工商银行 | 信用卡

Application Channels
paid by addressee.
Postage will be

Singapore only
For posting in
www.icbc.com.sg
立即登陆 www.icbc.com.sg 在线申请
OR 或是
COMPLETE APPLICATION FORM WITH
MANDATORY DOCUMENTS and MAIL/EMAIL TO US

美元消费首选卡 一卡双币 填写申请表并附上必需文件，邮寄或电邮给我们

Most savings for your USD$ spend OR 或是
尊享无尽便利 You can SUBMIT YOUR APPLICATION FORM
at the following BRANCHES
到我行网点递交申请表

出行中国必备卡
OUR BRANCHES
INDUSTRIAL AND COMMERCIAL BANK OF CHINA LIMITED
Widely Accepted Credit Card in China

ICBC VISA Dual Currency Credit Card

Main Office | Tel: 6538 1066
6 Raffles Quay #23-01 Singapore 048580
工银VISA双币信用卡 ( USD美元 / SGD新币 )
Business Hours
Monday-Friday 9:00am-6:00pm
Closed on Saturday, Sunday and Public Holiday

RMB Orchard Chinatown

Processing Centre Sub-Branch Sub-Branch
BUSINESS REPLY SERVICE

CREDIT CARD CENTRE

6 Raffles Quay #01-01 304 Orchard Road 133 New Bridge Road
SINGAPORE BRANCH

ICBC UnionPay Dual Currency Credit Card

6 Raffles Quay #01-01

工银银联双币信用卡 ( RMB人民币 / SGD新币 ) Singapore 048580 #01-36A/B Lucky Plaza #01-10 Chinatown Point
PERMIT NO. 08765

Singapore 048580

(Raffles Place Singapore 238863 Singapore 059413

MRT station Exit I) (Orchard (Chinatown
MRT Station Exit A) MRT Station Exit E)
Business Hours

3
Business Hours Business Hours
Monday - Friday
9:30am-4.00pm Monday-Friday Monday-Friday

年
美食 Closed on Saturday,
11:00am-7.00pm 11:00am-7:00pm
特惠卡 Sunday and Public Holiday Saturday
11:00am-4:30pm
Saturday-Sunday
Credit Card 11:00am-4:30pm

免年费 exclusively for Closed on Sunday

Closed on Public Holiday
dining deals and Public Holiday

Annual Membership Fee ICBC Koipy Dual Currency Credit Card Jurong East Paya Lebar Sembawang
工银可派双币信用卡 ( RMB人民币 / SGD新币 ) Sub-Branch Sub-Branch Sub-Branch
Waived for first 3 years
130 Jurong Gateway 60 Paya Lebar Road 30 Sembawang Drive
Road #01-213/215/217 #01-33/34/35/36 #02-18/19/20 Sun Plaza
Singapore 600130 Singapore 409051 Singapore 757713
Business Hours (Sembawang
Business Hours
MRT Station Exit B)
Monday-Friday Monday-Friday
10:00am-6:00pm Business Hours
11:00am-7:00pm
无门槛无上限返现卡 Saturday Saturday
Monday-Friday
Unlimited Cashback Card 11:00am-7.00pm
11:00am-4:30pm 11:00am-4:30pm
with no minimum spend Saturday-Sunday
Closed on Sunday Closed on Sunday
11:00am-4:30pm
and Public Holiday and Public Holiday

恣意人生 Holland Village Simei

Closed on Public Holiday

Punggol
畅游世界 Sub-Branch
257 Holland Avenue
Sub-Branch
3 Simei Street 6
Sub-Branch
83 Punggol Central
Singapore 278984 #01-K6/K7/K8 Eastpoint Mall #01-14 Waterway Point

首选 (Holland Village
MRT Station Exit B)
Business Hours
Singapore 528833
Business Hours
Singapore 828761
Business Hours
Monday-Saturday
ICBC Global Travel MasterCard Credit Card
工银万事达环球旅行信用卡 ( SGD新币 )
工行信用卡 Monday-Friday
9:00am-5:00pm
Monday-Saturday
11:00am-7.00pm 11:00am-7.00pm
Closed on Sunday Closed on Sunday
Saturday and Public Holiday
and Public Holiday
11:00am-4:30pm
Closed on Sunday
and Public Holiday

For enquiries, please contact our 24-hour Hotline:

