Beruflich Dokumente
Kultur Dokumente
Referral ID No./ Region/ Branch/ Channel/ Staff ID No./ Source Code/ Barcode Area
No. ID Perujuk Daerah Cawangan Saluran No. ID Pekerja Kod Rujukan
Please tick ( ) 1 (one) option below / Sila tanda ( ) 1 (satu) pilihan di bawah RHB CCAF-0104/18
CARDS / KAD-KAD
I wish to apply for the following card / Saya ingin memohon kad berikut:
No annual fee for all of the below Principal and Supplementary cards / Tiada yuran tahunan untuk semua kad Utama dan Sampingan di bawah
INFINITE CARD / KAD INFINITE VISA Programme Code / Kod Program: B Z A 9 1
All of the below cards will enjoy 1st year waiver for Principal Card and for life waiver for Supplementary Card on annual fees /
Semua kad di bawah akan menikmati pengecualian yuran tahunan untuk tahun pertama bagi Kad Utama dan seumur hidup bagi Kad Sampingan
REWARDS CARD / KAD MATA GANJARAN VISA MASTERCARD Programme Code / Kod Program: A V A 2 4
CASH BACK CARD / KAD REBAT TUNAI VISA MASTERCARD Programme Code / Kod Program: C Z A 3 8 C Z A 3 9
Card Delivery to / Penghantaran Kad ke Billing Address / Alamat Bil Branch, Please specify / Cawangan, Sila nyatakan
Name on Card /
Nama pada Kad
Sex / Jantina Male / Lelaki Female / Perempuan
Postcode /
Poskod
State / Country /
Negeri Negara
Office Address /
Alamat Pejabat Postcode /
Poskod
State / Country /
Negeri Negara
Office Tel. No. /
No. Tel. Pejabat
Position / Kindly choose code from the "Occupation Field Code" as stated at the last page of this application form /
Jawatan Sila pilih kod dari "Kod Bidang Pekerjaan" yang tertera di helaian akhir borang permohonan ini.
Sector of Employment / Kindly choose code from the "Sector of Employment" as stated at the last page of this application form /
Sektor Pekerjaan Sila pilih kod dari "Sektor Pekerjaan" yang tertera di helaian akhir borang permohonan ini.
Annual Income / Years employed /
Pendapatan Tahunan Tahun bekerja M M Y Y
Request to send my hardcopy statement to / Mohon untuk mengirim salinan cetak penyata saya ke : Home / Rumah Office / Pejabat
Please note that effective from 1 March 2019, a fee of RM1.00 will be charged to customers who receive hardcopy statement. /
Sila maklum bahawa mulai 1 Mac 2019, bayaran sebanyak RM1.00 akan dikenakan kepada pelanggan yang menerima penyata salinan cetak penyata.
*If you like to view your e-statement via www.rhbgroup.com, please proceed to register your online banking at the nearest RHB branches. /
*Jika anda ingin meneliti e-penyata anda melalui www.rhbgroup.com, sila daftarkan perbankan dalam talian anda di cawangan RHB terdekat.
I / We, (name) hereby declare that: / Saya / Kami (nama) mengesahkan bahawa:
I/We do not have any non-bank organization outstanding debts I/We do have non-bank organization outstanding debts as per below details
Saya/Kami tidak mempunyai baki hutang di institusi-institusi bukan kewangan Saya/Kami mempunyai baki hutang di institusi-institusi bukan kewangan seperti di bawah
Bank / Finance Company / Others / Type of Facility [Home Financing / Vehicle Financing / Financing Amount (RM) / Outstanding Balance (RM) / Monthly Payment
Bank / Syarikat Kewangan/ Lain-lain Personal Financing/Others] / Jumlah Pembiayaan (RM) Baki Belum Jelas (RM) Amount (RM) /
Jenis Kemudahan [Pembiayaan Perumahan / Pembiayaan Amaun Bayaran Balik
Kenderaan / Pembiayaan Persendirian/Lain-lain] Bulanan (RM)
I/We, the undersigned hereby declare that the above information provided by me/us are true and correct and in the event that the bank subsequently discovered that any of the information provided
are found to be false, incorrect or incomplete, the Bank shall have the absolute discretion to cancel or vary the facility approved.
