OCBC Bank

OCBC PayMaster Registration Form

Please complete this form, print and fax to 03-2711 9177.

YES! I wish to enrol for the OCBC PayMaster service

Name as in NRIC

New NRIC No

-

Old NRIC No

Tel No.(1)

-

Tel No. (2)

-

OCBC Credit Card No.

-

Exp. Date

Multimedia / Telecommunications

ASTRO

Account No.1

Account No.2

CELCOM

Account No.1

Account No.2

DIGI

Account No.1

Account No.2

MAXIS

Account No.1

Account No.2

TELEKOM

Account No.1

Account No.2

*Important note: For Unifi auto-billing, please register directly with Telekom by visiting www.tm.com.my and download the TM autobilling form
(TM homepage>Customer Support>Bill Payment>Autopay>Autopay subscription form).

Municipal Council (Assessment)

* MBPJ = Majlis Bandaraya Petaling Jaya * MPSJ = Majlis Perbandaran Subang Jaya * MBSA = Majlis Bandaraya Shah Alam
* MPK = Majlis Perbandaran Klang * MPPP = Majlis Perbandaran Pulau Pinang

MBPJ

Account No

MPSJ

Account No

MBSA

Account No

MPK

Account No

MPPP

Account No

DECLARATION AND AGREEMENT
I hereby authorise OCBC Bank to perform auto-billing on my OCBC Credit Card for the bills payment selected above. I agree to abide and be bound by the terms & conditions governing OCBC PayMaster Services including any amendments, supplements and additions thereto made from time to time by the Bank and I acknowledge having read and understood the terms and conditions which are available at the Bank's website at www.ocbc.com.my.

_____________________________________
Signature (per signature on OCBC Credit Card)

_________________________
Date

Important Note: If you are currently enrolled with any of the merchant(s) for auto-billing of the above mentioned bill(s), kindly ensure you have cancelled the existing auto-billing arrangement before submission of this form.