CHANGE OF ADDRESS / CONTACT DETAILS

Please mail original signed form to: Citibank Berhad Channel Support Unit, PO Box 12774, 50788 Kuala Lumpur.

**Please strike off if not applicable ** Important Notes

Name (as per IC / Passport / Company Registration)
1) PO Box Number, Company with PO Box Number, Citibank with PO
Box Number, Citibank addresses, Hotel addresses are not accepted.

New IC / Passport Number / Company Registration No.
I/We understand that the information given in this form will supersede
existing information in the bank records and I/we authorize Citibank
Berhad to change my/our contact details for the following account(s)
effective _________________________________ (dd / mm / yy)
Account Numbers
2) For accounts with JOINT AND mandate, the signatures of all joint
account must be provided below.
3) For change of address and telephone number in the USA, please
submit W-8Ben [Non-US Person] / W9 [US Person] form and/or
other supporting documents as proof of your status as a US
Person/Non-US Person[please specify the supporting documents below]
a) _____________________________________________
b) _____________________________________________
c) _____________________________________________

1. ________________________________________________ Important Notes for Banking Account Customer

2. ________________________________________________
3. ________________________________________________
4. ________________________________________________
5. ________________________________________________
Correspondence Address
Home Office
a) Change of Country of Residence to outside of Malaysia
If you have changed your country of residence, please be informed that
there may be applicable laws and regulations in the country you now reside
which may impact Citibank Berhads offering of products and services. You
are responsible for observing and complying with, the laws, regulations and
rules of your country of residence when pursuing wealth services offshore.
b) Offshore Wealth Services Policy
I am/We are aware of the laws in my/our country with regards to my/our
banking with you in Malaysia and/or in any other countries and I am/we are
fully responsible in complying with the same, and you shall not be liable in
any way whatsoever for any loss and/or liability imposed by my/our country
on me/us as a result of my/our non-compliance with any regulations, law or
legal process of my/our country.

By signing below, I/we: [1] acknowledge I/we have read and

__________________________________________________
__________________________________________________
City __________________________________________
understood the contents of this form [2] confirm that the
information given is correct and [3] complete and authorize
Citibank to verify the same against from any source which
Citibank may do so lawfully, as it may deem fit .

State __________________________________________ X
Authorized Signature(s) [As on banks file record]
Postcode __________________________________________
Remarks:
Country

Demographic Update

Domicile __________________________________
For Banks use:
Customer Number:
Permanent Residence ______________________________

Nationality ______________________________
Relationship Number:
Telephone Number

Please state Country & Area Code for both local and overseas Remarks:
telephone number.
Phone Type Country Code Area Code Telephone No.
Mobile 1
[Primary]
One Time-Pin [OTP] will be sent to primary mobile number Date Branch I/C Sighted Name & Initial

Mobile 2

Home
Internal Verification:
Office In Branch Out Branch

Fax/Others Special Remark:

[please specify] Advise customer to activate IN9 account

Email Address [if any] ______________________________________

[For e-statement enrollment, please use E-Statement Enrollment Form]
 CHANGE OF ADDRESS / CONTACT DETAILS
Please mail original signed form to: Citibank Berhad Channel Support Unit, PO Box 12774, 50788 Kuala Lumpur.

**Please strike off if not applicable ** Important Notes

Name (as per IC / Passport / Company Registration)
1) PO Box Number, Company with PO Box Number, Citibank with PO
Box Number, Citibank addresses, Hotel addresses are not accepted.

New IC / Passport Number / Company Registration No.
I/We understand that the information given in this form will supersede
existing information in the bank records and I/we authorize Citibank
Berhad to change my/our contact details for the following account(s)
effective _________________________________ (dd / mm / yy)
Account Numbers
2) For accounts with JOINT AND mandate, the signatures of all joint
account must be provided below.
3) For change of address and telephone number in the USA, please
submit W-8Ben [Non-US Person] / W9 [US Person] form and/or
other supporting documents as proof of your status as a US
Person/Non-US Person[please specify the supporting documents below]
a) _____________________________________________
b) _____________________________________________
c) _____________________________________________

1. ________________________________________________ Important Notes for Banking Account Customer

2. ________________________________________________
3. ________________________________________________
4. ________________________________________________
5. ________________________________________________
Correspondence Address
Home Office
a) Change of Country of Residence to outside of Malaysia
If you have changed your country of residence, please be informed that
there may be applicable laws and regulations in the country you now reside
which may impact Citibank Berhads offering of products and services. You
are responsible for observing and complying with, the laws, regulations and
rules of your country of residence when pursuing wealth services offshore.
b) Offshore Wealth Services Policy
I am/We are aware of the laws in my/our country with regards to my/our
banking with you in Malaysia and/or in any other countries and I am/we are
fully responsible in complying with the same, and you shall not be liable in
any way whatsoever for any loss and/or liability imposed by my/our country
on me/us as a result of my/our non-compliance with any regulations, law or
legal process of my/our country.

