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e-Banking /
Personal e-Banking and Automated Phone Banking Bill Payment Registration / Amendment Form
: ()
To : Hang Seng Bank Limited (The Bank)
*(1)
(2)3013
Please complete in BLOCK LETTERS, where appropriate, and *delete whichever inapplicable, return the (//)
completed form with a copy of your ID document either (1) by visiting any of our branches, or (2) by mail to Hang Date(DD/MM/YY)
Seng Bank Limited at GPO Box 3013, Hong Kong.
Part A Customer Information
()
Name(s) of Account Holder(s)
TO CHUN HONG
/ *
ID Document / Business Registration* No. Y345663(1)
e-Banking ?
Are you the existing Personal e-Banking user?
Yes No

Part B / Addition / Deletion of Bill Account Number(s)


e-Banking J202
Delete all Registered Bill Account Number(s) for bill payment via any accounts under the above-mentioned ID Document or Business Registration
No. by Personal e-Banking and Automated Phone Banking.
/ e-Banking # J201
Add / delete the following Bill Account Number(s) for bill payment via any accounts under the above-mentioned ID Document or Business J202
Registration No. by Personal e-Banking and Automated Phone Banking.#
/ /
Add Delete Merchant Code(s) Bill A/C No. / TELEBET A/C No. Add Delete Merchant Code(s) Bill A/C No. / TELEBET A/C No.
3501 3771-163212-41001 3505 5533-9812-3252-7743
3501 3771-163212-41027
3501 3771-163212-41019
/ () Merchant Name / Merchant Code Reference Table (1)
e-Banking the merchant(s) below is/are only applicable to payment to be made via Personal e-Banking

Merchant Name(s) Merchant Code(s)
A. Banking and Credit Cards # ^

American Express Card 3501


() Bank of Communications (Hong Kong Branch) 3576

The Bank of East Asia Credit Card and Revolving Loan 3506

BEA Merchant Collection Services 3527

() CCB (Asia) Banking Services 3531


China Merchants Bank AIO 3565
Chong Hing Bank 3517

Citibank Banking Services 3518


Citibank Merchant Collection Services 3520

Dah Sing Bank 3514


PB19-R34(YX)1-2 01/17 E <PB19>

Deutsche Bank Merchant Collection Services 3874

Diners Club 3502


HSBC Credit Cards 3504

() ICBC (Asia) 3530

Manhattan Manhattan Card 3503


() Public Bank (Hong Kong) Limited 3523
>>BS>BOS

Standard Chartered Credit Cards 3505


Shanghai Commercial Bank Credit Card 3508
OCBC Wing Hang Bank Limited 3512
Wing Lung Bank and Wing Lung Finance 3516

B. Other Financial Institutions Account(s) ^

HSBC Consumer Assets 0039

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Part B / () Addition / Deletion of Bill Account Number(s) (Cont.)
/ () Merchant Name / Merchant Code Reference Table(2)
e-Banking
the merchant(s) below is/are applicable to payment to be made via Personal e-Banking OR Automated Phone Banking

Merchant Name(s) Merchant Code(s)
A. Brokers Account(s) #
BOCI Securities Ltd 1047

Bright Smart 1077


Celestial (Cash) 0022

Chief Securities Limited 1064

Chow Sang Sang Securities Ltd ^ 1014

Christfund Securities Group ^ 1052

() CITIC Sec (HK) 1037


Fulbright Financial Group 1056
Haitong International Securities Group 0028
Sun Hung Kai Financial 1019
United Simsen Securities Limited 1073
VC Brokerage ^ 1098

B. Sport & Leisure Account(s) #


The Hong Kong Jockey Club 0020
# $0//
______________________________________________
________________

The daily limit for bill payment to such merchant(s) is preset to $0 . To increase/change your daily bill payment limit for the relevant merchant(s), please download
and complete the Daily Limit Maintenance / Request for Security Device Form and return it together with this form.
________________________________________________________________________________________
^ /Personal e-Banking
The bills of this merchant / this merchant category can only be paid via Personal e-Banking.

() Signature(s) of Account Holder(s) For Bank Use

Receiving Br.

Approved by
S.V.

X _______________________________________________________________________________
Please use signature(s) / chop(s) filed with Bank

253-204499-882
( Account No. _______________________________________________________)

e-Banking /
Notes : The use of this bill payment service is also governed by the Terms and Conditions for Integrated Account, Terms and Conditions for e-Banking Services,
and/or all other terms and conditions applicable from time to time in connection with the relevant accounts, transactions, services or products.
PB19-R34(YX) 2-2 01/17 E <PB19>
>>BS>BOS

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