Declaration

DECLARATION BY NON-MALAYSIAN APPLICANT (TICK WHERE APPROPRIATE)

No, I/my immediate family members    do not hold    have never held Senior Public Office    Yes, I/my immediate family members    currently hold    have held

Position held     Date From     to

I/We confirm that all the above information is true and complete and authorise the Bank to verify from whatever sources the Bank may consider appropriate including Inland Revenue Board and further to seek and obtain credit information related to my/our application from any source and by any means as the Bank deems fit. I/We acknowledge that the Card may only be used subject to the Terms and Conditions of the PB Visa Cardmember Agreement and agree to be bound by the Terms and Conditions of the Card. I/We agree to pay the prevailing annual fees upon approval and shall accept joint and several liability for all charges on my/our Card Account(s) with the Bank. The Bank shall reserve the absolute right to approve or reject my/our application as the Bank deems fit without assigning any reason.

I/We irrevocably consent to and authorise the Bank to disclose to Bank Negara Malaysia, any authority/body having jurisdiction over the Bank, any guarantor(s)/security parties, and/or its lawyers or any other debt collection agent, companies which are related to the Bank by virtue of Section 6 of the Companies Act 1965 at any time and without notice or liability any information relating to my/our affairs, banking accounts or conduct thereof (including my/our credit standing) to such extent and for such purposes as the Bank may in its absolute discretion deems necessary or expedient.

BANKING AND FINANCIAL INSTITUTIONS ACT 1989 (BAFIA) AND BNM GUIDELINES ON DISCLOSURE OF CUSTOMER INFORMATION

i) Sharing of customer information with related and associate companies within the Public Bank Group (PBB Group), parties approved by Bank Negara Malaysia (BNM) and/or third parties to enable the Bank and/or the related and associate companies within the PBB Group to perform its and/or their functions.

I/We understand and acknowledge that pursuant to the Banking and Financial Institutions Act (1989) (“BAFIA”), the Bank is legally permitted to disclose my/our information relating to my/our affairs, banking accounts or conduct thereof (including my/our credit standing) to third parties as approved by BNM to facilitate and/or enable the Bank and/or the related and associate companies within the PBB Group to perform its and/or their functions and I/we hereby irrevocably consent to and authorise the Bank to disclose the said information to any guarantor(s)/security parties, the Bank's lawyers, debt collection agents, third parties and/or related and associate companies within the PBB Group at any time and without notice or liability as the Bank may in its absolute discretion deem necessary or expedient to enable the Bank and/or the related and associate companies within the PBB Group to perform its and/or their functions. In doing so, I/we agree that the Bank shall be absolved from any responsibilities or liabilities whatsoever.

ii) Sharing of customer information for cross selling, marketing and promotional purposes with strategic alliances/3rd parties and to related/associate companies within the PBB Group.

Please tick any of the following :

I/We hereby irrevocably consent to and authorise the Bank to disclose any of my/our information (excluding information relating to my/our affairs or account) to any related and/or associate company within the PBB Group, the Bank's existing or future business partners or strategic alliances and/or any other 3rd party as the Bank may in its absolute discretion deem necessary or expedient for the purpose of cross-selling or the marketing and promotion of products and services. I/We hereby confirm that no further permission or consent from me/us is/are necessary or required in relation thereto and this shall constitute the consent required pursuant to Section 99(1)(a) of the BAFIA and any other contractual consent for such disclosures of information. In doing so, I/we agree that the Bank shall be absolved from any responsibilities or liabilities whatsoever. OR Unless further permission or consent in writing from me/us is/are obtained, the Bank shall not disclose any of my/our information to any related and/or associate company within the PBB Group and/or the Bank's existing or future business or strategic alliances and/or any other 3rd party for the purpose of cross-selling or the marketing and promotion of products and services.

TO BE COMPLETED BY THE PARENT/GUARDIAN FOR APPLICANT BETWEEN 12-18 YEARS OLD I  ,              (Name of Parent/Guardian)           (Parent's/Guardian's NRIC) being the Parent/Guardian of ,         (Name of Applicant)                         (Applicant's NRIC) hereby agree and give my consent to this application. In consideration of the Bank issuing a PB Visa Electron Card to the abovenamed Applicant at my request, I hereby agree to save the Bank harmless and indemnify the Bank (its successors in title and assigns) from and against all actions, suits, proceedings, claims, demands, losses, damages, costs, charges and expenses whatsoever incurred by the Bank or which may be taken or made against the Bank arising from my request and authorisation given herein and the issue and/or the use of the PB Visa Electron Card by the abovenamed Applicant. I further agree that my obligation herein shall continue and shall remain in full force and effect until my obligations herein are fully discharged to the Bank's satisfaction. This indemnity shall be valid during the continuance of this agreement and shall continue to remain in force up to 6(six) months after the eighteenth birthday of the abovenamed Applicant and shall be binding on my personal representatives and my heirs.