S OCBC PA BS 4 FR Gs ee Supplementary CardApplication Form @ £49 A RH Principal cardholder information > KARE RAMEE Not applicable for Business Credit Card and Student Credit Card 38 Principal Card No EHH A/S Full English / Portuguese Name of Principal Cardholder © JR-EiABIN Supplementary card applicant information rea See 2 BR « BLE TA DA sh BABE BL Fs AV eam GMTMAE A WIDER MA IE 6 AARERANTRES BMA RRA AN WT, 1 ROAKELRLER TRADER STERATR Please note: 1 Supplementary Cate applicant MUST be a immediate family member of the pi 2.Caraholcer of She Visa Supplementary Card should be FEMALE 3 Please attach copies ofthe Supplementary Cardholder entity Card and latest 3 months residential proof under your name. g. electricity bila bit/ahone bit 4Alldacuments submitted {including this application form) are not retuinable 5The Bank will ot state the reason(s) for ary unsuccessful application. {The bank will apply for your Personal Credit Report from the Credit Oata Platform operated by the Macao Postal Savings ‘Please use blue o back ball pen to complete this form. The erasable ball pen is not allowed OEM, Ok Ms 38/WXIEZ Full English / Portuguese Name » tsbas6206 Sumame fist E-EF57% ABA Relationship to Principal Cardholder "ps Chinese Name 1 HAZEN E, /8) ZB) Former / Other Name (Please enclose the proof of Former / Other Name) S938 848 ID Card No. » L H HWSEE RE Date of Birth » AYA/SEDD/MM/YY LLI/LLI/ WHSESOEE Place of Birth IRS Nationality » Sr42dtAF #888 Please remarks if you have one more nationality l Dou 1 "BE Education Level C WLEBEALE Master's degree or above) *%! Undergraduate 0 SLB Post-secondary 1 PEERDLE Secondary (F4 or above) C1 —Eh= Form Ito Form3 Ch //ABALIF Primary or below S8S01:R Marital Status O8SSingle 0 BS Married 0 BES Divorced DM Widowed Cl FtELiving Together _ SR#RABSupport People ##REALLHabitual Residential Address » S7/78C188 in Portuguese 289)B 18 Company Name > st/38 /a1328 9 in English /Portuguese 4438 Employment Industry 2x8)3biIE Company Address » #7404 Min Portuguese 3) Office Tel No, itt Position *8251A Annual Income berry L 1 L 1% L_18Months MAIL Email Address » £30 @F] Max. 30 Characters 2575 FHL F BE LIBRA The Bank will send you various updates via e-mailSocsc BAY ASS FR Bi Supplementary CardApplication Form © HiM=B Subsidiary application » 2650/7 A080 Please select your options ©B85 Web Dollar #8 8% Apply Web Dollar Virtual Card > (SANBES MOP 3,000 Preset credit limit MOP3.000 > KRS/HE&E8E/8 ENot applicable for Unionpay Credit Card (SABE Principal Card and Supplementary Card MBI Supplementary Card » 2 #zs8##806/8-# Principal cardholder already possess the card © Wms se aK GH ak TAEEE Free mobile alert service » (@RIRIMFL—IR Please select one options) O BBE RTE A MERE (OBERT ERMA EZ EARS) Principal Cardholder Mobile Phone No. (Principal and supplementary card transaction can be displayed on the mobile of principal cardholder) Le OR ERO RARE (RETAINERS) Supplementary Cardholder Mobile Phone No. (Supplementary cardholder can only display the transactions of supplementary card) be SHAM LATHOCE TERA SMOR ‘The use of Mobile alert Service will be governed by its terms and conditions. © S8iiBR Self-certification form > SG RBA 1 - SBR ATLL RON Z SAO AE Ifyou are currently a US. person, please contact the Bank for the purpose to complete additional compliance documents ANBAR M SNE RSS ABER (FATCA) 2S PRRES AARBAA LAMM G ERASE - MRR OIR LT AINE WRAL AIRAR AAT & AWESAAM FRRRE AAT () RAPLIMA SAARC IA HEIRS ORF) ATIR A URS IO A DUBS ACHES COP) RL OR A IRE FTA ZITA + (i) AARRRMAt ( MEE SIACSRM RTM) RAARAAZ! # DLR AVANT OPM AIRE] - s TRIZMA OSHA A) BRRBURIR EAMES OARS « XAMMELHSL TLS SOEUR RAR KARAS ER Customer Declaration in relation to U.S. Foreign Account Tax Compliance Act (FATCA) | declare that | have examined the information on the Personal /Joint Account Application Form, Commercial Account Supplementary Form or Credit Card Application Form and to the best of my knowledge and belief, itis true, correct, and complete. | further certify that: (1am using this self-certification form to document myself as an account holder of OCBC Bank (Macau) Limited, and the beneficial owner of all income in my account(s) maintained with