c Mr/En c Ms/Cik c Mdm/Pn c Others (Specify) / Lain-Lain (nyatakan)______________________
Full Name (as in I.C./Passport) / Nama Penuh (Seperti dalam K.P./Pasport)
Name to appear on card (Not more than 19 characters) / Nama dicetak di atas kad (tidak melebihi daripada 19 abjad)
(Name should be as close as possible to your full name / Nama hendaklah tidak jauh berbeza daripada nama penuh anda)
New I.C. No / No.K.P. Baru
– –
c Old I.C.No / No. K.P. Lama c MyPolis c MyTentera c Passport/Pasport
Mother’s Maiden Name (Compulsory for security purposes) / Nama Ibu (Wajib untuk tujuan keselamatan)
Date of Birth / Tarikh Lahir
D D – M M – Y Y
Nationality / Kewarganegaraanc Malaysian / Malaysiac Others / Lain-lain
______________________
Race / Bangsac Malay / Melayuc Chinese / Cinac Indian / Indiac Others / Lain-lain
______________________
Marital Status / Taraf Perkahwinanc Married / Berkahwinc Single / Bujangc Widowed / Balu / Dudac Divorced / Bercerai
No. of Dependants/ Bilangan Tanggungan
NOTE: All documents are non-returnable / NOTA: Semua dokumen tidak akan dikembalikan
Malaysian / Warga Malaysia
Identification / Pengenalan
• NRIC (front & back) for BOTH Principal & Supplementary applicants. / K.P. (depan & belakang) untuk KEDUA-DUA pemohon Kad Utama & Tambahan.
Employed / Bekerja • Latest 3 months salary slip / EPF statement / Form BE (with tax payment receipt) / Form EA. /
Penyata Gaji 3 bulan terkini / Penyata akaun KWSP / Borang BE (dengan resit pembayaran cukai) / Borang EA.
Commission-based / Pendapatan Komisen
• Latest 6 months salary slip / EPF statement / Form BE (with tax payment receipt) / Form EA. / Penyata gaji 6 bulan terkini / Penyata akaun KWSP / Borang BE (dengan resit pembayaran cukai) / Borang EA.
Self-Employed / Bekerja Sendiri
• Business registration certificate or Form 9 / 24 / 49 / Sijil pendaftaran perniagaan atau Borang 9 / 24 / 49. • Latest 6 months company’s bank statements / Form B (with tax payment receipt) / 6 bulan penyata bank
syarikat terkini / Borang B (dengan resit pembayaran cukai).
Non-Malaysian (Japanese Only) / Warga Asing (Warga Jepun sahaja)
Identification / Pengenalan
• Passport and visa for BOTH Principal & Supplementary applicants. / Pasport dan visa untuk KEDUA-DUA pemohon Kad Utama & Tambahan.
Employed / Bekerja • Work permit. / Permit kerja. • Latest 1 month salary slip. / Penyata gaji 1 bulan terkini.
Malaysia My 2nd Home Program (MM2H) / Program Malaysia Rumah Kedua Ku (MM2H)
• Malaysia My 2nd Home Program Permit (MM2H). / Permit Program Malaysia Rumah Kedua Ku (MM2H). • Latest 6 months pension slip from Japan / Latest 6 months income proof from Japan. / Pencen 6
bulan terkini dari Jepun / Bukti pendapatan 6 bulan terkini dari Jepun.
I Wish to Apply For / Saya Ingin Memohon
NEW ÆON CARD ÆON CARD
c New ÆON Gold VISAc New ÆON Gold MasterCard
I hereby assign the ÆON MEMBER Points to / Saya bersetuju supaya mata ganjaran ÆON MEMBER dimasukkan ke:
c ÆON Gold VISA c ÆON Gold MasterCardc ÆON Classic VISA c ÆON Classic MasterCard
ÆON BIG CARD ÆON TOUCH ’N GO ZING CARD
c ÆON BiG Gold VISAc ÆON BiG Classic VISA
I hereby assign the ÆON BiG Points to / Saya bersetuju supaya mata ganjaran ÆON BiG MEMBER dimasukkan ke:
I would like to apply ÆON Touch’n Go Zing Card forSaya ingin memohon Kad ÆON Touch ’n Go Zing untuk: ¨ Principal / Kad Utama ¨ Supplementary / Kad Tambahan
Expiry Date / Tarikh Luput
M M Y Y Y Y
5. Your Employment / Business Details Butir-butir Pekerjaan / Perniagaan Anda
Full Name (as in I.C or Passport) / Nama Penuh (Seperti dalam K.P. atau Pasport)
Office Tel No. / No. Tel Pejabat
–
Handphone No. / No. Tel Bimbit
–
c Mr/En c Ms/Cik c Mdm/Pn c Others (Specify) / Lain-Lain (nyatakan)__________________
Full Name (as in I.C or Passport) / Nama Penuh (Seperti dalam K.P. atau Pasport)
Home Tel No. / No. Tel Kediaman
–
Handphone No. / No. Tel Kediaman
–
Relationship with Principal Card Applicant Hubungan dengan Pemohon Kad Utama
_________________________________________________
Type of Occupation / Jenis Pekerjaanc Employed / Bekerja c Self-employed / Bekerja Sendiri
Name of Company / Nama Syarikat
Office Address / Alamat Pejabat
City / Bandar Postcode / Poskod
State /Negeri
Office Tel No. / No. Tel Pejabat Ext.