Saya/Kami, penandatangan di bawah, dengan ini mengesahkan bahawa maklumat yang disediakan oleh saya/kami di atas adalah benar dan betul dan sekiranya Bank kemudiannya mendapati bahawa
sebarang maklumat yang disediakan adalah tidak benar, salah atau tidak lengkap, pihak Bank berhak mengikuti budi bicara muklaknya membatal atau mengubah kemudahan yang telah diluluskan.
Name on Card /
Nama pada Kad
Sex / Jantina Male / Lelaki Female / Perempuan
Postcode /
Poskod
State / Country /
Negeri Negara
CONFIRMATION AND DECLARATION BY RHB BANK BERHAD CREDIT CARD APPLICANT / PENGESAHAN DARI PEMOHON KAD KREDIT RHB BANK BERHAD
I/We have been briefed on the description and benefits pursuant to the Product Disclosure Sheet that has been given to me/us of the RHB Credit Card applied herein. I/We hereby confirm
and declare that all the information provided by me/us is complete, true and correct and that I/we authorise RHB Bank Berhad (the Bank) to verify any information provided and to obtain
from any source including Inland Revenue as the Bank considers appropriate any information, which the Bank may require. The Bank may, at its sole and absolute discretion, approve or
reject my/our application. I/We agree that by signing and/or using the card(s), I/we agree to be bound by and to comply with all terms and conditions of the Bank Cardholder
Agreement(s) which will be sent to me/us with the card(s) upon approval of my/our application and any other terms and conditions imposed by the Bank from time to time for credit card
facilities and all amendments thereto and agree that the RHB Bank Visa/ MasterCard Credit Card may only be used to such terms and conditions. I/We understand the card(s) when issued
remain the property of the Bank and must be returned to the Bank upon request and shall be subjected to cancellation by giving notice of thirty (30) calendar days. I/We further
irrevocably and unconditionally agree, authorise and permit the Bank to share or disclose all the information provided by me/us to its co-brand partner(s) and/or its related corporations,
where necessary to operate the RHB Co-brand Credit Card(s) programme in order to provide me/us with services relating to said programme, to communicate with me/us, to promote
offers, to fulfill requests including redemption of co-brand partner’s points, and for identification, validation and verification purposes in relation thereto. I/We irrevocably agree and
consent to receiving SMS notifications from co-brand partner(s) and/or its related corporations in relation to any matter relevant to the RHB Co-brand Credit Card(s) which the Bank,
co-brand partner(s) and /or its related corporations may deem necessary from time to time. I/We hereby confirm that no further permission or consent from me/us is necessary or
required in relation to all of the above disclosures and this declaration shall constitute the consent required pursuant to Section 134 of Financial Services Act 2013 and any other
contractual consent for such disclosures. I/We acknowledge that my/our membership will be subjected to the further terms and conditions of the bank which will be given to me/us with
my/our approved credit card. I/We shall not dispute the contents of the faxed/emailed copy received by the Bank which shall be deemed as the original application form and/or
supporting document(s) and I/we shall produce the original application form and/or supporting document(s) to the Bank upon request. I/We agree to abide by the Anti-Money
Laundering, Anti-Terrorism Financing and Proceed of Unlawful Activities Act 2001 (Act 613). For Principal Card applicant only: I/We agree to be liable for all transactions charged to
my/our Principal Cardmember(s) and any Supplementary Card(s) issued. For Supplementary Card applicant only: I/We agree to be liable for all transactions charged to my
Supplementary Card(s) issued. I/We hereby confirm that the preferred language for this transaction which I/we opt for as stated below (Please tick where applicable).
