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Share the card privileges you enjoywith your loved ones.

Credit Cards

Create lasting memorieswith the ones you love

sc.com/sg

99 mm99 mm

402686 SCB Generic SuppCard Appform EC8.indd 1402686 SCB Generic SuppCard Appform EC8.indd 1 14/3/17 3:47 pm14/3/17 3:47 pm

Full name as in NRIC/Passport(Please write in capital letters and underline surname)

1 Mr 2

Ms 3 Dr

Principal card account number

01 NRIC 04

Passport No.

NRIC/Passport No. (Do not indicate FIN number)

Mobile Number (+ country code - area code)

This is needed for receiving an Additional Logon PIN (ALP) via SMS to logon to Online Banking. For overseas mobile phone numbers, please provide your country code and area code.

Email addressNeeded for eStatements (where applicable). Offi cial correspondence may be sent to this email address.

@

8336-1

40317

Standard Chartered Bank (Singapore) Limited | Reg. No. 201224747C | Printed MAR17

Principal

Cardholder’s signature & date

1st Supplementary

Cardholder’s signature & date

2nd Supplementary

Cardholder’s signature & date

By signing or submitting this application:1. You represent and warrant that all information (including any documents) You have given to us in connection with the application is correct, complete and not misleading.

If this is not the case You may be personally liable;2. You authorise us to verify any of the information You have given to us or Your credit standing from anyone we may consider appropriate (such as Your employer or an

authority or credit reference agency);3. You acknowledge that we may decline Your application without giving You any reason for doing so. If this happens, no contractual relationship arises between us and You

and You consent to us retaining all supporting documents submitted by You for the processing of this application, regardless of whether this application is approved or not;4. You confi rm and agree that we may give any information in connection with this application (including Your personal information) to any service provider (whether located in

or outside of Singapore) for the purposes of providing any service to You in connection with this application (including data processing). If You have applied for the Unlimited Card, You additionally authorise us and consent to the transfer and disclosure of any information relating to You and your Unlimited Card to EZ-Link and any third party as we and/or EZ-Link may deem necessary for the purpose of and/or in connection with the provision of the EZ-Link Facility and/or the EZ-Reload by Card Facility and the enrolment of your Unlimited Card for the EZ-Reload by Card Facility.

5. You consent to each of Standard Chartered PLC and its subsidiaries and affi liates (including each branch or representative offi ce) (“Standard Chartered Group”), its offi cers, employees, agents and advisers disclosing information relating to You (including details of the accounts, products or any security interest) to our head offi ce and any other member of the Standard Chartered Group in any jurisdiction (“permitted parties”); professional advisers, service providers or independent contractors to, or agents of, the permitted parties, such as debt collection agencies, data processing fi rms and correspondents who are under a duty of confi dentiality to the permitted parties; any actual or potential participant or sub-participant in relation to any of our obligations under our banking agreement between us, or assignee, novatee or transferee (or any offi cer, employee, agent or adviser of any of them); any credit bureau or credit reference agency, rating agency, business alliance partner, insurer or insurance broker of, or direct or indirect provider of credit protection to, any permitted parties; any fi nancial institution which You have or may have dealings for the purpose of conducting credit checks (including in the form of blank references); any court, tribunal or authority (including an authority investigating an offence) with jurisdiction over the permitted parties; a merchant or a member of Visa International or Mastercard International where the disclosure is in connection with use of a credit card; EZ-Link and any third party where the disclosure is in connection with the EZ-Link Facility and/or the EZ-Reload by Card Facility and the enrolment of your Unlimited Card for the EZ-Reload by Card Facility; any authorised person or any security provider; and anyone we consider necessary in order to provide You with services in connection with an account.

