home Address
Postcode City State
Home Tel. No. H/P No.
Type of Residence Owned Rented Employers Parents
Your Residence
Email Address Length of Stay MM YY
Hong Leong Bank Berhad (97141-X) 1/3 DMTM 008 NOV 2013
Mobile (BONUS)
Hong Leong Bank Berhad (97141-X) 2/3
Your Employment Information
Company Name
Postcode City State
Yes No
Yes No
Office Address
Name of Previous Employer (if working less than 1 year in present employment)
Company Registration No. (for self-employed)
Self-employed
Office Tel. No. Extension No.
Designation Gross Annual Income
Account No.
For:
Length of Service MM YY
Length of Service MM YY
Nature of Business
Your Other Financing Facilities (Non-bank)
Are you an existing Hong Leong Bank customer?
Type of Facility
Loan/Financing Amount
Instalment/Repayment Amount
Monthly Payment Instruction
I hereby authorize Hong Leong Bank to debit my Savings/Current Account monthly in settlement of my Hong Leong Credit Card two (2) calendar days before my Payment
Due Date (1st Attempt). In the event the 1st Attempt is unsuccessful, I further authorize Hong Leong Bank to debit my Savings/Current Account again one (1) calendar
day before my Payment Due Date, failing which I shall be liable for all late charges, penalties and fees whatsoever incurred in accordance with the relevant Cardholders
Agreement if payment of my outstanding balances under my Hong Leong Credit Card cannot be made by the Payment Due Date.
Minimum Payment
Full Payment
Your Spouses Details
Full Name (as per IC/Passport) Mr Madam Ms Others
Company name (if any)
Office Tel. No. Extension No.
Handphone No. Occupation
Emergency Contact
Friend or relative not staying with you
Full Name
Home Tel. No. H/P No.
Office Tel. No. Extension No.
Relationship
Home Office
Your Mailing Address
Home Hong Leong Bank branch code
Delivery of Credit Card
Office
DMTM 008 NOV 2013
Hong Leong Bank Berhad (97141-X) 3/3
DECLARATION Please sign in the boxes provided below
DD MM YY
/ /
Date
Signature of Applicant
DMTM 008 NOV 2013
Channel Campaign Br/Div (existing HLB code) Team Code
For Bank Use Only
Remarks:
D 4 1 T M 1 8 1 0 4 3 1 3
I confirm and agree that:- (a) all Information given above is true and complete;
(b) Hong Leong Bank Berhad (HLBB) is authorised to verify the information from
whatever sources and means that it deems appropriate; (c) I shall be subject to
the terms and conditions governing the use of HLBB MasterCard, Visa, American
Express and/or Touch n Go Card; (d) my application may be declined without any
reason given; (e) my personal borrowings from all sources within Malaysia do not
exceed in aggregate RM200,000 (for non-Malaysians only); (f) HLBB is authorised
to use, disclose and exchange any information relating to my affairs, banking
accounts or conduct thereof (including my credit standing) to and from any person
as HLBB may consider necessary including without limitation Bank Negara
Malaysia (BNM), Biro Maklumat Cek, Central Credit Reference Information System
(CCRIS), FIS, CTOS or any credit reference agency, Inland Revenue Authorities or
any authorities, any bureau/authority body having jurisdiction over HLBB or as
required by law, directives or guidelines (whether having the force of law or
otherwise), companies which are related to HLBB by virtue of Section 6 of the
Companies Act 1965, HLBB's lawyers, service providers, debt collection agents, any
security party or any third parties without further notice to me to such extent and
for such purpose as HLBB may in its absolute discretion deem necessary or
expedient in connection with the application, the distribution and provisions of
products and services; (g) where I have faxed or sent the credit card application
form to HLBB via email, I agree that the said faxed or scanned copy of application
form shall be regarded as an original for processing purposes, containing all true
and accurate particulars and that the said faxed or scanned copy of application
form and all card transactions arising in relation to it shall be valid and binding on
me but notwithstanding this, I will retain the original signed application form at
all times and make it available to HLBB upon request; (h) any inaccuracy or
misrepresentation in the said information will result in my waiving all rights of
dispute and will remain liable for all outstanding and all losses and expense
incurred by HLBB.
Financial Services Act 2013 (FSA) and BNM Guidelines on Credit Transactions
