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Welcome the world of benefits.

Enjoy greater benefits and privileges with Citibank DIVIDEND World MasterCard.

Citibank DIVIDEND World MasterCard

Benefits at a glance

Enjoy cash back on all your spend and these greatbenefits with Citibank DIVIDEND World MasterCard!

Terms and conditions apply. Visit www.citibank.com.sg/div for full details.

Complimentary travel insurance

Enjoy complimentary travel insurance coverage of up to S$1 million when you charge your travel expenses to your Citibank DIVIDEND Card.

(Activate your coverage before you travel)

Enjoy up to 10% Citi Rebate

Earn and redeem Citi Rebate instantly at over 700 locations islandwide.Refer to www.citibank.com.sg/citirebate for the list of participating merchants.

MasterCard® PayPass™

Citibank DIVIDEND World MasterCard comeswith MasterCard PayPass, letting you makeTap & Go™ payments. No signature is required for purchases that are S$100 or less!

Upgrade to Citibank DIVIDEND World MasterCard today. Fax to 6704 6529 or mail in this form.

Enjoy fuel savings of up to 18.3% at Esso and up to 18.1% at Shell, with a total of over 120 stations islandwide! Earn up to 5% cash back at all other petrol stations locally and overseas!

The most savings on fuel

Get up to 5% savings worldwide at grocery and health & beauty/pharmacy stores, 2% cash back on dining and 0.5% cash back for all other spends.

Daily savings all year longNEW

=+ +DAILY

SAVINGS, ALL YEAR LONG.on Groceries

%5Up toNew

Up toNew

on Health & Beauty

%5on Petrol

%18.3Up to

Citibank DIVIDEND World MasterCardMost cash back, more privileges.

I would like to upgrade to Citibank DIVIDEND World

MasterCard Card.

Existing annual fee will apply.

Please mail or fax your completed form to 6704 6529.

You can also call our 24-Hour CitiPhone Banking

Hotline at 6225 5225 to upgrade your card.

YES!

Citibank full disclaimers, terms and conditions apply to individual products and banking services. ©2014 Citibank. Citi, Citibank and Citi and Arc Design are registered service marks of Citigroup Inc. Citibank Singapore Limited Co. Reg. No. 200309485K Printed on 06/2014

Declaration: By signing above, I/we agree to convert my/our existing Citibank DIVIDEND Platinum MasterCard (as specified above) to Citibank DIVIDEND WORLD MasterCard. I/We authorise you to obtain and verify any information about me/us as you deem fit in your absolute discretion. I/We authorise the transfer and disclosure of any information relating to me/us (including information you obtain from third parties such as any credit bureau recognised by the Monetary Authority of Singapore (“MAS”) under or pursuant to the Banking Act (Chapter 19)(the “Banking Act”)) to and between the branches, subsidiaries, representative offices, affiliates and agents of Citibank, N.A. and third parties selected by any of them or you, wherever situated, for confidential use (including for use in connection with the provision of any products or services to me/us). You and any Citibank, N.A. branch, subsidiary, representative office, affiliate, agent or third party selected by any of them or you may transfer and disclose any information as may be required by applicable law, court, regulator or legal process. Without prejudice to the generality of the foregoing, where you are a member of, or subscriber for the information sharing services of, any credit bureau recognised by the MAS under or pursuant to the Banking Act, I/we expressly authorise: (a) you to transfer and disclose to any such credit bureau; and (b) any such credit bureau to transfer and disclose to any fellow member or subscriber as may be recognised as such by MAS, any information relating to me/us and/or any of my/our card account(s) (and for such purposes) as may be permitted under or pursuant to the Banking Act. I/We agree that my/our obligations under my/our existing Citibank DIVIDEND Platinum MasterCard (as specified above) will be transferred to my/our Citibank DIVIDEND WORLD MasterCard account. I/We agree to be bound by the terms and conditions of the Citibank DIVIDEND WORLD MasterCard Cardmember’s Agreement. I/We warrant that any information given by me/us for the purpose of this upgrade is true and correct. Upon my/our receipt of the Citibank DIVIDEND WORLD MasterCard, I/we agree to destroy my/our existing Citibank DIVIDEND Platinum MasterCard(s) (as specified above). If I/we have provided an authorisation to Citibank to bill/charge the premium payments in respect of any Insurance Policy(ies) (defined below) which I/we have applied for and/or any recurring bill payments in respect of the merchants as set out in http://www.citibank.com.sg/recurringmerchants (“Merchants”) to my/our existing Citibank DIVIDEND Platinum MasterCard(s), I/we authorise Citibank to bill/charge (i) the premium payments in respect of these Insurance Policy(ies), and (ii) all my recurring bill payments in respect of these Merchants, to my/our Citibank DIVIDEND WORLD MasterCard instead of my/our existing Citibank DIVIDEND Platinum MasterCard(s) upon my/our successful upgrade to Citibank DIVIDEND WORLD MasterCard. I/We understand and agree that any other recurring payment arrangements on my/our existing Citibank DIVIDEND Platinum MasterCard (s) will cease upon my/our successful upgrade to Citibank DIVIDEND WORLD MasterCard (as mentioned above), unless I/we have provided authorisation to the relevant billing organisation and Citibank to bill/charge such payments to my/our Citibank DIVIDEND WORLD MasterCard (as mentioned above). “Insurance Policies” refer to the insurance policies as set out in www.citibank.com.sg/insurancepolicylist which are underwritten by ACE Insurance Limited, Royal & Sun Alliance Insurance Plc, MSIG Insurance (Singapore) Pte Ltd and Card Protection Plan Limited and exclusively offered to customers of Citibank Singapore Limited. “Insurance Policy” refers to any of these Insurance Policies. Any reference in this Declaration to “you”, “your” or “Citibank” shall mean Citibank Singapore Limited.

Note that existing General Insurance plans distributed by Citibank that are currently recurring on your existing card will be transferred to your new Citibank DIVIDEND World MasterCard.

CITIBANK DIVIDEND WORLD MASTERCARD CARD UPGRADE FORM

Given Name (As in NRIC/Passport)

Tel (H) (HP)

Existing Citibank DIVIDEND Platinum MasterCard No.

Existing Citibank Supplementary Card No.

NRIC (for Singaporeans & PR)

Passport Number (for expatriates)

_____________________________________ _____________________________________________Principal Cardmember’s Signature Supplementary Cardmember’s Signature (if any) Date: Date:

CL ADJ: Y/N/NA A D C

Account Number:

WU9AC1AØ (820/CPØ)

FOR BANK USE