(65) 6369 5588 or
The Sole RMB Clearing Bank In Singapore
Your Preferred RMB Bank email to [email protected]
 Finance Charge: 24% per annum on the amount withdrawn, chargeable on a daily basis on each cash 5. agree that at my/our sole risk, the Bank is authorised but not obliged, to receive any instruction given by or
IMPORTANT INFORMATION 重要信息 advance and accruing from the date of such advance until the date upon which such advance (and any over the phone, facsimile transmission, computer, email or any other electronic device, SMS from mobile
outstanding interest) is repaid in full. telephone (collectively “Instructions”) from or purporting to be from me/us without separate verification by
8.2. RMB Card Account cash advance fee and charge the Bank as to the genuineness of such Instructions.
This information is intended to be used as a quick consumer guide and must be read
Fee: 3% of amount withdrawn (minimum charge of ¥9.00) per transaction. 6. confirm that I am not an/ we are not undischarged bankrupt(s), and have no statutory demand served on
together with the ICBC Credit Card Cardmember Agreement (“Cardmember Agreement”)
me/us, and do not have legal proceedings commenced against me/us. I/We further confirm that no debt
only. This forms the “Fee Schedule” defined in the Cardmember Agreement. For full details, Finance Charge: 18.25% per annum on the amount withdrawn, chargeable on a daily basis on each
cash advance and accruing from the date of such advance until the date upon which such advance repayment scheme under the Bankruptcy Act (Chapter 20) applies to me/us.
please refer to the Cardmember Agreement, which provisions shall prevail in the event of any
inconsistencies. All terms which are not defined herein shall bear the meanings ascribed to (and any outstanding interest) is repaid in full. 7. authorise the Bank to debit any of my/our accounts maintained with the Bank either singly or jointly with any
them in the Cardmember Agreement. 8.3. USD Card Account cash advance fee and charge other person for any arrears, outstanding fees, monthly repayment, accrued interest and all other monies
due and payable to me/us hereunder without any further reference to me/us. If I am the principal cardholder,
Fee: 5% of amount withdrawn (minimum charge of US$15.00) per transaction.
I understand and agree that I am responsible for all charges, fees, interest and liabilities (collectively
1. Annual Membership Fee (Inclusive of GST) - Waived for first 3 years Finance Charge: 24% per annum on the amount withdrawn, chargeable on a daily basis on each cash “Outstanding”) charged to the principal card and the supplementary card. If I am the supplementary
advance and accruing from the date of such advance until the date upon which such advance (and any cardholder, I understand that I am only responsible for the Outstanding of my supplementary card.
Principal Supplementary
outstanding interest) is repaid in full.
Platinum S$150.00 S$75.00 8. agree that the Bank shall reserve the right to:
9. Fee For Balance Inquiry at ATM
Gold S$120.00 S$60.00 a. terminate or cancel or suspend my/our right to use the Card or the account;
9.1. UnionPay Dual Currency Credit Card
Classic S$30.00 S$15.00 b. refuse to authorise any Card transaction; or
Balance inquiry fee at China UnionPay or ICBC ATM is ¥4.00 per transaction within Mainland China.
c. refuse to re-issue, renew or replace the Card.
2. Repayment Grace Period Balance inquiry fee at China UnionPay or ICBC ATM is S$0.80 per transaction outside Mainland China.
9. understand that the final credit limit indicated is solely at the Bank’s discretion. Where I/we have existing
25 days from statement date 9.2. Visa Dual Currency Credit Card
unsecured credit facilities with the Bank, I/we agree and consent to the Bank reviewing and adjusting the
3. Minimum Payment Balance inquiry fee at Visa, Plus or ICBC ATM is US$0.62 per transaction within U.S. Territory. credit limit of such unsecured facilities at the Bank’s discretion.
Minimum Payment is 3% of the monthly balance outstanding, plus any Minimum Payment sum outstanding Balance inquiry fee at Visa, Plus or ICBC ATM is S$0.80 per transaction outside Singapore and U.S. 10. authorise, permit, consent and give my/our written permission to the Bank and any of its officers to collect,
from the previous Statement, plus amounts in excess of the credit limit, or S$50.00 (SGD Card Account)/ Territory. store, use, disclose or divulge any information with respect to me/us or any of my/our accounts with the