By signing below, I/we: [1] acknowledge I/we have read and

__________________________________________________
__________________________________________________
City __________________________________________
understood the contents of this form [2] confirm that the
information given is correct and [3] complete and authorize
Citibank to verify the same against from any source which
Citibank may do so lawfully, as it may deem fit .

State __________________________________________ X
Authorized Signature(s) [As on banks file record]
Postcode __________________________________________
Remarks:
Country

Demographic Update

Domicile __________________________________
For Banks use:
Customer Number:
Permanent Residence ______________________________

Nationality ______________________________
Relationship Number:
Telephone Number

Please state Country & Area Code for both local and overseas Remarks:
telephone number.
Phone Type Country Code Area Code Telephone No.
Mobile 1
[Primary]
One Time-Pin [OTP] will be sent to primary mobile number Date Branch I/C Sighted Name & Initial

Mobile 2

Home
Internal Verification:
Office In Branch Out Branch

Fax/Others Special Remark:

[please specify] Advise customer to activate IN9 account

Email Address [if any] ______________________________________

[For e-statement enrollment, please use E-Statement Enrollment Form]
 CHANGE OF ADDRESS / CONTACT DETAILS
Please mail original signed form to: Citibank Berhad Channel Support Unit, PO Box 12774, 50788 Kuala Lumpur.

**Please strike off if not applicable ** Important Notes

Name (as per IC / Passport / Company Registration)
1) PO Box Number, Company with PO Box Number, Citibank with PO
Box Number, Citibank addresses, Hotel addresses are not accepted.

New IC / Passport Number / Company Registration No.
I/We understand that the information given in this form will supersede
existing information in the bank records and I/we authorize Citibank
Berhad to change my/our contact details for the following account(s)
effective _________________________________ (dd / mm / yy)
Account Numbers
2) For accounts with JOINT AND mandate, the signatures of all joint
account must be provided below.
3) For change of address and telephone number in the USA, please
submit W-8Ben [Non-US Person] / W9 [US Person] form and/or
other supporting documents as proof of your status as a US
Person/Non-US Person[please specify the supporting documents below]
a) _____________________________________________
b) _____________________________________________
c) _____________________________________________

1. ________________________________________________ Important Notes for Banking Account Customer

2. ________________________________________________
3. ________________________________________________
4. ________________________________________________
5. ________________________________________________
Correspondence Address
Home Office
a) Change of Country of Residence to outside of Malaysia
If you have changed your country of residence, please be informed that
there may be applicable laws and regulations in the country you now reside
which may impact Citibank Berhads offering of products and services. You
are responsible for observing and complying with, the laws, regulations and
rules of your country of residence when pursuing wealth services offshore.
b) Offshore Wealth Services Policy
I am/We are aware of the laws in my/our country with regards to my/our
banking with you in Malaysia and/or in any other countries and I am/we are
fully responsible in complying with the same, and you shall not be liable in
any way whatsoever for any loss and/or liability imposed by my/our country
on me/us as a result of my/our non-compliance with any regulations, law or
legal process of my/our country.

By signing below, I/we: [1] acknowledge I/we have read and

__________________________________________________
__________________________________________________
City __________________________________________
understood the contents of this form [2] confirm that the
information given is correct and [3] complete and authorize
Citibank to verify the same against from any source which
Citibank may do so lawfully, as it may deem fit .

State __________________________________________ X
Authorized Signature(s) [As on banks file record]
Postcode __________________________________________
Remarks:
Country

Demographic Update

Domicile __________________________________
For Banks use:
Customer Number:
Permanent Residence ______________________________

Nationality ______________________________
Relationship Number:
Telephone Number

Please state Country & Area Code for both local and overseas Remarks:
telephone number.
Phone Type Country Code Area Code Telephone No.
Mobile 1
[Primary]
One Time-Pin [OTP] will be sent to primary mobile number Date Branch I/C Sighted Name & Initial

Mobile 2

Home
Internal Verification:
Office In Branch Out Branch

Fax/Others Special Remark:

[please specify] Advise customer to activate IN9 account

Email Address [if any] ______________________________________

[For e-statement enrollment, please use E-Statement Enrollment Form]