CITIBANK SUPPLEMENTARY CREDIT CARD APPLICATION …

1 CITIBANK SUPPLEMENTARY CREDIT card APPLICATION FORMV ersion : card account No. 03 SUPPLEMENTARY card applications urname/Family Name (as in NRIC/Passport)Title Mr MsGiven Name (as in NRIC/Passport)Hanyu Pinyin Name (If any) (as in NRIC/Passport)Alias Name (If any) (as in NRIC/Passport)Hanyu Pinyin Alias Name (If any) (as in NRIC/Passport) Married Name (If any) (as in NRIC/Passport) Name to appear on CREDIT card (max. 19 characters) Date of Birth Country of Residence Day Mth YrNationalityPermanent Resident Ye s NoNRIC (for Singaporeans & PRs)Passport Number (for Foreigner)Address Please refer to address as set out in copy of my NRIC submitted with this applicationHouse # Postal Code Email Address (in BLOCK LETTERS)Monthly IncomeS$ , Occupation.

2 Employer s Name Length of Employment Yr Nature of Business Banking and Finance 10 Medical 80 IT & Communications 60 Retail/F&B 70 Manufacturing 20 Property Related 40 Employment Agencies 60 Transport 30 Government 50 Others 90 Relationship with Main CardmemberMobile Phone Number Your second level of authentication for online transactions will be sent by SMS to this mobile phone number04 PREFERRED CREDIT LIMIT(Minimum CREDIT limit is S$1,000.)No Preference^: SUPPLEMENTARY : ^ I have no preferred CREDIT Limit. I consent to CITIBANK assigning me with a CREDIT Limit which shall be determined at its absolute card Preferred CREDIT Limit S$_____ * Please note that the Combined CREDIT card (s) CREDIT Limit is applicable to main applicant only.

3 It refers to the aggregate CREDIT limit in respect of all your CITIBANK CREDIT card account (s).01 CHOICE OF SUPPLEMENTARY CARDSS upplementary Cards applied will follow the association of the main CREDIT CardCITI PREMIERMILES card ( 33/ 3 )Annual Fee Free for lifeCITI REWARDS card ( 5 /42 /43 /52 /55 /57 ) Annual Fee S$ waived for first yearCITI CASH BACK card ( 4 /4 /58 ) Annual Fee S$ waived for first yearCITI CASH BACK+ (PLUS) card (45 / 45) Annual Fee S$ waived for first year CITI CLEAR PLATINUM card (82 /85 )Annual Fee S$ waived for first yearCITI LAZADA VISA SIGNATURE card ( 6 )Annual Fee S$ waived for first yearCITI M1 PLATINUM VISA card (86 )Annual Fee S$ waived for first yearCITI PLATINUM card (37 /59 )

4 Annual Fee S$ waived for first yearCITI SMRT PLATINUM VISA card (83 )Annual Fee S$ waived for 2 yearsCITI PRESTIGE card (44 )Annual Fee Free for lifeIf I wish to have a free CREDIT report, I may obtain it within 30 calendar days from the date of approval or rejection of this APPLICATION from CREDIT Bureau (Singapore) Pte Ltd. s website. Alternatively, I may bring the approval or rejection letter and my NRIC to the following CREDIT Bureau (Singapore) Pte Ltd. s registered office to obtain a free CREDIT MAIN CARDMEMBER S PARTICULARSS urname/Family Name (as in NRIC/Passport)Given Name (as in NRIC/Passport)Hanyu Pinyin Name (If any) (as in NRIC/Passport)Alias Name (If any) (as in NRIC/Passport)Hanyu Pinyin Alias Name (If any) (as in NRIC/Passport)Married Name (If any) (as in NRIC/Passport)NRIC (for Singaporeans & PRs)Passport Number (for Foreigner)

5 APPLICATION REQUIREMENTS SUPPLEMENTARY applicants must be aged 18 years old and above Annual fee waiver for up to two SUPPLEMENTARY cards per principal account Citi Prestige SUPPLEMENTARY cards are unlimited and free for SUPPORTING DOCUMENTS (Mandatory)For Singaporeans and PRs: A copy of NRIC (both sides); If address on NRIC is different from address provided in this APPLICATION , a copy of utility bill, bill for landline, or bank statement with applicant s name and Foreigners: A copy of valid Passport; A copy of Employment Pass/Work permit with at least 6 months validity; A copy of utility bill, bill for landline, bank statement, government issued correspondence, government issued Identification card with Singapore residential address and applicant s name; Hotel/Hostel/Service apartment addresses are not note: SUPPLEMENTARY cards may be assigned a CREDIT limit by the main Instructions:The completed APPLICATION form and all supporting documents may be submitted:1.

6 2. in person, at any CITIBANK branch; or3. by post, to CITIBANK Singapore Ltd, Global Consumer Group, Robinson Road Box 356 Singapore 900706 The promotions, products and services mentioned in this APPLICATION are not offered to individuals resident in the European Union, European Economic Area, Switzerland, Guernsey, Jersey, Monaco, San Marino, Vatican, The Isle of Man, the UK, Brazil and New Zealand. This APPLICATION form is not, and should not be construed as, an offer, invitation or solicitation to buy or sell any of the products or services mentioned herein to such SUPPLEMENTARY CREDIT card APPLICATION FORMV ersion.

7 DECL AR ATIONBy signing below, I/we confirm my/our agreement to the terms of the Customer Confirmation and Declaration which can be viewed at and acknowledge that I/we have reviewed the Product Highlights which can be viewed at I/We agree that my/our signing of this APPLICATION shall constitute my/our written permission for any such disclosure for the purposes of Section 47 and the Third Schedule of the Banking Act (Chapter 19) or any other disclosure imposed by applicable laws or regulations. Please note that this APPLICATION form should be submitted by you at a CITIBANK branch or by post.

8 Main Applicant s Signature DateSupplementary Applicant s Signature DateFOR BANK USE ONLYAC:App IDRM:Y / NCIPP - NTBSPF/NESS MATCHED:Y / NADDN VE:Y / NADC1P: B /SY / N1N: BY / NCL:SOURCE CODE:INSTANTNON-INSTANTNO PROMO SB9AF01O SO9AM01 OREMARKS (CI):Please Tick S K 8 A M A 0 0 for product 420 CITIBANK full disclaimers, terms and conditions apply to individual products and banking services. 2022 CITIBANK . Citi, CITIBANK and Citi and Arc Design are registered service marks of Citigroup Inc.

9 CITIBANK Singapore Limited Co. Reg. No. 200309485K Printed on 11/2022