OCBC Bank (Macau) Limited {il)_ 1am currently not a US. person (including resident alien individual ie. green card holder), and am not treated as a US. citizen or resident for US. tax purposes. | undertake to notify OCBC Bank (Macau) Limited in writing promptly of any change in the information, documents and supporting materials provided to OCBC Bank (Macau) Limited before which makes this self-ceriication form incorrect. TWR-E*28 A Signature of Supplementary Card Applicant x @) > Bem MSM EER TZ AICM MI Signature to be in conformity with specimen filed with the Bank SUS39HI FOR BANK USE ONLY PERNUS Br /Dept ‘Approved bySocsce BAY ASS FR Bi Supplementary CardApplication Form © BPH Declaration DRAGER LRA TIRES URN: SAE RE: NARRATOR ADA ATI BE) SRIRAM REFN CRA MRIEI » AMI) SABRI «1 (We) contr that the above infomation and other information subsequenty proved by me (us fom time ta time ae re, complete nd correc, snd undersland thal ve} shallprvide OCBC Bark Macau liruted reenaterefened tos the ‘ary endence and elvan creat car may become eect only pn confirmation bythe Bank wth mes} DRAGRIAS WARIO RN - TRA Z RA ULMER RENEE RGR SR SLAS RI RI Z RR AR RTARAMSLRAMRSATCALODRAACE RA CORR KALB STRAT EMAL TERA ALLE FREE +1 {ve undestara thatthe Sark ll ely on te information provided and t be provided subsequethby me us} ad the formation contained nts appaton formas he princpalbass on which ne Bark shallrate decors as tawhethert gran the ole rp ofthe loan and urge wa futher coraons raul uch grant tne mace. ve) herby declare hat ve) have not concealed any det Ife) have a ay have incuted ane) undetstand that if ay nrrmation mentored in ts paragraphs in any aspect, incomplete o inaccurate, (ve) may be abl threo, SRACTRIR MRAM GN A) TERIOR (OEE 1 (We) agree thatthe Bank shal hve the ight to cechne my (out) ppaton without ging any JEALSAEDNLARALMATAGRARABLZ RABAT OKIE BRAILES PMIERS SBIR “1 (Wie) agree and Understandtattisapplation fem and phtocopesalldocumerts supple by eon beha of me shalbelngto he Sark arcwilne be reruned regardless whether ny lout appieatin herinis approved orn PRACRRSIBGHE DARA AE ZAM RARER ARI) RAGMI IRSA RUM RETRRLUOR AIA 18) Undertake to promply provide the ifermation and decurents a the Bank may request fim time to time and (ne) understand ny (ou flue to provide any ofthe sid information and dacuments may ulin the Bark approving ns cred cardsppliestion ri tn decuren= © EAM Data Privacy SA SROR GeOLA a RA NRPS REIREESLSE- The personal data gathered inthis aphaton frm anal infoation ‘lating this application lle pressed bythe Sank in comaharce with applicable ls an dat privacy protectin in Macau 1) AREER th FES fF Te purposes for which your personals may beusedcompri arr allo the flung pupae (NRSERRE Syst sUe AISI ARRAN : processing of apleatons or banking andjor athe nancalservees ane Tacs (i) RR RA MILES BARE RUOIBAE «operation ofthe services ane credit facies provided toast subjects, (iy ASSES AE: ensuing thecredtworhinss of at subjects; (iGo BL AEA EEDA RE researching ardor designing marcas related produ’ fo dat subjects (WPS SES «REED ML LA8Bh NH «for operational purposes, credit assessment ret scring model or statscl analysis DRAGER METAR MET MARTE MRR RMA: ERIE I ROG MM FD) «FERS PUREST AL ‘QSYORIe SMILE MAS» QIRZARLIC A BTA RARIECTTESLTYA IER «(We agveetha the sank may rove relevant inoratin toemployeesof the Bank andor any member ofthe OCRC Bank Group including ts ranches, holeing company, epesertative offces, subsides and wists and provide relevant fica Ssersices andr produets to meus} many form inludng but nimi to making eet assessment or planning threugh an automatic assessment ster. DRAGER RAH ENIHIN ZITO RE ZR ATARI EAI» LEIP ERAT = HBIGER » EWR IRL AE (We) autre ‘he Bante zslse to and exchange with whomsoever in any aspect the Sank may conse appropiate the above nfozmation ous the above infotration te ebtain ‘idence rm ary thi party othe purpose a eiing the authentic ofthe inoration, SARE)RM RETINAS AMIR DLT AA RATA LONM «ak A NG THAT OATH RM RA TAR EMMIENE AL ARTRRAEBMANLN AMR RBGRO RAR Lota EONAR BERIT SIL RS AR BH ABR AME MERE (ie) ageetnatal personal ata relating tome colectec bythe San ‘rom time me maybe used and