¥50.00 (RMB Card Account)/ US$50.00 (USD Card Account), whichever is greater. 9.3. Global Travel MasterCard Credit Card Bank, or my/our financial conditions, or any services and/or other agreements, business, transactions or
4. Late Payment Charge Balance inquiry fee at MasterCard or ICBC ATM is S$0.80 per transaction outside Singapore. dealings between the Bank and me/us as the Bank considers appropriate for the purpose of providing or
Kindly ensure that your payment reaches us on or before PAYMENT DUE DATE by paying the Minimum continuing to provide me/us with any services or transactions in relation to any of my/our account with the
10. Retrieval Fees (Inclusive of GST)
Payment or the closing balance on or before the due date. Bank, to and between:
10.1. Requests for copies of sales drafts and statements are subject to the following charges:-
Late payment charge rate is calculated at 5% of the whole amount of Minimum Payment or S$40.00 (SGD Charge a. the holding company or head office, branches, subsidiaries, representative offices, affiliates and
Card Account)/ ¥40.00 (RMB Card Account)/ US$40.00 (USD Card Account), whichever is greater. (per copy of each statement) associated or related corporations of the Bank wherever located;
5. Overlimit Fees Sales Draft Current To 2 Months S$5.00 b. data centres acting for the Bank, agents of the Bank and their respective officers, servants, agents,
If the current balance account exceeds the credit limit, an overlimit fee of S$40 (SGD Card Account)/ ¥40.00 More than 2 Months To 1 Year S$10.00 wherever situated;
(RMB Card Account)/ US$40.00 (USD Card Account) will be charged. Statement of Account Current to 3 Months old Free c. any person who has agreed to provide or is providing security to the Bank for all or any moneys and/or
6. Interest Charges for purchases liabilities owing or payable by me/us to the Bank from time to time;
Above 3 months old S$5.00
No Interest charges will be levied if payment of the whole of the statement balance is received by the Bank d. any other persons: (i) to or through whom the Bank assigns or transfers or novates or may potentially
Overseas address and duplicate statement S$5.00
on or before the Payment Due Date (except on cash advance and balance transfer). If payment is not made assign or transfer or novate all or part of its rights and obligations hereunder; (ii) with or through whom
in full by the payment due date, interest charges will be calculated at such rate per annum on a daily basis in the Bank enters into or may potentially enter into any participation or sub-participation; (iii) with whom the
10.2. Service charge for insufficient funds
the currency of the card account on (a) the amount of each transaction made from the date of transaction until Bank outsources the performance of any operational function of the Bank, including and without limitation
Returned cheque (per returned cheque) S$40.00 to a third party service provider whether within or outside of Singapore to perform any of the outsourced
the receipt of full payment (b) the current balance specified in the statement less any partial payment, from the
date of such partial payment to the date the Bank receives full payment of the current balance. The interest Returned GIRO (per returned GIRO) S$40.00 functions;
charges for purchases are as follows:- 10.3. Card replacement fee e. any financial institution, credit bureau or credit reference agency, rating agency, business alliance partner,
SGD Account interest rate 24% per annum Each card replacement (Principal or Supplementary) S$20.00 insurer or insurance broker, direct or indirect provider of credit protection whether within or outside of
RMB Account interest rate 18.25% per annum Singapore for the purpose of conducting credit checks and/or screening activities, and to contact my/
11. Lost or Stolen Cards Report and Limitation of Liability
our employer(s) for the purposes of verifying my/our employment status, such checks may take the form
USD Account interest rate 24% per annum Please report loss of card immediately by calling Card Centre at our 24-hour Hotline: (65) 6369 5588. of a bank reference or employment verification and may be performed before or after the Card has been
7. Transactions in Foreign Currencies Your liability for any unauthorised transactions carried out due to the loss or theft of the card is limited to approved;
7.1. UnionPay Dual Currency Credit Card (RMB/SGD) SGD$100 only if:-
f. any government agencies, regulators, securities exchanges, futures exchanges and authorities whether
