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Customer Request Form '16

1) The document is a customer request form for Petron Miles, a loyalty program. 2) It allows customers to request new registrations, change details, retroactive claims, or transfer points between cards. 3) For lost, stolen or faulty cards, customers must immediately call the Petron Miles hotline to block the card and prevent point loss.

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Paklie Fazli
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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795 views1 page

Customer Request Form '16

1) The document is a customer request form for Petron Miles, a loyalty program. 2) It allows customers to request new registrations, change details, retroactive claims, or transfer points between cards. 3) For lost, stolen or faulty cards, customers must immediately call the Petron Miles hotline to block the card and prevent point loss.

Uploaded by

Paklie Fazli
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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CUSTOMER REQUEST FORM Note:

1) Please complete the form in BLOCK LETTERS. All personal particulars are necessary for us to process your requests. For lost/stolen/faulty cards,
2) Fax the form to us at 03-2161 8233, email to [email protected] or drop it at any Petron Service Stations. please call the Petron Miles
3) For more information, please call the Petron Miles Customer Service Centre at 1 300 888 812. Hotline immediately to
block the card.

Type of request (Please tick where applicable)


*Required fields

(A) New Registration/Change of Details (B) Retro Claim (C) Points Transfer

Petron Miles Privilege Card No.*


7 8 2 5 0 5 8 - -

Full name (as per NRIC)*

New NRIC No.* - - Army or Police ID / Passport No.

Address*
(Malaysia Address Only)

Postcode* City Email

State

Home Tel. No. Office Tel. No. Mobile Tel. No.*


- - 0 1 -

(A) Change of Details

For change of details, kindly complete the above section only.

(B) Retro Claim (NOTE: Please attach original receipt)

Total Purchase: RM

(C) Points Transfer

For transfer of points from Lost/Stolen/Faulty Card/Card Misprinting No.


- -

To new Card No.


- -

For Lost/Stolen/Faulty/Misprinted Card, please contact the Petron Miles Customer


Service Centre at 1 300 888 812 IMMEDIATELY to BLOCK THE CARD.
Petron will not be held responsible for points lost if customers fail to notify the
Petron Miles Customer Service Centre to block the card.
Please allow up to 4 weeks for points transfer. Once points are transferred, the old card
will be deactivated. You must be the registered owner of all cards.
Station A/C No.:

Operator / Station Stamp

For office use only


Member's Signature* Date:

✃ (Please detach)

For Cardmember Retention (Please Keep This Portion for Reference)


Station A/C No.:

Old Card No. - - Operator / Station Stamp

New Card No. - -

No. of points to be transferred


This retention slip is only applicable for Section C (Lost/Stolen/Faulty)
Date:
For office use only
Terms and conditions apply for all Petron Miles Privilege Card.

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