csclosd 1 such purposes and such person whether ino etsde Macau} 2s may bein accordance withthe Ban's plies on use and dscsue of personal data set ut in stamens cubs, ems and condion rrties made salable by the Banke ts customers frm ime tote anc uch data may be closed (by Way a ank references ar ethers) tary fini Insttution with which hae or propose thave desing to erable sch rancinsti.ton to conduct ced chect on mele. IAAGT ARAM RZESALR: Oe RTARTA TAROT ALOR RGEAEZ SARROKAZFM = LASMREAALS) RISO FFARR ZAM ACB ALIRS «fe agree to receive any leat male the Bankand agree thatthe Bank may. necesany send ‘epiymentremindeso promtlonalinfrmatin te my (out mobilephone number isch manner asthe Bank may dem appropriate or make enue rom and inform me though te contact number and emall access et outin the appliation form as provides by meus} tothe Sank by erent means OSARMSE: HAMMAR ZAM SAS ATACE ASE CRIM T KAR LitPehcnHEe@e/E MLSE MTEIRICMRMIEILZ IRIS EM « 1) agree erat any termination of ary areement by mye or he Bank nallnot ac or terminate my authorization te dsc infermation giver abo in reston to Information inte posession of he Bark a etrinaton, fr he purpses ofthe applicable laws WAA(AS AEE RECA (82 RORANAAARESAHa ROSANA MTMAMAE (OES RA SEM RRR GOR RASA MRR AMM LRA Tyo RIE RE (aR REMI AB 2 mR TORH ASR RMT ROR (ER RTE ROME ARSE « Wel may at anytime in accorsance withthe applicable awe (ehecewhether the dank ralas dats about me and have aces ta such data upon paying such es as may be imposed y the Sank Uidreaie the ant cove any dts relating to me whichis naceut (idrequst the Sanit ivorm me af the tems of data whieh ae rutinelydsclsed to a elt ference agen and inthe event of def toa deb ellen gene (Gish request the dane prove me with unr infrmation te erable the making ofan accers and covecon request othe relevant cea ference agencyor debt calcio agency and (sree te Banke ease using his peranaldat orits marketing purposes witnau charge ARGHLIMEROE LA AREAL MEL ATOR OF RE SRE RRMA EPR «AS (53)035 The Bark willrespond to alllegtimate requests fr information and where applet corel amend elete your personal data. you wish make sucha request rif you have questons or ommerts about ths Dat Pavey Ply lease contact he Bork at (8552655 6785 BY BBS Fe Se Qocse Supplementary CardApplication Form © BZ Authorised signature 2: RTPA ARAE) 1. AAS) RUNTIME WE RCO TAM AME 2A) CARA RERROEREN BF SRANAABHAAM THERE BMRA) GEREN HRPRA (8) HERA (S) FARBER RMSE IAA A LEA ERE RARE RSE <3. FA (8) HERA BAS LRM RTH AAS) SAMBORA 2 RB ALLS OIA CET IIMB «SA 8) FREY A DBART ARAGE) LIPO RIM) RE RAR Lute TIRE —USUR AER ISABMCARTE RE BIA A (3) RRA: To: OCBC Bank (Macau) Limited 1. I/We hereby confirm that the information given above is correct and complete and authorize you to confirm this from any source you may choose. 2. I/We acknowledge that the use of the Credit Card is sub ject to the terms and conditions of the Bank Credit Card Cardholder Agreement and which | /we understand willbe given to me / us with my / our Credit, Card. Ifthe said agreement is not completely acceptable to me / us, the issued card(s) shall be cut into halves across the magnetic stripe and / or Virtual Card account information immediately returned to the Bank for cancellation. 3. 1/ We confirm that unless otherwise notified the Bank inwriting together with this application form, as at the date of this application, | am / we are not a relative or spouse of any of the directors / supervisory council members of OCBC Bank (Macau) Limited oF relative or spouse of any of the directors of its immediate holding company in Hong Kong. 1/ We Undertake to notify the Bank immediately in writing if | / we become so related to any of the directors or supervisory ‘council members. | / We hereby confirm the truthfulness and correctness of my / our above confirmation and where applicable, the contents of all such written notification, which shall be binding on me / us 3 £4979 AS8% Signature of Principal Cardholder x &) BiB Date » yar Domyvy LLI/L1I/L1L4I JERE-EeHIR ABER Signature of Supplementary Card Applicant x BIW Date » a/s/# po/muyvy L_1I/LLI/L1LI S8/751FH_FOR BANK USE ONLY RO. PH AP AS. cr Oo SUB-TYPE SCN ‘APP cSCN