a. No administrative fee will be charged for Card Transactions in RMB & SGD. (a) you have has immediately notified the Bank of the loss, theft or unauthorised disclosure; within or outside Singapore to which the Bank is required to make disclosure under applicable laws
b. Non-RMB and non-SGD transaction: Card Transactions may be charged in the official currency of (b) you have has assisted the Bank in the recovery of the unauthorised charges incurred; pursuant to the directives of such government agencies regulators, securities exchanges, futures
the country wherein such Card Transaction has taken place and converted into Singapore Dollars (c) you furnish the Bank with a police report accompanied by written confirmation of the loss, theft or exchanges and authorities;
at such exchange rate determined by China UnionPay. unauthorised disclosure and any other information that the Bank may require; and g. any merchant or member of card association where disclosure is in connection with the use of a debit
c. Non-RMB and non-SGD transaction: The transaction will be subject to an administrative fee of (d) the Bank is satisfied that such loss, theft or unauthorised disclosure is not due to the Cardmember’s card or credit card or ATM card;
1.5% on the amount converted. negligence or default h. any person who provides introducing services to the Bank;
7.2. Visa Dual Currency Credit Card (USD/SGD) i. any person to whom the Bank is under a duty to disclose;
a. No administrative fee will be charged for Card Transactions in USD & SGD. j. any other person to whom the Bank considers such disclosure to be necessary or expedient for the Bank
b. Non-SGD, non-USD and non-AUD transaction: The transaction will be converted at the prevailing DECLARATION AND AGREEMENT 声明及协议 to observe and perform its obligations hereunder or is necessary in order to provide the Customer with
exchange rates of Visa, first to USD then, to SGD. services in connection with the account;
c. AUD transaction: The transaction will be converted to SGD at the prevailing exchange rates of k. where applicable, in respect of any RMB account), clearing or agent bank and any relevant authorities in
Visa. IMPORTANT: You must read and agree to the terms and conditions before China as the Bank deems fit for purposes of the Bank disclosing and/or reporting all information relating
d. Non-SGD and Non-USD transaction made using Visa Cards: an administrative fee of 2.5% on the
signing and submitting the application. to the RMB account and all RMB account related transactions;
amount converted will be charged. 注意：阅读本条款及协议细则，如果您理解并且同意本条款及协议细则，请 l. (where applicable, in respect of any USD account), clearing or agent bank and any relevant authorities
e. Dynamic currency conversion: If your card transaction is converted into USD/SGD via dynamic 签名并递交申请表。 as the Bank deems fit for purposes of the Bank disclosing and/or reporting all information relating to the
currency conversion (a service offered at certain overseas ATMs, merchants or websites), you USD account and all USD account related transactions;
acknowledge that the process of conversion and the exchange rates applied will be determined m. any recipients who receive the information described above where it is necessary to provide me/us with
by the relevant ATM operator, merchant or dynamic currency conversion service provider, as the In consideration of the Bank issuing the ICBC Credit Card(s) to me/us at my/our request, I/We hereby
services in connection with the account; and
case may be. Visa card transactions converted via dynamic currency conversion will be subject to irrevocably:-
a fee of 0.8% on the converted USD/SGD amount. Currently, the fee of 0.8% is absorbed by us, n. the Bank and its strategic partners to contact or use such information for the purposes of informing me/
1. confirm that I/We have read, understood and agree to be bound by the following (“Terms”):
we will notify you of any change in the future per the method stipulated in the Card Agreement. us of any products that they may offer from time to time.
a. ICBC Credit Card Cardmember Agreement (“Cardmember Agreement”),
By continuing to use the Card, you are taken to have agreed to the changes in the fee, unless you 11. agree that all personal data provided by me/us in this application for the ICBC Koipy Dual Currency Platinum
terminate the Card per the Cardmember Agreement by cutting the Card into halves, returning to b. Account Terms and Conditions (“Account Terms”), Credit Card/ICBC Koipy Dual Currency Gold Credit Card (“Co-brand Card”), and any information and