and Exposures with Connected Parties (Guidelines)
To enable the Bank to comply with the FSA and the said Guidelines, I shall declare
to the Bank whether I am a connected party under the Guidelines, which includes
but is not limited to, a spouse, child, parent or financial dependant of the Banks
Director, Executive Officer or credit-approving/appraising/reviewing officer or in
the case of a corporate/business-customer, includes an entity controlled by such
abovementioned Banks persons. If at any time I become a connected person, I
must notify the Bank in writing immediately. The Bank reserves the right to
terminate the Facility in the event I fail to make the appropriate or correct
declaration, resulting in the Bank contravening the FSA or the said Guidelines.
Right to Disclose Information
In addition to the permitted disclosures provided under Schedule 11 of the FSA,
the Borrower irrevocably authorizes and permits the Bank, its officers and
employees to disclose and furnish all information concerning the Facilities, this
Agreement, present and future accounts of the Borrower and any other matters
relating to the Borrower or its business and operations to :
(a) other financial institutions granting or intending to grant any credit facilities
to the Borrower, the Central Credit Bureau or any other central credit bureau
established by Bank Negara Malaysia, Cagamas Berhad, Biro Maklumat Cek,
Credit Guarantee Corporation, any other relevant authority as may be
authorized by law to obtain such information or such authorities/agencies
established by Bank Negara Malaysia or any agency established by the
Association of Banks in Malaysia;
(b) any current or future corporation which may be associated or related with the
Bank (as defined in the Companies Act 1965), including representative and
branch offices and their respective representatives;
(c) the Security Parties or any party intending to provide security in respect of the
Facility;
(d) the Banks auditors, solicitors and/or other agents in connection with the
recovery of moneys due and payable hereunder; and
(e) the Banks professional advisers, service providers, nominees, agents,
contractors or third party service providers who are involved in the provision of
products and services to or by the Bank and its related or associated companies.
The Borrower hereby irrevocably consents to such disclosure and confirms that the
Bank, its officers and employees shall be under no liability for furnishing such
information or for the consequences of any reliance which may be placed on the
information so furnished in accordance with this Agreement.
(1) I hereby declare that I have fully disclosed to HLBB all of my outstanding
financing facilities with all financial service providers including non-financial
entities. Any inaccuracy or misrepresentation provided by me in the aforesaid
information shall not be attributed to the HLBB failure to adhere to any BNM
guidelines that may be applicable. (2) I hereby acknowledge that in the event
the financing tenure extends into my retirement age, I am aware that it is my
responsibility to ensure that I have a retirement plan to adequately cater for
the financing repayments accordingly. (3) I hereby declare that HLBB is entitled
to charge my credit card account with a service tax of RM50 for every principal
card and RM25 for every supplementary card issued, renewed or upgraded and
I hereby authorize HLBB to make the relevant tax payment of the same to the
Royal Customs Department. (4) I hereby acknowledge receipt of the HLBB
Credit Cards Product Disclosure Sheet.
Note: Customers who wish to opt-out from the sharing of our customer base
within the HLB Group for marketing and promotional purposes are required
to call our Call Centre at 03-7626 8899 to register their instructions to opt-out
of the said sharing.
Questions Answers C G P M E F W
What is this
product about?
A credit card is a card whose Cardholder has been granted a revolving credit line. The card enables the Cardholder to make purchases and/or
cash advances up to a pre-arranged limit. The credit granted can be settled in full by the end of a specified period or in part, with the balance
taken as extended credit. Interest may be charged on the transaction amounts from the date of each transaction or only on the extended credit
where the credit granted has not been settled in full.

