Credit Card Conversion Application Form

Let us know which Citibank Credit Card you would like to convert to, and we will get it done for you!*

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Send it to us by email to
Complete this application form
[email protected]
Step Step
Or mail to
CITIBANK BERHAD (297089-M)
Unsecured Credit Initiation
CREDIT CARDS : CREDIT LINE MAINTENANCE
LEVEL 16, MENARA CITIBANK
165, JALAN AMPANG
* Credit card conversion programme - terms and conditions apply 50450 KUALA LUMPUR

MY PERSONAL PARTICULARS
Please indicate the Citibank Credit Card account number which you would like converted :

Full name as per NRIC : _________________________________ Gender: Female Male

NRIC : _________________________________ Important Note :

Residency Information : Conversions are only applicable from a VISA to VISA type card or a
MasterCard to MasterCard type card
Citizen/ Nationality Malaysia Others ________
(please specify country) By converting your existing Citibank Credit Card, your
supplementary card(s) assigned to this account will
Permanent Resident(s) Malaysia Others ________
(please specify country) also be duly converted.
Place of Residence (Domicile) Malaysia Others ________
(please specify country)

Bumiputera Status Bumiputera Non-Bumiputera

Note: If you do not update/declare any permanent residency, “Permanent

CARD TYPE YOU WISH TO CONVERT TO

Yes, I wish to convert my existing Citibank Credit Card to: (Please tick one)

□ CITI PRESTIGE MASTERCARD WORLD ELITE □ CLEAR MASTERCARD

□ CITI PREMIERMILES VISA SIGNATURE □ CLEAR VISA

□ CITI REWARDS MASTERCARD □ SHELL GOLD VISA

□ CITI REWARDS VISA □ CITI SIMPLICITY+ VISA

□ CASH BACK PLATINUM VISA

□ CASH BACK PLATINUM MASTERCARD

□ CASH BACK VISA

DECLARATION FOR CREDIT CARD

By signing below, I hereby confirm that the Bank has informed me and I fully understand that in accordance with prevailing Bank Negara Malaysia
Guidelines, if my annual income is RM36,000 or less, I can only hold credit cards as a Principal Cardmember from a maximum of two (2) credit
card issuers (‘’Maximum Issuer Restriction’’). I declare that so long as the Maximum Issuer Restriction applies to me:
(1) I will be holding credit cards from a maximum of two (2) credit card issuers (including the Bank as an issuer); and
(2) If I am an existing Citibank Principal Cardmember holding credit cards from more than two (2) credit card issuers (including the Bank as an
issuer), I undertake to comply with the Maximum Issuer Restriction effective 1 January 2012.

Card Conversion Form (Sept 2018)

If you are applying for a permanent increase in your credit card, please provide information on your debt obligations with non-banks.
Type of Debt Obligations Amount of each monthly Outstanding Balance Capacity Name of Non-Bank
Installment / Payment (RM) (RM) (Self / Joint / Guarantor)

TOTAL

Important Note :
Debt obligations include both secured and unsecured financing from non-banks that provide credit facilities.
Any non-disclosure of complete and accurate information may impact the Bank’s decision on your application.

By signing below, you agree to the following terms and conditions:

Your conversion application is subject to the following terms and conditions:

1. All outstanding balances for unbilled installments, balance transfers, other fees and charges, Citibank One Bill, Autopay services and Credit
Shield services (if any) will be transferred to your new card upon activating your new card.
2. Your current credit card will remain active for a period of 90 days after successful conversion and will be blocked after that. Please cut up
your current credit card it into halves or several pieces across the magnetic strip and embedded microchip upon receiving and activating your
new card.
3. These terms and conditions also apply to supplementary cards. Cardmembers are urged to understand the features of their cards and refer
to the specific terms and conditions governing the use of their Credit Cards. Please visit www.citibank.com.my or call CitiPhone at 03-
23832000 to enquire.
4. The Credit Card Conversion mentioned in this application form are not offered to individuals resident in the European Union, European Eco-
nomic Area, Switzerland, Guernsey and Jersey. This application form is not, and should not be construed as, an offer, invitation or solicitation
to buy or sell any of the Credit Card Conversion mentioned herein to such individuals.
5. All Rewards Points or Rebates accumulated on your current card will be transferred to your new card according to the following schedule:

Existing Credit Card New Citibank Credit Card Rewards / Rebates Conversion
Category A - Rewards based Category A - Rewards based card All Rewards Points will be transferred to my New Citi-
card Clear / Rewards / Prestige bank Credit Card at a ratio of
Choice / Silver / Clear / Gold / 1 Rewards Point : 1 Rewards Point
Rewards / Rewards Platinum /
Prestige / Citibusiness Gold Category B - PremierMiles based card All Rewards Points will be transferred to my New Citi-
PremierMiles Visa bank Credit Card at a ratio of
6 Rewards Points : 1 PremierMile

Category C - Rebates based card All Rewards Points will NOT be transferred to my New
Cashback Platinum / Cashback / Shell Gold/ Sim- Citibank Credit Card. I will redeem all Rewards Points
plicity+ prior to conversion, failing which my Rewards Points
will be forfeited.
Category B - PremierMiles Category A - Rewards based card All PremierMiles will be transferred to my New Citibank
based card Clear / Rewards / Prestige Credit Card at a ratio of
PremierMiles Visa 1 PremierMile: 6 Rewards Points
Category D - Rebates based card All PremierMiles will NOT be transferred to my New
Cashback Platinum / Cashback / Shell Gold/ Sim- Citibank Credit Card. I will redeem all
plicity+ PremierMiles prior to conversion, failing which my
PremierMiles will be forfeited.
Category C - Rebates based Category A - Rewards based card All remaining rebates accumulated in my Existing Cred-
card Clear / Rewards / Prestige it Card which is not redeemed or insufficient for re-
Cashback / Cashback Platinum / demption (whichever applicable) prior to conversion will
Shell Gold/ Simplicity+ NOT be transferred and will be forfeited when I convert
Category B - PremierMiles based card to my New Citibank Credit Card.
PremierMiles Visa
Category C - Rebates based card
Cashback Platinum / Cashback / Shell Gold/ Sim-
plicity+

Please sign :

Principal Cardmember’s Signature : _________________________________