the Bank and pay all outstanding balance in full. c. Internet and Mobile Banking Terms and Conditions (“Internet and Mobile Banking Terms”), details of my/our Co-Brand Card and the account(s) including but not limited to the transactions performed
7.3. Global Travel MasterCard Credit Card thereunder may be disclosed to the respective co-brand partners to enable the Co-Brand Partners, its
d. Personal Data Protection Policy (“PDPP”).
agents and service providers to collect, use and disclose my/our personal data to any party the Co-Brand
a. Non-SGD, and non-USD transaction: The transaction will be converted at the prevailing exchange and on such other terms and conditions as the Bank may prescribe from time to time, copies of which are Partner deems necessary for the purpose of:
rates of MasterCard, first to USD then, to SGD. available at any of the Bank’s branches or at www.icbc.com.sg.
b. Non-SGD transaction made using MasterCard Cards: an administrative fee of 2.5% on the amount a. processing this application and provide services associated with the Co-Brand Card account,
2. represent and warrant that all information provided in the application form and all documents submitted to
converted will be charged. b. administering any benefit, privilege and term applicable to the Co-Brand Card account, and
the Bank are complete, true and accurate, and undertake to immediately inform the Bank if there is any
c. Dynamic currency conversion: If your card transaction is converted into SGD via dynamic currency change or inaccuracy in the information. c. conducting research or analysis relating to any product and/or service provided by the Co-Brand Partner,
conversion (a service offered at certain overseas ATMs, merchants or websites), you acknowledge whether conducted by the Co-Brand Partner(s) or jointly with any other party
3. acknowledge that the Bank may decline my/our application without giving me/us any reason for doing so.
that the process of conversion and the exchange rates applied will be determined by the relevant 12. acknowledge and agree that you and the Co-Brand Partner (if any) will be separately collecting, using and
I/We further consent to the Bank retaining all documents submitted by me/us for the processing of this
ATM operator, merchant or dynamic currency conversion service provider, as the case may be. disclosing my/our personal data and each party shall only be responsible for its own collection, use, or
application, regardless of whether this application is approved or not.
MasterCard card transactions converted via dynamic currency conversion will be subject to a fee disclosure of my/our personal data, and shall not be liable for the other party’s handling or use thereof. I/We
of 1% on the converted SGD amount, or at such other rate as determined by us. We will notify you 4. consent to the Bank sending me/us at my/our sole risk through any means the Bank may deem appropriate,
agree to directly address any queries, access or correction requests, or complaints in relation to the handling
of any change. any credit card, any information regarding my/our account, personal identification number, statements of
of my/our personal data to the relevant party.
7.4. A cash transactional fee of 1% will be charged on any withdrawals over the counter from the RMB or accounts, any alerts (including but not limited to transaction or activation alert) and any other communications
or correspondences addressed to me/us (collectively “information”) to my/our address(es) or my/our mobile 13. apply for the Card to be issued to me/us, and that the Bank be authorised to renew and replace the Card(s)
USD Card Account.
number(s) in accordance with the Bank’s records. I/We further agree to bear all risks (e.g. non-receipt or until termination. Further, if I/we request for ATM access (eg, for the purpose of cash advance), I/we agree
8. Cash Advance Fee Charges that the use of the Card as an ATM card will indicate my/our acknowledgement and acceptance of the
disclosure to any unauthorised third party) arising from the sending of the information and release the Bank
8.1. SGD Card Account cash advance fee and charge from any liability or responsibility in any way for any losses that I/we may suffer as a result of the non-receipt Bank’s Account Terms.
Fee: 5% of amount withdrawn (minimum charge of S$15.00) per transaction. or disclosure of the same.
 ICBC Credit Card Application Form 工行信用卡申请表 PERSONAL DETAILS 申请人资料 APPLICANT ADDRESS DETAILS 申请人住址信息