Saya/Kami telah diberitahu tentang keterangan dan faedah berhubung dengan Helaian Pendedahan Produk yang telah diberikan kepada saya/kami berkaitan dengan Kad Kredit RHB
yang dimohon di sini. Saya/Kami dengan ini mengesahkan dan mengaku kesemua maklumatyang diberikan oleh saya/kami adalah lengkap, benar dan tepat dan saya/kami memberi
kebenaran kepada RHB Bank Berhad (Bank) untuk mengesahkan sebarang maklumat dan mendapat daripada mana-mana sumber termasuk Lembaga Hasil Dalam Negeri sebarang
maklumat yang dianggap perlu atau diperlukan oleh Bank. Bank berhak atas budi bicara mutlaknya untuk melulus atau menolak permohonan saya/kami. Saya/Kami bersetuju dengan
menandatangani dan/atau menggunakan kad, saya/kami bersetuju untuk diikat oleh dan mematuhi kesemua terma-terma dan syarat-syarat Perjanjian Ahli Kad yang akan dihantar
kepada saya/kami bersama kad setelah permohonan ini diluluskan dan kesemua term-terma dan syarat-syarat Perjanjian Kad Kredit Bank dan terma-terma dan syarat-syarat lain yang
dikenakan oleh Bank dari semasa ke semasa untuk kemudahan Kad Kredit dan kesemua pindaan dan bersetuju bahawa Kad Kredit VISA/MasterCard RHB Bank hanya boleh digunakan
tertakluk kepada terma-terma dan syarat-syarat tersebut. Saya/Kami faham bahawa kad adalah sentiasa hakmilik Bank dan hendaklah diserahkan kepada Bank apabila diminta dan
boleh dibatalkan oleh Bank dengan memberi notis tiga puluh (30) hari kalendar. Saya/Kami dengan perihal tidak boleh dibatalkan dan dengan tiada syarat bersetuju untuk memberi
kebenaran dan membenarkan Bank berkongsi atau memberi semua maklumat yang dibekalkan oleh saya/kami kepada rakan kongsi jenama bersamanya dan/atau syarikat berkaitan
untuk menjalankan program Kad Kredit Rakan Kongsi Jenama Bersama RHB Bank bagi menyediakan perkhidmatan-perkhidmatan yang bersangkutan dengan program berkenaan kepada
saya/kami, untuk berkomunikasi dengan saya/kami, mempromosikan tawaran, memenuhi permintaan termasuklah penebusan mata dan juga untuk tujuan pengenalan, mengesahkan
serta penentusahan yang berkenaan dengannya. Saya/Kami bersetuju dan mengizinkan untuk menerima pemberitahuan SMS dari rakan kongsi jenama bersama dan/atau syarikat
berkaitan berkenaan dengan sebarang perkara yang berkaitan dengan Kad Kredit Rakan Kongsi Jenama Bersama RHB Bank seperti mana yang dianggap perlu oleh Bank, rakan kongsi
jenama bersama dan/atau syarikat berkaitan dari semasa ke semasa. Saya/Kami dengan ini mengesahkan bahawa tiada kebenaran atau kelulusan selanjutnya dari saya/kami adalah
perlu berkaitan dengan perkara tersebut di atas dan deklarasi ini adalah kebenaran yang perlu di bawah Seksyen 134 Akta Perkhidmatan Kewangan 2013 dan segala kebenaran berasas
kontrak untuk pemberian maklumat tersebut. Saya/Kami mengakui bahawa permohonan saya/kami akan tertakluk kepada terma dan syarat daripada Bank yang akan diberikan kepada
saya/kami dengan Kad Kredit saya/kami yang diluluskan. Saya/Kami tidak akan mempertikaikan isi kandungan salinan faks/e-mel yang diterima oleh Bank yang dikira sebagai borang
permohonan sebenar dan/atau dokumen sokongan dan saya/kami akan mengemukakan borang permohonan sebenar dan/atau dokumen sokongan kepada Bank apabila diminta.