i. It is a Classic VISA/MasterCard/Amex Credit Card, which gives the cardholder a minimum approved credit line of RM2,000 for usage.
ii. It is a Gold VISA/MasterCard/Amex / Fortune VISA / MTV VISA / Essential VISA / WISE Gold VISA Credit Card, which gives the cardholder a
minimum approved credit line of RM2,000 for usage.

iii. It is a Platinum VISA/MasterCard/Amex / WISE Platinum VISA Credit Card, which gives the cardholder a minimum approved credit line of
RM12,000 (VISA / MasterCard) and RM20,000 (Amex) for usage.

What do I
get from this
product?
A revolving credit line approved by the Bank, based on the Cardholders eligibility. Cardholder will be subjected/entitled to:
Finance Charges
i. Retail Purchases
To be calculated on a daily basis after the interest free period provided the current balance of the cardholders previous statement is fully paid
by payment due date. Otherwise, interest will be calculated on a daily basis from respective posting date. The finance charge may vary for each
account based on the cardholders past 12 months repayment behaviour as below:

ii. Cash Advance
- 18% p.a. of the outstanding amount calculated on a daily basis from transaction date until full repayment date.
- 10.8% p.a. calculated on daily basis, from date of transactions. However, if cardholder defaults in payment of any
outstanding balances due to the Bank, the Bank shall reserve the right to charge the standard rate of 18% p.a.
NOTE: There is a maximum daily cash withdrawal (cash advance) limit for all cards, depending on the approved credit limit of your card.
Maximum daily cash withdrawal limit:

Cash Back
1% Cash Back will be credited for all valid Retail Transactions (both local and international) EXCLUDING Cash Advances, Cash-on-Call, Flexi
Payment Plan, Balance Transfers, Petrol transactions, Finance Charges, Late Charges and Annual Fee Payment. Minimum retail transactions in a
month to qualify for the cash back is RM100.
10% Cash Back will be credited for all eligible Retail Transactions (both local and international) in enrolled categories EXCLUDING Cash Advances,
Cash-on-Call, Flexi Payment Plan, Balance Transfers, Finance Charges, Late Charges and Annual Fee Payment, and subject to a maximum of
RM100 per month. To qualify, a minimum of any 10 retail transactions in the calendar month and each with a minimum amount of RM50 is
required.

Real Cash Earnings

1% Real Cash for all retail purchases.
Real Cash Earnings will only be credited upon accumulating a minimum earnings of RM20 per month and subject to a maximum of RM50 per month.
Qualifying retail purchases exclude cash-type transactions, Cash-on-Call, instalment conversion plans, fees and charges.
i. Interest on Real Cash Earnings
Daily balance of Real Cash Earnings will earn interest based on the prevailing 3-month fixed deposit rate
ii. Extra Real Cash Earnings
Total annual retail spend: RM38,000 Bonus: RM280
Total annual retail spend: RM68,000 Bonus: RM880
Total annual retail spend: RM108,000 Bonus: RM1,800

Reward Points
All valid Retail Transactions would be given Reward Points

What are my
obligations?
Minimum Monthly Repayment
5% of the outstanding balance or a minimum of RM50, whichever is higher.
Interest Free Period for Retail Purchase transaction
20 days from the statement date provided the current balance of the Cardholders previous statement is fully paid by payment due date.
Otherwise, interest shall be charged on retail purchase transactions from respective posting dates.
The Principal Cardholder shall be liable for all outstanding balances incurred on the Principal and/or Supplementary Card(s). The Supplementary
Cardholder shall be liable for all outstanding balances incurred on his/her Supplementary Card only.