–
Nature of Business / Jenis Pekerjaan
___________________________________
Position / Jawatan
___________________________________
Years of Service/ Tempoh Berkhidmat
–
RM
MY Y M
Submit Application Form, Supporting Documents & Mail-in to / Hantar Borang Permohonan, Dokumen Sokongan & Mel kepada: ATTENTION / PERHATIAN: Credit Card Sales,
AEON Credit Service (M) Bhd, Level 29, Menara Olympia, No. 8 , Jalan Raja Chulan, 50200 Kuala Lumpur.
First Year FREE /
Percuma untuk
Tahun Pertama
2. Your Residence / Kediaman Anda
3. Your Collection of Card(s) / Pengambilan Kad-Kad Anda
4. Your Billing Preference / Pilihan Utama untuk Penyata Anda
Residential Address / Alamat Kediaman
City / Bandar Postcode / Poskod
State /Negeri
Home Tel No. / No. Tel Kediaman
–
Handphone No. / No. Tel Bimbit
–
Permanent Residential Address / Alamat Kediaman Tetap
City / Bandar Postcode / Poskod
State /Negeri
Years of Stay / Tempoh Menetap
–
9. Credit Facilities from Non-Banks / Kemudahan Kredit dari Institusi Bukan KewanganType of Loan / Jenis Pinjaman
Financial Institution / Institusi Kewangan
Monthly Repayment / Bayaran Bulanan
Type of Loan / Jenis Pinjaman
Financial Institution / Institusi Kewangan
Monthly Repayment / Bayaran Bulanan
1. 3.
2. 4.
8. Your Supplementary Card Applicant Details / Maklumat Pemohon Kad Tambahan Anda
Full Name (as in I.C./Passport) / Nama Penuh (Seperti dalam K.P./Passport)
Name to appear on card (Not more than 19 characters) / Nama dicetak di atas kad (tidak melebihi daripada 19 abjad)
(Name should be as close as possible to your full name / Nama ini hendaklah tidak jauh berbeza daripada nama penuh anda)
New I.C. No / No. K.P.Baru
– –
c Old I.C.No / No. K.P.Lama c MyPolis c MyTentera c Passport/Pasport
Date of Birth / Tarikh Lahir
Mother’s Maiden Name (Compulsory for security purposes) /Nama Ibu (Wajib untuk tujuan keselamatan)
D D – M M – Y Y
Residential Address / Alamat Kediaman
City / Bandar Postcode / Poskod
State / Negeri
Home Tel No. / No Tel Kediaman
–
Handphone No. / No Tel Bimbit
–
E-mail Address / Alamat E-mel _______________________
Name of Company / Nama Syarikat
Office Tel No. / No. Tel Pejabat Ext.
–
Relationship with Principal Card Applicant / Hubungan dengan Pemohon Kad Utama
_________________________________________________
ÆON Card Type / Jenis Kad ÆONPRINCIPAL /
UtamaSupplementary /
Tambahan
Annual Fee / Yuran Tahunan
ÆON Card (VISA / MasterCard) / Kad ÆON (VISA / MasterCard)
Gold / Emas RM95 RM60Classic / Klasik RM30 RM20
ÆON BiG Card (VISA) with AEON BiG Member Card benefits / Kad ÆON BiG (VISA) dengan faedah Kad AEON BiG Member
Gold / Emas RM95* RM60*
Classic / Klasik RM30* RM20*
NEW ÆON Card (VISA / MasterCard) with AEON MEMBER Card benefits / Kad NEW ÆON (VISA / MasterCard) dengan faedah Kad AEON MEMBER
Gold / Emas RM95* RM60*
Classic / Klasik RM30* RM20*
Motorcycle Association Affinity Card (VISA) / Kad Motorcycle Association Affinity (VISA)
Gold / EmasFree for life / Percuma
sepanjang hayat
Free for life / Percuma sepanjang
hayat* Annual Fee for Second Year onwards is waived with a minimum of 12 transactions per year. /
Yuran tahunan kedua dan seterusnya dikecualikan dengan minimum 12 transaksi setahun.Other Fees & Charges / Yuran & Caj - Caj Lain
ÆON Touch ’N Go Zing Card / Kad ÆON Touch ’N Go Zing
An automatic reload amount of RM100 will be directly debited to the ÆON Credit Card with auto-reload fee of RM2 / Tambah nilai automatik sebanyak RM100 akan didebitkan terus ke Kad Kredit ÆON dengan yuran tambah nilai sebanyak RM2.
NEW ÆON Gold / Classic Card / Kad Emas / Klasik NEW ÆON
AEON MEMBER Card membership fee of RM12 yearly or RM24 for three years (payable at ÆON MEMBER Customer Service Counter). Applicant must have valid AEON MEMBER Card membership / Yuran keahlian Kad AEON MEMBER sebanyak RM12 untuk setahun atau RM24 untuk tiga tahun (Bayaran boleh dibuat di Kaunter Perkhidmatan pelanggan Ahli ÆON). Pemohon mesti mempunyai keahlian Kad AEON MEMBER yang sah.
AEON BiG Member Card / Kad AEON BiG Member Waived / Dikecualikan.
All applicable Goods & Services Tax (“GST”) and taxes of a similar nature herein shall be payable by the Cardholder. / Sebarang Cukai Barangan dan Perkhidmatan dan lain-lain cukai yang seumpamanya perlu dibayar oleh Pemegang Kad.
For further detail please log on to www.aeoncredit.com.my / Untuk maklumat lanjut sila layari www.aeoncredit.com.my
Submit Application Form, Supporting Documents & Mail-in to / Hantar Borang Permohonan, Dokumen Sokongan & Mel kepada: ATTENTION / PERHATIAN: Credit Card Sales,
AEON Credit Service (M) Bhd, Level 29, Menara Olympia, No. 8 , Jalan Raja Chulan, 50200 Kuala Lumpur.
First Year FREE /
Percuma untuk
Tahun Pertama