6. You have read and understood our Customer Terms and Credit Card Terms, and the applicable documents referred to in Part A of our Customer Terms forming our banking agreement which are available at any of our branches and on our website at www.standardchartered.com.sg and You agree to be bound by them for the use of any product we may provide You with;

7. You acknowledge that You are bound by any variation we make to these documents, in accordance with our banking agreement. In particular, You understand that by entering into our banking agreement You give indemnities, authorisations, consents and waivers and agree to limitations on our liability;

8. You consent to us contacting You at the address, email address and phone numbers You have provided to us, to give You information on other products and services that we, or our strategic partners, may offer. You further consent to us sharing any of Your information in relation to this application with any of our strategic partners;

9. You consent to us sending at Your sole risk, by ordinary mail or other means we deem appropriate, any credit card, all information regarding Your account, personal identifi cation number, all statements of accounts, Your security codes relating to Your access to the electronic banking services, and any other communications or correspondences addressed to You (collectively “personal information”) in accordance to Your addresses on our records;

10. You agree that any risks (e.g, non-receipt or disclosure to any unauthorised third party) arising from the sending of the personal information will be fully borne by You and that we will not be held responsible in any way for any losses that may be suffered by You as a result of the non-receipt or disclosure of the same to any unauthorised third party;

11. You agree that at Your sole risk, we are authorised but not obliged, to receive any instruction given by or over telephone, mobile telephone, telex, facsimile transmission, telegraph, cable, computer, email or any other electronic equipments, short message services from mobile telephone (collectively “Oral Instructions”) from or purporting to be from You without separate verifi cation by us as to the genuineness of the Oral Instructions;

12. You apply for the Bank’s electronic banking services and acknowledge that Your use of the electronic banking services is governed by our banking agreement and our Electronic Banking Terms and Conditions;

13. You authorise us to debit any of Your accounts maintained with us either singly or jointly with any other person for any arrears, outstanding fees, monthly repayment, accrued interest and all other monies due and payable to us without any further reference to You;

14. You confi rm that You are not an undischarged bankrupt and no statutory demand has been served on You at the same time of this application;15. If You are the Principal Cardholder, You acknowledge that You will be liable for all transactions made using Your card and the supplementary card(s). If You are the

Supplementary Cardholder(s), You will be liable for all transactions made using Your supplementary card(s);16. With respect to the credit card(s) applied for:

(a) if You have applied for the Unlimited Cashback Credit Card (the “Unlimited Card”): (i) You acknowledge that we have enabled:

(A) the stored value facility (the “EZ-Link Facility”), of which EZ-Link Pte Ltd (“EZ-Link”) is the holder and operator, on the Unlimited Card; and(B) the automatic top-up facility for the EZ-Link Facility provided by EZ-Link and paid for by You through the debiting of payments from your Unlimited Card (the

“EZ-Reload by Card Facility”) such that the Unlimited Card will be revalued automatically (by debiting the Unlimited Card account) when the remaining stored value on the EZ-Link Facility incorporated into the Unlimited Card falls below zero or becomes negative;

(ii) You authorise us to apply to EZ-Link on your behalf for the EZ-Reload by Card Facility. You understand that, upon activation by You of your EZ-Reload by Card Facility at any TransitLink Ticket Offi ce or at any GTM (General Ticketing Machine) located in Mass Rapid Transit stations and bus interchanges, a default amount of S$50 or such other sum which we and/or EZ-Link may stipulate from time to time (such default amount or other revaluation amount as notifi ed to You from time to time, the “Revaluation Amount”) will be automatically debited from the Unlimited Card account and credited to the EZ-Link Facility incorporated into the Unlimited Card; and

(iii) You authorise us to hold and set aside the Revaluation Amount, together with EZ-Link’s convenience fee of $0.25 (if any) or such other amount which EZ-Link may stipulate from time to time for the EZ-Reload by Card Facility, from the available balance in the Unlimited Card account up to the time You activate the EZ-Reload by Card Facility and also when the stored value on the EZ-Link Facility incorporated into the Unlimited Card falls below S$20 (or such other amount which we and/or EZ-Link may stipulate); and

17. You ask for a credit card to be issued to the Principal Cardholder, the Supplementary Cardholder(s) (if any) as stated in this application and that we renew and replace them until termination. If You request for ATM access, You agree that signing or the using of the card as an ATM card will indicate Your acknowledgement and acceptance of our banking agreement.

