Please debit the UNIRinggit required to the following Credit Card account / Sila debitkan UNIRinggit yang diperlukan ke akaun Kad Kredit berikut:

Enquiries / Pertanyaan & Pesanan : 03-26128 121 Fax / Faks : 03-26900 121Mail / Surat : UOB Call Centre, Level 15, Menara UOB, 50350 Jalan Raja Laut, Kuala Lumpur. P.O.Box 11212, 50738 Kuala Lumpur.

Cardmember's Signature / Tandatangan Ahli Kad Kredit Date / Tarikh*As per specimen signature of your UOB Visa/Mastercard account / Sepertimana contoh tandatangan pada akaun UOB Visa/Mastercard anda

ENRICH MILES / ASIA MILES / KRISFLYER MILES / BIG POINTS

ANNUAL FEE / YURAN TAHUNAN

CUSTOMER'S DETAILS / BUTIRAN PELANGGAN

I would like to convert my UNIRinggit towards the Annual Fee Redemption / Saya ingin menukar UNIRinggit saya kepada Penebusan Yuran Tahunan

* Annual Fee Redemption is applicable to Principal Cardmembers only / Penebusan Yuran tahunan adalah untuk Kad Ahli Utama sahaja.* Please allow ONE (1) month for annual fees redemption to take effect / Tempoh SATU (1) bulan diperlukan untuk yuran penebusan tahunan berkuatkuasa.

UOB Visa ONE ClassicCode / Kod: C17001 UNIRinggit: 28,000 (each)UOB Visa ONE PlatinumCode / Kod: C17002 UNIRinggit: 68,000 (each)UOB Mastercard Lady's ClassicCode / Kod: C17003 UNIRinggit: 28,000 (each)UOB Mastercard Lady's PlatinumCode / Kod: C17004 UNIRinggit: 50,000 (each)

UOB Mastercard Preferred PlatinumCode / Kod: C17006 UNIRinggit: 80,000 (each)UOB Visa PRVI Miles/MastercardPreferred Platinum Dual CardsCode / Kod: C17007 UNIRinggit: 120,000 (each)UOB Visa YOLOCode / Kod: C17011 UNIRinggit: 37,000 (each)

UOB Visa InfiniteCode / Kod: C17009 UNIRinggit: 240,000 (each)UOB Mastercard Lady's SolitaireCode / Kod: C17010 UNIRinggit: 120,000 (each)UOB Visa PRVI MilesCode / Kod: C17005 UNIRinggit: 80,000 (each)

Cardmember's Name /Nama Ahli Kad Kredit :

NRIC or Passport No /No. KP atau Pasport :Card Number 1 /Kad no.1 :Card Number 2 /Kad no.2 :

Tel. No. (Home) /No. Tel. (Rumah) :

Tel. No. (Office) / No. Tel. (Pejabat) :

Tel. No. (Mobile) /No. Tel. (Bimbit) :

* To avoid duplication and delay, please do not send in your redemption form if you have placed your order by fax / Bagi mengelakkan pesanan berulang dan kelewatan memproses, jangan poskan borang penebusan sekiranya anda telah membuat pesanan secara faks* Photocopies of the redemption form may be used / Salinan fotostat borang penebusan boleh digunakan

FOR BANK USESignature:

Name:Date:

Approved by / Diluluskan oleh Processed by / Diproses oleh Verified by / Disahkan oleh

I confirm that I have read the UNIRinggit Rewards Programme Terms and Conditions stated on www.uob.com.my and shall abide by the conditions stated in that document. I consent to and authorise the Bank to disclose any information relating to me and/or my account(s) to Malaysia Airlines / Singapore Airlines / Cathay Pacific / DCR Marketing and/or any other third parties without further notice to me for the purpose of carrying out my instructions as per this UOB UNIRinggit Rewards Programme Redemption Form in relation to the redemption of my UNIRinggit. / Saya mengaku bahawa saya telah membaca Terma dan Syarat Program Ganjaran UNIRinggit di www.uob.com.my dan akan patuh kepada syarat yang dinyatakan dalam dokumen itu. Saya dengan ini bersetuju dan memberi kuasa kepada pihak Bank untuk mendedahkan dari semasa ke semasa apa maklumat yang berhubung dengan saya kepada Malaysia Airlines / Singapore Airlines / Cathay Pacific / DCR Marketing dan/atau parti-parti berkenaan tanpa sebarang notis kepada saya bagi tujuan penebusan UNIRinggit sepertimana yang telah diisi di dalam borang penebusan.

Please √ which Redemption Programme you wish to enjoy / Sila tanda mana satu Penebusan Program yang dikehendaki

MILES AND ANNUAL FEE REDEMPTION FORM / BORANG PENEBUSAN PROGRAM MILES DAN YURAN TAHUNAN

ENRICH PROGRAMME / ASIA MILES / KRISFLYER / BIG POINTS / PENEBUSAN PROGRAM ENRICH / ASIA MILES / KRISFLYER / BIG POINTS

ANNUAL FEE REDEMPTION / PENEBUSAN YURAN TAHUNAN

Acc No./ID No - Enrich Miles/Asia Miles/KrisFlyer/AirAsia BIGNo. Akaun/No. ID - Enrich Miles/Asia Miles/KrisFlyer/AirAsia BIG

3,500

Frequent Flyer Programme/Program Frequent Flyer

Item Code/Kod Butiran

UNIRinggit Required/UNIRinggit Yang Diperlukan

Quantity/Bilangan

Total UNIRinggit/Jumlah UNIRinggit

M18001

7,000M18002

6,500M18003

8,500M18004

10,500M18005

7,000M18006

500 Asia Miles

1,000 Enrich Miles(For Other UOB Cards)

1,000 Enrich Miles(Only for UOB Privilege Banking Visa Infinite and Visa Infinite Cardmembers)

1,000 KrisFlyer Miles(Only for UOB Privilege Banking Visa Infinite and Visa Infinite Cardmembers)

1,000 AirAsia BIG Points (Only for UOB Visa PRVI Miles and Preferred Platinum Card)

3,000M18011 500 Asia Miles(Only for UOB Privilge Banking Visa Infinite and VisaInfinite Cardmembers)

1,000 KrisFlyer Miles(For Other UOB Cards)

Email / E-mel :