Saya/Kami bersetuju untuk mematuhi undang-undang Akta Pencegahan Pengubahan Wang Haram, Pencegahan Pembiayaan Keganasan Dan Hasil Daripada Aktiviti Haram 2001 (Akta
613). Untuk pemohon Kad Utama sahaja: Saya/Kami bersetuju untuk menanggung kesemua transaksi yang dicajkan kepada Kad Utama saya/kami dan Kad Tambahan yang dikeluarkan.
Untuk pemohon Kad Tambahan sahaja: Saya/Kami bersetuju untuk menanggung kesemua transaksi yang dicajkan kepada Kad Tambahan yang dikeluarkan. Saya/Kami mengesahkan
bahawa saya/kami memilih bahasa seperti yang dinyatakan di bawah sebagai bahasa untuk transaksi ini (Sila tanda mana yang berkenaan).
English / Bahasa Inggeris Bahasa Malaysia
PRIVACY NOTICE FOR NEW CUSTOMERS / NOTIS PRIVASI UNTUK PELANGGAN-PELANGGAN BARU
I/We understand that RHB Bank Berhad ("RHB") will use, collect, record, store, share and/or process my/our personal information, including, without limitation, my/our contact details,
background information, financial data and other information relevant to my/our application for the product and / or service which
(a) I/We have provided in this form or through any other contact with RHB Banking Group (which shall include RHB's holding company(s), subsidiary(s), and any associated company(s),
including any company as a result of any restructuring, merger, sale or acquisition), or
(b) has been obtained from analysis of my/our payment and other transactions/services within the RHB Banking Group, or
(c) has been obtained from third parties such as employers, joint applicants/accountholders, guarantors, legal representatives, industry/financial related associations, credit bureaus
or credit reporting agencies, retailers, social networks and fraud prevention agencies or other organizations
for any and/or all of the following purposes (“Purpose”), if applicable:
(i) providing this product and/or service and notifying me/us about important changes or developments to the features;
(ii) updating and managing the accuracy of RHB Banking Group's records;
(iii) prevention, detection or prosecution of crime, and complying with legal and regulatory obligations;
(iv) assessment and analysis including credit / lending / insurance risks / behaviour scoring / market and product analysis and market research;
(v) communications and ensuring customer satisfaction, which may include conducting surveys to improve the quality of our products and services, responding to inquiries and
complaints and to generally resolve disputes;
(vi) determining the amount of my/our indebtedness and recovering debt that I/we owe to RHB;
(vii) maintaining my/our credit history for present and future reference;
(viii) enabling an actual or proposed assignee of RHB, or participant or sub-participant of RHB to evaluate my/our transactions which are intended to be the subject of the
assignment, participation or sub-participation;
(ix) cross-selling, marketing and promotions of products and/or services of RHB Banking Group and its strategic alliances;
(x) for RHB’s corporate events (including networking events, launching of products, etc) /contests, of which photographs/ images of me/us may be captured and may be used for
RHB’s publications; or
(xi) protecting RHB Banking Group's interests and other ancillary or related purposes.
I/We understand and acknowledge that it is necessary for RHB to process my/our personal information for the Purpose, without which RHB will not be able to provide the product/service
that I/we have requested from RHB and to notify me/us about important changes or developments to the products/services. Where I/we have provided RHB with sensitive personal
information (in particular, information consisting my/our physical/mental health for applications of insurance products/services), I/we hereby provide RHB with my/our express consent
to process the same in the manner described in this Privacy Notice. I/We may exercise my/our options in respect of receiving marketing materials (including cross-selling, marketing
and promotions as described above) at any time by visiting any RHB Bank Branch or contact RHB Banking Group Customer Care Centre at 03-9206 8118.
I/We understand that RHB may disclose my/our personal information (or sensitive personal information, if applicable) to other companies within the RHB Banking Group, service
providers, merchants and strategic partners, vendors including debt collection agencies, professional advisers, industry/financial related associations, credit bureaus or credit reporting
agencies and fraud prevention agencies, governmental agencies, other financial institutions and any of their respective agents, servants and/or such persons, whether located within or
outside Malaysia for the Purpose, if applicable, subject at all times to any laws (including regulations, standards, guidelines and/or obligations) applicable to RHB.