18. You consent to us disclosing information relating to You contained in this application (excluding income related information) to Singapore Post Limited (“SingPost”) in order for us to provide you with the SingPost Platinum Card privileges and benefi ts provided by SingPost in connection with the SingPost Platinum Card, and for SingPost to provide you with information on its products and services.

Important Information for Your Preferred Credit LimitYou understand and agree that:19. The existing credit limit of the credit card indicated in this form (“Card”) will be the overall limit that applies to and is shared among the principal credit cards of the principal

cardholder indicated in this form and corresponding supplementary credit card(s) issued in respect of such principal credit cards.20. In relation to this application, the existing credit limit of the Card will apply to each supplementary credit card(s) issued in respect of the Card.Unless stated otherwise, “You” means collectively the Principal Cardholder and the Supplementary Cardholder(s) (if any) in this application.

4 Endorsement

Please complete this application form in full and mail or fax to 6305 1701 together with clear copies of

the NRIC (front and back) of the Principal Cardholder and Supplementary Card applicant(s). For more

information, please call our 24-hour Client Contact Centre at 1800 747 7000.

Supplementary Card Application FormShare all the privileges of being a Standard Chartered Cardholder with

your loved ones. Give them Supplementary Cards that are free for life!• Unlimited Cashback*

• Platinum Visa/MasterCard

• SingPost Platinum

• NUS Alumni Platinum

• PruPrestige Visa Signature

• Priority Banking Visa Infi nite

• MANHATTAN World

• Tigerair Platinum MasterCard

• Business Platinum

• Prudential Platinum

• Visa Infi nite

3 2nd Supplementary Credit Card (Cardholder must at least 18 years old)

For Supplementary Cardholder applicant: I confi rm that my preferred credit limit for the supplementary card to be issued to me in this application is the same as the existing credit limit of the credit card held by the principal cardholder indicated in this application.

Full name as in NRIC/Passport(Please write in capital letters and underline surname)

1 Mr 2

Ms 3 Dr

Name to appear on new credit card(s) (5-19 characters including space)

If this is not provided, the Bank shall have the discretion to decide on the name to appear on the credit card.

01 NRIC 04

Passport No.

NRIC/Passport No. Date of birth

Relationship to Principal CardholderGender 1

M 0 F

Mobile Number (+ country code - area code)

Residential address in Singapore

Block

Unit

Postal Code

Street

✓

*The EZ-Link Facility will be enabled on the Unlimited Cashback Credit Card and this card will also be pre-enrolled for EZ-Reload by Card upon card activation. The default revaluation amount is $50 and a convenience fee of $0.25 will be charged by EZ-Link for each top-up.

1 Principal Cardholder’s Particulars

2 1st Supplementary Credit Card (Cardholder must at least 18 years old)

For Supplementary Cardholder applicant: I confi rm that my preferred credit limit for the supplementary card to be issued to me in this application is the same as the existing credit limit of the credit card held by the principal cardholder indicated in this application.

Full name as in NRIC/Passport(Please write in capital letters and underline surname)

1 Mr 2

Ms 3 Dr

Name to appear on new credit card(s) (5-19 characters including space)

If this is not provided, the Bank shall have the discretion to decide on the name to appear on the credit card.

01 NRIC 04

Passport No.

NRIC/Passport No. (Do not indicate FIN number) Date of birth

Relationship to Principal CardholderGender 1

M 0 F

Mobile Number (+ country code - area code)

Residential address in Singapore

Block

Unit

Postal Code

Street

✓

(please attach a copy of your NRIC (front and back) or Passport)

(please attach a copy of your NRIC (front and back) or Passport)

99 mm99 mm

402686 SCB Generic SuppCard Appform EC8.indd 2402686 SCB Generic SuppCard Appform EC8.indd 2 14/3/17 3:47 pm14/3/17 3:47 pm