What are
the fees and
charges I have
to pay?
Annual Fees

Tier Cardholders Payment Behavior Retail Interest Rate (%) p.a.
1 Cardholders who promptly settle their minimum payment due for 12 consecutive months 15% p.a.
2 Cardholders who promptly settle their minimum payment due for 10 months or more in a 12-month
cycle; and
17% p.a.
3 Cardholders who do not fall within the above categories. 18% p.a.
Classic Gold Platinum MTV Essential Fortune
RM3,000 RM8,000 RM8,000 RM7,500 RM7,500 RM7,500
Read this Product Disclosure Sheet before you decide to take up Hong Leong Classic Card, Gold Card, Platinum Card, MTV Card, Essential Card, Fortune Card or
WISE Card. Be sure to also read the general terms and conditions.
Card type
Principal Supplementary
MasterCard Visa American Express MasterCard Visa American Express
Classic RM80 RM80 RM80 RM40 RM40 RM40
Gold RM160 RM160 RM160 RM80 RM80 RM80
Platinum RM400 RM400 RM800 First card FREE, subsequent card RM200 RM400
MTV N/A
RM160
one time joining
fee RM20
N/A N/A RM80 N/A
Essential N/A RM100 N/A N/A RM50 N/A
Fortune N/A RM160 N/A N/A RM80 N/A
WISE Gold N/A RM160 N/A N/A RM80 N/A
WISE Platinum N/A RM300 N/A N/A RM150 N/A
The information provided in this sheet is valid as at November 2013 Date Received of Product Disclosure Sheet: _________________________________
C: Classic Card G: Gold Card P: Platinum Card M: MTV Card E: Essential Card F: Fortune Card W: WISE Card
Product Disclosure Sheet
Questions Answers C G P M E F W
What are the
fees and charges
I have to pay?
Cash Advance Fee
i The cash advance fee is 5% of the amount advanced or a minimum of RM20, whichever is higher. This is imposed for each cash advance
transaction. Minimum withdrawal for each cash advance is RM200.
ii. The cash advance fee is 2% of the amount advanced or RM5, whichever is higher. This is imposed for each cash advance transaction. Minimum
withdrawal for each cash advance is RM200. The Bank reserves the right to impose the standard rate of 5% per transaction or RM20, whichever
is higher, at its sole discretion.

Card Replacement Fee
Any card replacement will be subjected to a Replacement Card Fee of RM50 (or such amount as may be determined by the Bank from time
to time).

Overseas Transaction Conversion Fee
Transactions in Foreign Currency - The conversion rate as determined by Visa International, MasterCard International or American Express, plus
any administration fees charged by Visa International, MasterCard International or American Express, plus up to 1% administration fee imposed
by the Bank.
Transactions in Ringgit Malaysia (RM) - Any administration fees charged by Visa International, MasterCard International or American Express.

Credit Card Service Tax (CST)
Every Principal and Supplementary Card will be charged a service tax of RM50 and RM25, respectively upon card issuance and card anniversary.

Sales Draft Retrieval Fee
Sales draft retrieval requests will be subjected to a Sales Draft Retrieval Fee of RM20 per copy.

Additional Statement Request Fee
Request for Credit Card statements exceeding the preceding 2 months will be charged a fee of RM5 per statement.

IBG Transaction Fee
A nominal Fee of RM2 will be charged on every credit balance refund or fund transfer made via Interbank GIRO (IBG).

Category Maintenance Fee
A maintenance service fee of RM10 is imposed at the point of maintenance for each category.

What if I fail
to fulfill my
obligations?
Late Payment Charge
Minimum RM10 or 1% of the total outstanding balance as at statement date, whichever is higher, subject to a maximum of RM75.

Right to Set-off
The Bank may at its own discretion and by giving a 21 calendar days notice, set-off any credit balance in your account(s) maintained with us
against any outstanding balance in this credit card account.

Liability for Unauthorised Transactions
The Cardholders maximum liability for unauthorized transactions in the event of lost or stolen credit card, shall not exceed RM250, provided the
Cardholder has not acted fraudulently and reported the lost/stolen card incidence as soon as possible.
If you fail to abide by the Terms & Conditions of the Credit Card, we have the right to terminate your card.