Please complete this form in ENGLISH with the mandatory documents. Mr 先生 Miss 小姐 Mrs 太太 Mdm 女士 Dr 博士 Residential Address 住家地址
• Principal applicant must be aged 21 years and above
• Supplementary applicant^ must be aged 18 years and above Full Name as in NRIC/Passport (Please underline surname) Postal Code 邮编
• Principal applicant must have a minimum annual income of S$30,000 姓名（与身份证件/护照一致，并于姓氏下划线）
Overseas Permanent Address (for Foreigner) 海外永久居住地址 (适用于外籍人士)
请用英文填写此申请表，并提交此申请表必需文件。
• 主卡申请者年龄须满二十一岁或以上
• 副卡申请者^年龄须满十八岁或以上 Name to appear on Card (Including surname) 信用卡上姓名（含姓氏）
Postal Code 邮编
• 主卡申请者年收入须达三万元新币
Residential Status 住宅性质
ICBC Koipy Dual Currency Platinum Credit Card (RMB/SGD) Date of Birth Male 男性 Self-owned 自有 Parents’ 父母所有 Rented 租用
D D 日 M M 月 Y Y 年 Gender 性别
工银可派双币白金信用卡（人民币／新币） 出生日期 Female 女性 Mortgaged 抵押 Employers’雇主所有 Others 其他
ICBC UnionPay Dual Currency Platinum Credit Card (RMB/SGD)
Singapore Citizen 新加坡公民 SPR 新加坡永久居民 S Residential Type 住宅种类
工银银联双币白金信用卡（人民币／新币） Private Apartment/Condominium
NRIC No. 身份证件号码 HDB-3Rm/4Rm 政府组屋三房/四房
ICBC VISA Dual Currency Platinum Credit Card (USD/SGD) 私人公寓
Foreigner 外籍人士 Nationality 国籍 HDB-5Rm/Executive Apartment
工银VISA双币白金信用卡（美元／新币） 政府组屋五房/公寓式组屋 Landed Property 有地住宅
ICBC Global Travel MasterCard Credit Card (SGD) Passport No. 护照号码 Executive Condominium/HUDC Others 其他
工银万事达环球旅行白金信用卡（新币） 执行共管公寓
Expiry Date 有效期至 D D 日 M M 月 Y Y 年
NOTICE: The English version of this application form shall prevail. 注意: 此申请表的内容以英文为准。 Years of Residence 居住年数 Y Y 年 M M 月

