PERSONAL INFORMATION
CUSTOMER NAME
*
NRIC NO.(NEW)
*
NRIC NO.(OLD)
DEBIT CARD NO.
*
VALID THRU (CARD EXPIRY DATE)
JANUARY
FEBRUARY
MARCH
APRIL
MAY
JUNE
JULY
AUGUST
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER
/
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
LAST TRANSACTION
MOTHER MAIDEN NAME
*
MOBILE NO.
*
-
OFFICE NO.
-
HOUSE NO.
-
E-MAIL ADDRESS
*
INDICATES REQUIRED FIELD
I WISH TO ACTIVE :
ONLINE TRANSACTION
OVERSEAS TRANSACTION
BOTH
PLEASE TICK IF YOU WANT TO SPECIFY THE EXPIRY DURATION.
IF DATE IS NOT SPECIFIED, THE SERVICE WILL BE ACTIVATED UNTIL CARD'S EXPIRY DATE
ACTIVATION START
28
29
30
31
MAY
JUNE
JULY
AUGUST
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER
2023
2024
ACTIVATION END
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11
12
13
14
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18
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20
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26
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29
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31
JANUARY
FEBRUARY
MARCH
APRIL
MAY
JUNE
JULY
AUGUST
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER
2023
2024
2025
2026
2027
2028
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WORD VERIFICATION
Dear Valued Customers, Bank Islam Debit Card-i provides you with the convenience to perform retail transactions including overseas and Card-Not-Present (CNP*) transactions as our card comes with high safety security feature through the application of “3D secured” which require One-Time-Password (OTP) verification. However, there are certain merchants of overseas and CNP transactions that do not equipped with high safety security features. As such, in order to safeguard the interest of our valued customer, we wish to inform that there are certain risks associated with overseas and CNP transactions which are NOT authenticated via safety authentication method as follows:- 1. The information of your Bank Islam Debit Card-i might be stolen through merchant using unsecured/inadequate authentication method or with intention to commit fraud; 2. The stolen information of your Bank Islam Debit Card-i details might be used to perform series of unauthorised transactions; and 3. The unauthorised transaction occurred on your card may result in you would not be able to use the full amount of the disputed transaction until completion of the investigation. Nevertheless, Bank Islam shall perform investigation on any claim of unauthorised transaction. Please refer to our Bank’s website or our terms and conditions to know more on how to safeguard your debit card-i against unauthorised transaction. Effective 1st January 2016, all Bank Islam Debit Card-i shall be disabled for all overseas and CNP transactions. However, you may opt to enable/continue enjoying overseas and CNP transactions by calling us at 03-26 900 900. For more information, please refer to our FAQ at www.bankislam.com.my. Thank you. * CNP transaction comprises of Mail Order Telephone Order (MOTO), direct debit and e-commerce transactions.
I HEREBY CONFIRM THAT I HAVE READ AND UNDERSTAND THE INFORMATION AND RISK ASSOCIATED
TO CNP AND OVERSEAS TRANSACTION AS STATED ABOVE. I ACKNOWLEDGE AND AFFIRM THAT ALL THE
INFORMATION PROVIDED IS TRUE.