I/We further understand that I/we may request for correction (if my/our personal information is inaccurate, outdated, incomplete, etc), access to (a prescribed fee may be charged), or
deletion (if I/we no longer have any existing products/services with RHB Banking Group) of my/our personal information or limit the processing thereof at any time hereafter by
submitting such request via post, email or fax to the following address:
RHB Banking Group Customer Care Centre
Level 7 Menara AA, JalanTun Razak, 50400 Kuala Lumpur, Malaysia.
Facsimile number: 03 9206 8088 / Telephone number: 03 9206 8118 / Email: customer.service@rhbgroup.com
I/We acknowledge that RHB Banking Group may modify or update its Privacy Notice from time to time, a copy of which is available at www.rhbgroup.com and that I/we may channel any
complaints or inquiries I/we may have in the manner indicated above.
Date of Cancellation
b) Bank: Tarikh Pembatalan:
Date of Cancellation
c) Bank: Tarikh Pembatalan:
v. Please proceed to submit my RHB Credit Card Application immediately and I understand RHB Bank may at its sole and absolute direction, approve or reject my application.
Sila teruskan permohonan saya dengan segera bagi mendapatkan kad kredit RHB Bank dan saya memahami bahawa RHB Bank berhak atas budi bicara mutlaknya untuk melulus atau
menolak permohonan saya.
CREDIT RATING AGENCIES (CRA) CONSENT DECLARATION FORM / BORANG AKAUN KEBENARAN AGENSI PELAPORAN KREDIT
I/We, authorize and consent RHB Bank to obtain any credit information from CTOS and/or other registered Credit Reporting Agencies as defined under the Credit Reporting Agencies Act
2010 without further notice to me/us to such extent and for the purpose of the followings (whichever is applicable) :-
Copy of MyKad or MyPR or Other Country PR (front and back)/ Passport copy
Salinan MyKad atau MyPR atau PR Lain Negara (depan dan belakang)/
salinan Pasport
Recent 1-month salary slip/
1 bulan penyata gaji terkini
i. Recent 3-month salary slip; AND/
3 bulan penyata gaji terkini; DAN
ii. Recent 3-month bank statement evidenced by salary crediting/
3 bulan penyata bank bukti pengkreditan gaji terkini
i. Recent 6-month salary/ commission slip; AND/
6 bulan penyata gaji/ komisen; DAN
ii. Recent 6-month bank statement evidenced by salary crediting/
6 bulan penyata bank bukti pengkreditan gaji terkini
Recent 6-months bank statement/
6 bulan penyata bank bukti pengkreditan gaji terkini
Latest EPF Statement (Min. 6 months contribution)/
Penyata KWSP terkini (Min. 6 bulan sumbangan)
i. Copy of the M & A or Constitution (for limited company)/
Salinan M & A atau Perlembagaan (untuk syarikat berhad)
ii. Latest Tax Payment Receipt/ Resit sah Pembayaran Cukai terkini
i. Latest Notice of Assessment; AND/ Notis Taksiran terkini; DAN
ii. Latest tax payment receipt/ Resit sah Pembayaran Cukai
(For Singapore only)/ (Untuk warganegara Singapura saja)
i. Latest Pension Letter/ Pension Statement; AND/
Surat / penyata pencen terkini; DAN
ii. Recent 3-month bank statement showing crediting of pension/
3 bulan penyata bank bukti pengkreditan gaji terkini
Mandatory Documents/ Dokumen Mandatori
Death, Total and Permanent Disability (TPD) & Dread Disease (DD) / Kematian, Hilang Upaya Menyeluruh dan Kekal (HUMK) dan Penyakit Kritikal (PK) Pays for your
RHB Credit Card Total Outstanding Balance up to a maximum of RM100,000 (for Co Brand and Cash Back) and RM300,000 (for Rewards, World, Signature and Infinite
Card). / Membayar Keseluruhan Baki Tertunggak Kad Kredit RHB anda sehingga maksimum RM100,000 (untuk Kad Co Brand dan Cash Back) dan RM300,000 (untuk
Kad Rewards, World, Signature dan Infinite).