What if I fully
settle the
balance before
its maturity?
Early Settlement Penalty
RM70 will be charged if the Cardholder fully settles the Balance Transfer amount before the expiry of the chosen Balance Transfer period.
RM25 will be charged if the Cardholder fully settles the Cash-on-Call amount before the expiry of the Cash-on-Call installment period.

What are the
major risks?
By paying minimum monthly repayment, the Bank will charge interest on the outstanding amount at tiered rate, according to your payment
behaviour, until it is fully settled. Do use your credit card wisely to ensure effective financial planning. Please feel free to contact the Bank for
financial planning consultation and repayment alternatives, if necessary.
If your credit card and/or PIN is lost or stolen, please notify the Bank immediately at HOTLINE +603-7626 8899.

What should I
do if there are
changes to my
contact details?
The Bank must be informed of any changes to your contact details as soon as possible to ensure all correspondences reach you on a timely
manner. You may call us at 03-7626 8899 to make the changes. For Hong Leong Online cutomers, please log on to Hong Leong Online Personal
and select Update My Account followed by Update Contact Info.

Where can I get
assistance and
redress?
If you have difficulties in making repayments, you should contact us earliest possible to discuss repayment alternatives. You may contact us at:
Hong Leong Bank Berhad, PFS Credit Control Credit Card. Tel: +603-7626 8311
Alternatively, you may seek the services of Agensi Kaunseling dan Pengurusan Kredit (AKPK), an agency established by Bank Negara Malaysia
to provide free services on money management, credit counselling, financial education and debt restructuring for individuals. You can contact
AKPK at: Tingkat 8, Maju Junction Mall, 1001, Jalan Sultan Ismail, 50250 Kuala Lumpur.
Tel: 1-800-88-2575 E-mail: enquiry@akpk.org.my
POWER! (Pengurusan Wang Ringgit Anda) Programme, offered by AKPK, promotes prudent money management and financial discipline to
individual borrowers. To register and for further information, kindly call 1-800-88-2575 or visit the website at www.akpk.org.my
If you wish to feedback on the products or services provided by us, you may contact us at:
Hong Leong Bank Credit Cards, Tower A, PJ City Development, 15A, Jalan 219, Section 51A, 46100 Petaling Jaya, Selangor.
Tel: +603-7626 8899 Fax: +603-7946 8888 E-mail: hlonline@hlbb.hongleong.com.my
If your query or complaint is not satisfactorily resolved by us, you may contact Bank Negara Malaysia LINK or TELELINK at:
Block D, Bank Negara Malaysia, Jalan Dato Onn, 50480 Kuala Lumpur.
Tel: 1-300-88-5465 Fax: +603-2174 1515 E-mail: bnmtelelink@bnm.gov.my

Where can I
get further
information?
Should you require additional information on credit cards, please refer to the banking info booklet on Credit Cards, available at all our branches
and the www.bankinginfo.com.my website.
For latest information contained in this Product Disclosure Sheet and full terms & conditions of our products, please visit
www.hlb.com.my. In the event of any dicrepencies, the latest information and terms & conditions on the Hong Leong Bank website shall
prevail.

Other credit
card products
available
More exciting Credit Card Products:
i. Hong Leong Platinum Business Credit Card ii. Hong Leng ACCCIM Credit Card
And check out the following privileges that come with our Credit Cards:
i. Touch n Go Card the companion card that is linked to your Hong Leong Credit Card. It auto-reloads RM100 every
time the balance in the Touch n Go Card falls below RM50.

ii. Balance Transfer (BT) iii. Cash-on-Call (COC) iv. Extended Payment Plan (EPP)
Fee Amount Fee Amount
Issuance Fee RM10 per card Touch n Go Auto Reload Fee RM2 per auto reload transaction
Card Replacement Fee RM10 per card Touch n Go Refund Processing Fee RM5 per request
Legal action may be taken against you if you do not keep up repayment on your credit card balance.
C: Classic Card G: Gold Card P: Platinum Card M: MTV Card E: Essential Card F: Fortune Card W: WISE Card