Credit Card Application - Form

About You

Step 3 of 3

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Credit Card Application

Step 1 of 1

1. Choice of Card

Which credit card are you interested in?

Requested Credit Card Limit (BND)

Please note that the approved credit limit is subject to Baiduri Bank Sendirian Berhad's credit evaluation. Baiduri Bank Sendirian Berhad reserves the right to offer a lower credit limit than requested which applicants may choose to accept or decline. Baiduri Bank Sendirian Berhad also reserves the right to reject the application without providing any reason.

2. Card Collection Details

I would like to collect my Baiduri Card at

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Credit Card Application

Step 1 of 2

2. Declaration for Credit Card Application

I/ We the undersigned hereby:

Confirm, warrant and represent to you that as the date of this application, there are no suits, legal or execution proceeding to be instituted against me/us or any of my/our assets.
Confirm, warrant and represent to you that the information provided in this application form and any other information given to Baiduri Bank Sendirian Berhad in any other documents in relation to this application are true, accurate and complete and Baiduri Bank Sendirian Berhad may rely on such information in assessing my/our application.
Authorize Baiduri Bank Sendirian Berhad to contact my/our bankers and/or other sources at any time to obtain any information needed to process this application.
Agree that Baiduri Bank Sendirian Berhad has the absolute right to decline this application without giving any reason whatsoever.
Agree that if my/our application is accepted by Baiduri Bank Sendirian Berhad, I/We shall be bound by Baiduri Bank Sendirian Berhad’s Terms and Conditions (as may be applicable and amended from time to time) relating to credit cards and any other services or facilities made or to be made available to me/us (such Terms and Conditions being deemed to have been incorporated here by reference) and I/We shall pay all fees and charges levied by Baiduri Bank Sendirian Berhad in relation to this application.
Confirm that I have received the Personal Credit Card Product Disclosure Sheet that contains key information on the cards’ features, fees charged and obligations of the Cardholders and understand the explanation given in my preferred language.
Confirm that Baiduri Bank Sendirian Berhad has briefed me the basis of interest computation on the Credit Card.
Confirm that I have read and understood the Credit Card Cardholder Agreement which is available in softcopy in Baiduri Bank Sendirian Berhad’s website at www.baiduri.com.bn.
Consent to the collection, use and disclosure of your personal information as set out in our Privacy Policy available at www.baiduri.com.bn.

I hereby agree to all Declaration For Credit Card Application as stated above.

By clicking on the "Submit" button, I consent to the collection, use and disclosure of my personal information detailed in this form in the manner prescribed in the Privacy Policy available at www.baiduri.com.bn.

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Credit Card Application

Step 2 of 3

3. Customer Personal Information

No. of years resided here

Correspondence Address

Same as residential address

Correspondence Address

Correspondence Address Postcode

Overseas permanent address for expatriates

OVERSEAS PERMANENT ADDRESS POSTCODe

Overseas Contact No.

4. Employment Details

Date Joined

Monthly Gross Income (B$)

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Personal Credit Card Application

Step 3 of 3

5. Customer Spouse Information

Identity Document No.

Identity Document Colour

Date of Birth

Nationality

Occupation

Annual Income

Name of Employer

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We are ready to submit your Credit Card application

About You

1. Personal Information

title

[title]

Fullname (as per identity document)

[fullname]

Gender

[gender]

DATE OF BIRTH

[DOB]

COUNTRY OF BIRTH

[country-of-birth]

Nationality

[nationality]

Country of Residence

[country-of-residence]

BRUNEI ISSUED IC NUMBER

[id-no]

BRUNEI ISSUED IC EXPIRY DATE

[id-expiry-date]

Passport NUMBER

[passport-no]

Passport Expiry Date

[passport-expiry-date]

MARITAL STATUS

[matital-status]

2. Contact Details

Residential Status

[residential-status]

RESIDENTIAL ADDRESS IN BRUNEI

[residential-address]

Postcode

[residential-postcode]

Country

Brunei

CORRESPONDENCE ADDRESS

[correspondence-address]

Postcode

[correspondence-postcode]

Country

[correspondence-country]

overseas residential address

[overseas-residential-address]

Postcode

[overseas-residential-postcode]

Country

[overseas-residential-country]

MOBILE PHONE NUMBER (MAIN)

[mobile-no]

HOME TELEPHONE NUMBER

[telephone-no]

OVERSEAS CONTACT NUMBER

[overseas-no]

EMAIL ADDRESS

[email-address]

3. Employment Details

EMPLOYMENT STATUS

[employment-status]

OCCUPATION DETAIL

[occupation-detail]

Employment term

[employer-term]

CONTRACT EXPIRY DATE

[contract-expiry-date]