Double Indemnity for accidental death./ Indeminiti Berganda bagi Kematian Akibat Kemalangan .
In addition, additional 100% of total Credit Card Total Outstanding Balances will be payable to the nominees of the Life Assured for accidental death./ Tambahan pula,
100% daripada Keseluruhan Baki Tertunggak Kad Kredit akan dibayar kepada penama-penama Hayat Yang Diinsuranskan yang meninggal dunia akibat kemalangan.
Important Notice / Notis penting
You should answer the questions asked by Tokio Marine Life Insurance Malaysia Bhd. (Us) honestly, fully and accurately. Failure to give answers that are full and accurate
may result in Your policy being avoided, a claim not being paid or reduced, or the terms of the policy being changed. You are advised to take reasonable care not to make
any misrepresentation when answering any questions asked by Us. In addition to answering the questions in the proposal form, You are also required to take reasonable
care to tell us any matter which You know to be relevant to Our decision on whether to accept the risk or not and the rates and terms to be applied. You must inform us
if there is any change to the information given in the proposal form after You submitted the proposal form but before the contract is entered into or varied. lf You do not
understand Your duty as stated above or if You need any further explanation, You can contact Us or Our sales representative. / Anda perlu menjawab soalan yang ditanya
oleh Tokio Marine Life Insurance Malaysia Bhd.(“Kami”) secara jujur, lengkap dan tepat. Kegagalan untuk memberikan jawapan yang lengkap dan tepat boleh
menyebabkan polisi Anda dielakkan, tuntutan tidak dibayar atau dikurangi, atau syarat-syarat diubah. Anda dinasihati untuk mengambil langkah yang sewajarnya untuk
tidak membuat sebarang salah nyataan apabila menjawab soalan-soalan yang ditanya oleh Kami. Selain daripada menjawab soalan-soalan dalam borang cadangan, Anda
juga dikehendaki mengambil langkah yang sewajarnya untuk memberitahu Kami apa-apa perkara yang Anda tahu yang berkaitan dengan keputusan Kami sama ada untuk
menerima atau tidak risiko dan kadar dan terma yang terpakai, Anda mesti memberitahu Kami jika ada apa-apa perubahan kepada maklumat yang diberikan dalam
borangcadangan setelah Anda menghantar borang cadangan itu tetapi sebelum kontrak tersebut ditandatangani atau diubah. Jika Anda tidak faham kewajipan Anda
seperti yang dinyatakan di atas atau jika Anda memerlukan penjelasan yang lebih lanjut, anda boleh hubungi Kami atau wakil jualan Kami.
LIFE CREDIT SHIELD DECLARATION / PENGAKUAN LIFE CREDIT SHIELD
Declaration / Pengakuan
I hereby authorise RHB Bank Bhd to disclose to Tokio Marine Life Insurance Malaysia Bhd. any information relevant to obtain this insurance coverage. / Saya
1. dengan ini memberi kuasa kepada RHB Bank Bhd untuk mendedahkan kepada Tokio Marine Life Insurance Malaysia Bhd. apa-apa maklumat yang berkenaan untuk
mendapatkan perlindungan khas ini
I hereby request and authorise RHB Bank Bhd to debit my RHB Credit Card Account(s) to Tokio Marine Life Insurance Malaysia Bhd. for premium due under Life
2. Credit Shield in which I have enrolled. / Saya dengan ini meminta dan memberi kuasa kepada RHB Bank Bhd untuk mendebit Akaun-akaun Kad Kredit RHB saya
kepada Tokio Marine Life Insurance Malaysia Bhd. untuk premium yang perlu dijelaskan di bawah Life Credit Shield yang telah saya sertai.