MANDATORY DOCUMENTS 必需文件 Employment Pass No. 工作准证号码

Billing To 账单寄至 Residential Address 住家地址 Office Address 办公地址
1. Please submit the following IDENTIFICATION DOCUMENTS that are Expiry Date 有效期至 D D 日 M M 月 Y Y 年
applicable to applicants and tick off the relevant box below: EMPLOYMENT DETAILS 申请人职业资料
请递交以下与申请人相关的身份证明文件，并勾选相应空格： Chinese IC No. (for Chinese citizens)
中国身份证号码（适用于中国公民） Name of Company 公司名称
For Singapore Citizens and Permanent Residents 新加坡公民／永久居民
Photocopy of NRIC (front and back) 正反两面身份证复印件 Name as in Chinese IC (for Chinese citizens)
中国身份证姓名（适用于中国公民）
For Foreigners 外籍人士
Office Address 办公地址
Photocopy of Employment Pass / Visit Pass / Student Pass (valid for at least 9 months) Marital Status 婚姻状况
and Passport 工作准证(有效期九个月以上)与护照复印件 Postal Code 邮编
Single 单身 Married 已婚 Divorced 离婚 Widowed 寡居/鳏居
2. Please submit the following INCOME DOCUMENTS that are applicable to
the principal applicant and tick off the relevant boxes below: No. of Dependants 受赡养人数 Length of Employment 受雇年限 Y Y 年 M M 月
请递交以下与主卡申请人相关的收入证明文件，并勾选相应空格：
For Salaried Employees 受雇人士 Education Level 教育程度 Type of Business/Industry 公司业务性质
Latest 3 months’ computerised/electronic payslips; or Secondary 中学 Diploma 专业文凭 Postgraduate 研究院 Banking & Finance 银行金融 Manufacturing 制造
最近三个月电脑打印薪资表；或
Pre-University 高中 Tertiary 大学 IT/Communications 信息科技/通讯 Government 政府部门
Latest 12 months’ CPF Contribution History Statement; or
最近12个月的CPF记录；或 Others 其他 Please specify 请注明 Retail 零售 Hotel 酒店
Latest Income Tax Notice of Assessment and Others 其他 Please specify 请注明
the latest computerised/electronic payslip. Mobile No. 移动电话 (mandatory for transaction alert)
Current Position 当前职位
最近1年的所得税缴税通知书和最近1个月电脑打印薪资表
For Commission-based Employees 佣金制雇员 Home Telephone 住宅电话 GM/MD/CEO Professional 专业技术人员
Latest 12 months’ CPF Contribution History Statement; or 总经理/董事经理/行政总裁
Civil Servant 公务员
最近12个月的CPF记录；或 Office Telephone 办公电话 Fax No. 传真号码 Managerial 管理人员
Executive 执行人员
Latest 2 years’ Income Tax Notice of Assessment. Administrative 行政人员
最近2年的所得税缴税通知书 Commission Earner 佣金人士
Email Address 电子邮箱 Retired 已退休
For Self-employed 自雇人士 (mandatory for transaction alert)
Others 其他 Please specify 请注明
Latest 12 months’ CPF Contribution History Statement; or Mother’s Maiden Name 母亲（婚前）姓名
最近12个月的CPF记录；或 Employment Status 受雇性质
Latest 2 years’ Income Tax Notice of Assessment. I, or my Family member1/Close associate2, is/was a Politically Exposed Person3. Permanent 长期受雇 Contract ( Expiry M__ Y____ )
最近2年的所得税缴税通知书 您，或您的家庭成员1，或与您关系密切成员2，是或曾经是，一名政治公众人物3。 合约形式 ( ____年__月期满 )
3. For Foreigners, please submit the PROOF OF ADDRESS such as the latest No 否 Yes 是
telephone bill or bank statement*. Please specify 请注明 Gross Annual Income 年收入S$
外籍人士，请提供地址证明，如近期电话账单或银行账单。 I am a Director of ICBC. Other Annual Income
For Singapore Citizens and Permanent Residents, please submit the 您是ICBC董事会成员之一。 No 否 Yes 是 其他年收入 S$ Source 来源
PROOF OF ADDRESS such as the latest telephone bill or bank statement*
if your billing address differs from NRIC. If your current employment period is less than one year, please complete the following:
新加坡公民/永久居民，如果您的邮寄地址与NRIC上不同，请提供地址证明， Name of Contact Person 联系人姓名 如果您从事目前的工作未满一年，请填写下列信息：
如近期电话账单或银行账单。
Name of Previous Employer 前受雇公司名称
*Address on telephone bill/bank statement must match the billing address in the
application form Previous Job Title 前受雇职位
*电话账单或银行账单上邮寄地址必须与申请表上一致 Contact No of Contact Person 联系电话 Relationship 关系
^ Supplemetary applicant must be a family member1 or a person of close relation4. Length of Employment 受雇年限 Y Y 年 M M 月
^ 副卡申请者必须是主卡申请者的家庭成员1或亲属4
1st SUPPLEMENTARY CARD APPLICANT’S DETAILS 第一附属卡申请人资料 2nd SUPPLEMENTARY CARD APPLICANT’S DETAILS 第二附属卡申请人资料 MARKETING CONSENT 营销意向
ICBC Koipy Dual Currency Platinum Supplementary Credit Card (RMB/SGD) ICBC Koipy Dual Currency Platinum Supplementary Credit Card (RMB/SGD) I consent to receiving information on your new credit card products and
工银可派双币白金附属信用卡（人民币／新币） 工银可派双币白金附属信用卡（人民币／新币） services via text message, telephone call and fax.
ICBC UnionPay Dual Currency Platinum Supplementary Credit Card (RMB/SGD) ICBC UnionPay Dual Currency Platinum Supplementary Credit Card (RMB/SGD) 本人有兴趣通过短信、电话、传真收到工行信用卡的新产品与服务资讯。
工银银联双币白金附属信用卡（人民币／新币） 工银银联双币白金附属信用卡（人民币／新币） Yes 是 No 否
ICBC VISA Dual Currency Platinum Supplementary Credit Card (USD/SGD) ICBC VISA Dual Currency Platinum Supplementary Credit Card (USD/SGD)
工银VISA双币白金附属信用卡（美元／新币） 工银VISA双币白金附属信用卡（美元／新币）
APPLICANT’S PREFERRED CREDIT LIMIT* 申请人倾向的信用额度
ICBC Global Travel MasterCard Supplementary Credit Card (SGD) ICBC Global Travel MasterCard Supplementary Credit Card (SGD)
工银万事达环球旅行白金附属信用卡（新币） 工银万事达环球旅行白金附属信用卡（新币） *Credit limit is subject to Bank’s approval and absolute discretion.

