UOB Indonesia : Supplementary Card Information eForm

Primary Credit Card Number*

(Fill with last 6 digits Primary Credit Card Number)

Nama as per E-KTP (For WNI) / Passport (For WNA)*

ID Number*

E-KTP (For WNI)/ Passport (For WNA)

Kitas Number (For WNA)

Supplementary Credit Card Number*

(Fill with last 6 digits Supplementary Credit Card Number)

Mother's Maiden Name*

Mobile phone number*

Relationship with basic*

Occupation*

Occupation

(if others)

Company Name*

Note: if Housewife, and Retiree please write NA

Position*

Note: if Housewife, and Retiree please write NA

Nature of business*

Note: if Housewife, and Retiree please choose others

Nature of Business

(if others) Note: if Housewife, and Retiree please write NA

I agree to provide UOBI with my personal data for the purpose of updating my personal details for my Supplementary Credit Card.
I hereby declare that the information provided above is correct and true.

*This process is mandatory to ensure your Supplementary Credit Card can be used