I acknowledge and agree that the claim proceeds of Life Credit Shield shall be made to RHB Bank Bhd for purpose of settling the total outstanding credit card
3. balance. / Saya mengakui dan bersetuju bahawa prosid tuntutan untuk Life Credit Shield hendaklah dibayar kepada RHB Bank Bhd untuk tujuan menjelaskan baki
keseluruhan tertunggak kad kredit.
I have read and understood the Product Disclosure Sheet provided to me in respect of the insurance coverage plan proposed in this form, including but not limited
4. to the terms, description, benefits and limitation of the Life Credit Shield. / Saya telah membaca dan memahami Risalah Pendedahan Produk yang diberikan kepada
saya berkenaan dengan pelan perlindungan insurans yang dicadang dalam borang ini, termasuk tetapi tidak terhad kepada terma-terma, huraian-huraian,
manfaat-manfaat dan batasan-batasan pada Life Credit Shield.
I agree and authorise Tokio Marine Life Insurance Malaysia Bhd., its affiliates, agents and business associates to collect, record, hold and store my personal data
5. including any sensitive personal data collected via this insurance application or otherwise, for the purpose of processing this insurance application. / Saya
bersetuju dan memberi kuasa kepada Tokio Marine Life Insurance Malaysia Bhd., Syarikat gabungan, ejen dan rakan perniagaan untuk mengumpul, merekod,
memegang dan menyimpan data peribadi saya termasuk apa-apa data peribadi yang sensitif yang dikumpul melalui permohonan insurans ini atau seballiknya,
untuk tujuan memproses permohonan insurans ini.
I confirm that I am in good health, have not been advised of or received any treatment for any major health conditions such as heart disease, stroke, cancer,
6. hepatitis, HIV infection or AIDS, diabetes, hypertension, respiratory disease, kidney disease or any other disorders or disabilities. / Saya mengesahkan bahawa
saya dalam keadaan sihat dan tidak pernah dinasihatkan untuk menjalani atau menerima apa-apa rawatan untuk apa-apa keadaan kesihatan serius seperti
penyakit jantung, strok, kanser, hepatitis, jangkitan HIV atau AIDS, kencing manis, hipertensi, penyakit respirasi, penyakit buah pinggang atau sebarang gangguan
dan kecacatan yang lain.
Yes / Ya No / Tidak
PERSONAL DATA NOTICE & CONSENT STATEMENT / NOTIS DATA PERIBADI DAN PENYATA PERSETUJUAAN
I complete this Enrollment Form base on the above Declaration and my understanding that my personal information will be strictly processed in accordance with the
Personal Data Protection Act 2010 which shall extend to its amendments, modifications and re-enactments thereof, other related legislation and Tokio Marine Life
Insurance Malaysia Bhd’s strict internal policy. For further information, I can log on to Tokio Marine Life Insurance Malaysia Bhd’s website at
http://www.tokiomarine.com/my/en/about-us/corporate-policies/privacy-policy.html/
Saya mengisi Borang Pendaftaran berdasarkan Deklarasi di atas dan saya memahami bahawa maklumat peribadi saya akan tegas diproses selaras dengan Akta
Perlindungan Data Peribadi 2010 termasuk pindaan-pindaannya, pengubahsuaian dan enakmen semula, atau undang-undang lain yang berkaitan dengan polisi
dalaman Tokio Marine Life Insurance Malaysia Bhd yang ketat. Untuk maklumat yang selanjut, saya boleh melayari laman web Tokio Marine Life Insurance Malaysia
Bhd’s. http://www.tokiomarine.com/my/en/about-us/corporate-policies/privacy-policy.html
Yes / Ya
I would like to enrol for my Life Credit Shield. I understand that the monthly cost of the insurance coverage is RM0.65 per every RM100 of the total outstanding
balance of my RHB Credit Card. / Saya ingin mendaftar Life Credit Shield saya. Saya faham bahawa kos untuk perlindungan insurans adalah RM0.65 bagi setiap
RM100 daripada keseluruhan baki tertunggak Kad Kredit RHB saya.