I prefer and give consent to be granted a credit limit that is no more than
Mr 先生 Miss 小姐 Mrs 太太 Mdm 女士 Dr 博士 Mr 先生 Miss 小姐 Mrs 太太 Mdm 女士 Dr 博士 , I understand that the bank has the right to grant
Full Name as in NRIC/Passport (Please underline surname) Full Name as in NRIC/Passport (Please underline surname) me a credit limit that is lower than what I have indicated.
姓名（与身份证件/护照一致，并于姓氏下划线） 姓名（与身份证件/护照一致，并于姓氏下划线） 本申请人倾向和同意被授予信用额度不超过 ，并且本申请人理解
银行有权授予本申请人的信用额度低于本申请人所标明的信用额度。
I have no preference on my credit limit.
Name to appear on Card (Including surname) 信用卡上姓名（含姓氏） Name to appear on Card (Including surname) 信用卡上姓名（含姓氏）
本申请人对信用额度无倾向。

Supplementary card(s) will share the Principal cardholder’s credit limit.

Date of Birth Male 男性 Date of Birth Male 男性
D D 日 M M 月 Y Y 年 Gender 性别 D D 日 M M 月 Y Y 年 Gender 性别 附属卡将共享主卡的信用额度。
出生日期 Female 女性 出生日期 Female 女性
By signing here, I/We hereby read, understood and agree to the DECLARATION
Singapore Citizen 新加坡公民 SPR 新加坡永久居民 S Singapore Citizen 新加坡公民 SPR 新加坡永久居民 S AND AGREEMENT set out in this form. I/We affirm the said DECLARATION AND
NRIC No. 身份证件号码 NRIC No. 身份证件号码 AGREEMENT and agree to abide and be bound by the matters stated herein.
Foreigner 外籍人士 Nationality 国籍 Foreigner 外籍人士 Nationality 国籍 本申请人阅读，理解和同意此信用卡相关声明及协议内容，并同意接受其约束，申请办理信用卡。

Passport No. 护照号码 Passport No. 护照号码

Expiry Date 有效期至 D D 日 M M 月 Y Y 年 Expiry Date 有效期至 D D 日 M M 月 Y Y 年

My residential address is identical to the Principal Applicant’s residential address. My residential address is identical to the Principal Applicant’s residential address.
我的住家地址与主卡申请人的住家地址相同。 我的住家地址与主卡申请人的住家地址相同。 Principal Applicant 1st Supplementary Applicant 2nd Supplementary Applicant
Yes 是 Yes 是 主卡申请人签名 第一副卡申请人签名 第二副卡申请人签名
Date 日期： Date 日期： Date 日期：
No. My residential address is 否。我的住家地址是 No. My residential address is 否。我的住家地址是
Please do not alter. 请不要涂改
Definitions:
1 Family member means a parent, step-parent, child, step-child, adopted child, spouse, sibling, step-sibling and adopted sibling.
Postal Code 邮编 Postal Code 邮编 2 Close associate means that you are closely connected to the Politically Exposed Person, either socially or professionally.
3 Politically Exposed Person means a person entrusted with the following roles domestically or in a foreign country or in an
international organisation as a head of state, a head of government, government ministers, senior civil or public servants,
Mobile No. 移动电话 Mobile No. 移动电话 senior judicial or military officials, senior executives of state owned corporations, senior political party officials, members of
the legislature and senior management of international organisations. An international organisation is established by formal
Home Telephone 住宅电话 Home Telephone 住宅电话 political agreements between member countries that have the status of international treaties, whose existence is recognized
by law in member countries and which are not treated as a residual institutional unit of the country in which it is located.
4 Persons of close relation shall include grandparents, grandparents-in-law, fiance or fiancee, and nieces or nephews.

Email Address 电子邮件 Email Address 电子邮件

CREDIT BUREAU REPORT 征信报告
Name of Company 公司名称 Name of Company 公司名称
From 1 April 2016, if you wish to have a free credit report, you may obtain it within
Office Address 办公地址 Office Address 办公地址 30 calendar days from the date of approval or rejection of this application via the
credit bureau website listed below. Alternatively, you may bring the approval or
Postal Code 邮编 Postal Code 邮编 rejection letter and your NRIC to the following credit bureau’s registered office to
obtain a free credit report.
Type of Business/Industry 公司业务性质 Type of Business/Industry 公司业务性质
Banking & Finance 银行金融 Manufacturing 制造 Banking & Finance 银行金融 Manufacturing 制造 从2016年4月1日起，您可在此申请结果的30天内，通过以下征信网站免费获取征
信报告。您也可以携带申请结果通知信和您的身份证件，到征信局前台获取免费
IT/Communications 信息科技/通讯 Government 政府部门 IT/Communications 信息科技/通讯 Government 政府部门 征信报告。
Retail 零售 Hotel 酒店 Retail 零售 Hotel 酒店 Credit Bureau (Singapore) Pte Ltd
Others 其他 Please specify 请注明 Others 其他 Please specify 请注明 2 Shenton Way
#20-02 SGX Centre 1
Gross Annual Income 年收入 Occupation 职业 Gross Annual Income 年收入 Occupation 职业 Singapore 068804
S$ S$ Tel: (65) 6565 6363
www.creditbureau.com.sg
Relationship to Principal Applicant 与主卡持有人的关系 Relationship to Principal Applicant 与主卡持有人的关系
FOR BANK USE ONLY 银行专用
I, or my Family member /Close associate , is/was a Politically Exposed Person .
1 2 3
I, or my Family member1/Close associate2, is/was a Politically Exposed Person3.
您，或您的家庭成员1，或与您关系密切成员2，是或曾经是，一名政治公众人物3。 您，或您的家庭成员1，或与您关系密切成员2，是或曾经是，一名政治公众人物3。
No 否 Yes 是 Please specify 请注明 No 否 Yes 是 Please specify 请注明

I am a Director of ICBC. I am a Director of ICBC.

您是ICBC董事会成员之一。 No 否 Yes 是 您是ICBC董事会成员之一。 No 否 Yes 是