JOB TITLE/DESIGNATION

[job-title]

LENGTH OF CURRENT EMPLOYMENT (YEARS)

[employment-year]

NAME OF CURRENT EMPLOYER/BUSINESS

[employer-name]

EMPLOYER/BUSINESS ADDRESS

[employer-address]

EMPLOYER/BUSINESS ADDRESS POSTCODE

[employer-address-postcode]

EMPLOYER/BUSINESS COUNTRY

[employer-address-country]

OFFICE TELEPHONE NUMBER

[office-no]

OFFICE EMAIL ADDRESS

[office-email]

ANNUAL INCOME (BND)

[annual-income]

OTHER INCOME (BND)

[other-income]

SOURCE OF OTHER INCOME

[source-of-other-income]

4. Spouse Details

title

[spouse-title]

FULL NAME (AS PER IDENTITY DOCUMENT)

[spouse-fullname]

DOB

[spouse-dob]

Contact Number

[spouse-contact-no]

Email Address

[spouse-email]

5. Tax Residence Declaration

ARE YOU A U.S. PERSON?

[us-person]

ARE YOU A TAX RESIDENT IN OTHER COUNTRIES?

[tin]

Credit Card Application

1. Choice Of Card

Which credit card are you interested in?

[card-type]

Requested Credit Card Limit (BND)

[card-limit]

I WOULD LIKE TO COLLECT MY BAIDURI CARD AT

[collect-location]

3. Customer Personal Information

NO. OF YEARS RESIDED HERE

[resided-no]

CORRESPONDENCE ADDRESS

[address]

CORRESPONDENCE ADDRESS POSTCODE

[postcode]

OVERSEAS PERMANENT ADDRESS FOR EXPATRIATES

[oversea-address]

OVERSEAS PERMANENT ADDRESS POSTCODE

[oversea-postcode]

OVERSEAS CONTACT NO.

[oversea-contact-no]

4. Employment Details

DATE JOINED

[date-joined]

MONTHLY GROSS INCOME (B$)

[monthly-income]

5. Customer Spouse Information

IDENTITY DOCUMENT NO.

[id-no]

IDENTITY DOCUMENT COLOUR

[document-colour]

DATE OF BIRTH

[DOB]

NATIONALITY

[nationality]

OCCUPATION

[occupation]

ANNUAL INCOME

[annual-income]

NAME OF EMPLOYER

[name-of-employer]

Please review your information above. If you have selected multiple products, you will be prompted to continue with the remaining product(s).

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We are ready to submit your Credit Card application

Declaration For Credit Card Application

I/ We the undersigned hereby:

Confirm, warrant and represent to you that as the date of this application, there are no suits, legal or execution proceeding to be instituted against me/us or any of my/our assets.
Confirm, warrant and represent to you that the information provided in this application form and any other information given to Baiduri Bank Sendirian Berhad in any other documents in relation to this application are true, accurate and complete and Baiduri Bank Sendirian Berhad may rely on such information in assessing my/our application.
Authorize Baiduri Bank Sendirian Berhad to contact my/our bankers and/or other sources at any time to obtain any information needed to process this application.
Agree that Baiduri Bank Sendirian Berhad has the absolute right to decline this application without giving any reason whatsoever.
Agree that if my/our application is accepted by Baiduri Bank Sendirian Berhad, I/We shall be bound by Baiduri Bank Sendirian Berhad’s Terms and Conditions (as may be applicable and amended from time to time) relating to credit cards and any other services or facilities made or to be made available to me/us (such Terms and Conditions being deemed to have been incorporated here by reference) and I/We shall pay all fees and charges levied by Baiduri Bank Sendirian Berhad in relation to this application.
Confirm that I have received the Personal Credit Card Product Disclosure Sheet that contains key information on the cards’ features, fees charged and obligations of the Cardholders and understand the explanation given in my preferred language.
Confirm that Baiduri Bank Sendirian Berhad has briefed me the basis of interest computation on the Credit Card.
Confirm that I have read and understood the Credit Card Cardholder Agreement which is available in softcopy in Baiduri Bank Sendirian Berhad’s website at www.baiduri.com.bn.
Consent to the collection, use and disclosure of your personal information as set out in our Privacy Policy available at www.baiduri.com.bn.

We hereby agree to all Declaration For Credit Card Application as stated above.

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Submit

Thank You!

Your application for a Credit Card has been successfully submitted with reference

[app-id]

Your preferred branch will contact you within three (3) business days from today to arrange for an appointment to complete your application.

A confirmation email will be sent to you with important information regarding your application. Please check your spam or junk mail folder if you have not received it.

If you have any questions, please contact our Customer Helpline at +673 2449666, quoting the application reference above.

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