QT-02133 - UOB Recurring Bill Payment Form (192x210mm) v4FA

Disclaimer

United Overseas Bank Limited (“UOB”) assumes no liability or responsibility for the acts or defaults of the merchant or defects in the goods or services offered by the merchants. UOB is not an agent of the merchant. Any dispute about the quality or service standard must be resolved directly with the merchant.

The merchant may impose conditions for the usage of the goods or services. UOB will not be responsible for any injury, loss or damage suffered as a result of the usage of the goods and services. While the information provided herein is believed to be reliable as at the date of printing, United Overseas Bank Limited

makes no representation or warranty whether expressed or implied, and accepts no responsibility or liability for its completeness or accuracy. UOB and the participating merchants reserve the right to vary/amend the terms and conditions without prior notice.

Terms and conditions.

1. You warrant that the information you have provided is true and correct and authorise United Overseas Bank Limited (“UOB”) to disclose such details to the relevant merchants as may be necessary to facilitate your participation in this service. 2. You confirm and agree that if this application has been sent by fax

and/or email, UOB is authorised to rely and act upon on the faxed and/or emailed copy without the original. 3. Your UOB Card account must be in good standing and remain valid for the monthly bills to be debited successfully. 4. The following are ineligible: UOB American Express Cards, UOB JCB Cards, UOB

UnionPay Cards, UOB Purchasing Cards, UOB Corporate Cards and UOB Private Label Cards. 5. Please allow at least six weeks for processing of your application. 6. Please continue to pay to the relevant merchants until you see the amount reflected on your monthly UOB Card statement. 7. All applications are

subject to approval from the relevant merchants. UOB will not notify customers separately of their application status. 8. Your account name with the relevant merchants must be the same as the name shown on your UOB statement, unless otherwise specified. 9. Should you cancel or replace your card, please

make alternative payment arrangements with your relevant merchants. 10. If your existing account is paid by GIRO, the GIRO payment arrangement will be terminated. 11. Please contact the relevant merchants to make alternative payment arrangements should you wish to terminate this payment arrangement. 12.

If any payment charged to your UOB Card is unsuccessful for any reason whatsoever, you will be responsible for arranging payment to that merchant by other means. 13. UOB shall not be liable for any loss, expenses, delays, mistakes, neglect or omission in the transmission of payment under this service or for any

unsuccessful payment. 14. UOB reserves the right to amend these terms and conditions and reject or decline any application in its sole discretion without giving any reasons. For details, please refer to uob.com.sg.

United Overseas Bank Limited Co. Reg. No. 193500026Z

YES! I would like to pay my bills with my UOB Card.

Name:

Mobile No.:

Signature of Cardmember Date

PLEASE SIGN

Simply complete the form below and mail or fax to us at 6353 3013.

PAYMENT CONSENT

Town Council 1

Please indicate your choice of Town Council by ticking ONE of the check boxes below.

Aljunied-Hougang

Bishan-Toa Payoh

Chua Chu Kang

Holland-Bukit Panjang

Marine Parade

Jalan Besar

Pasir Ris-Punggol

Tampines

Tanjong Pagar

West Coast

Reference No.:

Town Council 2

Please indicate your choice of Town Council by ticking ONE of the check boxes below.

Aljunied-Hougang

Bishan-Toa Payoh

Chua Chu Kang

Holland-Bukit Panjang

Marine Parade

Jalan Besar

Pasir Ris-Punggol

Tampines

Tanjong Pagar

West Coast

Reference No.:

Policy No.(s):

Name of Insured:

United Home Protection Insurance:

D H O F 1 2

Motor Insurance:

D H O M 1 1

United Personal Accident Insurance:

D H O P 1 1

My Singtel Account No.(s):

Name of 3

Party Account Holder:

Party’s Singtel Account No.(s):

StarHub Account No.(s):

•

M1 Bill Account No. 1:

M1 Bill Account No. 2:

M1 Bill Account No. 3:

UOB Card No.

Source: IT

M Y Y

UOB BILL PAY SERVICE FORM

Office No.:

If you wish to pay for another person’s

Singtel account, please fill up the following:

(not applicable for Singtel-UOB Platinum

Cardmember)

All StarHub customers: Please fill in your UOB Card

details in the StarHub Payment Slip (found on your

StarHub bill). Sign and mail it together with this

application form.

By signing here, I certify that I have read and agreed to the Terms and Conditions stated below. By indicating the Account No.(s), Customer No.(s),

Reference No.(s), Policy No.(s) and all other information as required by the respective billing organisation(s) stated below, I hereby authorise and

give my consent to the respective billing organisation(s) to charge the bills/fees /charges/ premium/subscription to my UOB Card.

I consent to United Overseas Bank Group("UOB") collecting, using and disclosing my personal data for the purpose of informing me about

its card products and card-related services, via voice calls or text messages or email. This is in addition to any other consent which I may

have provided to UOB in respect of the collection, use and/or disclosure of my personal data and shall be without prejudice to and does

not derogate from UOB's rights to collect, use and/or disclose my personal data under the law.

Note: The approval of the following authorisation will supercede existing payment instructions with the respective merchants

for the respective Account No.(s) indicated below. Please allow at least 6 weeks for processing of your application.

Card Expiry Date

This facility is only available for the following insurance plans. UNI$ will

not be awarded for sign-ups with UOI.

Note: This facility will not be extended to customers who have existing standing payment arrangements with UOB (such as Property

Mortgaged Insurance) or UOI.

Delivery Address:

Postal Code:

Email Address

(Your username will be the same as your email address):

Residential Type Monthly delivery fee

HDB [ ] S$3

Private Apartment [ ] S$4

Landed Property [ ] S$5

Publication

Monthly subscription rates

All-in-One Package

(Print + Digital) *^

All Digital Package

(Online + Smartphone + Tablet)

The Straits Times &

The Sunday Times

[ ] S$29.90 [ ] S$29.90

The Business Times [ ] S$29.90 [ ] S$34.90

Lianhe Zaobao [ ] S$26.90

[ ] Chinese 3-in-1 Bundle

PDF Version (Lianhe Zaobao

+ Lianhe Wanbao + Shinmin

Daily News) S$29.90

Lianhe Wanbao [ ] S$26.90

Shin Min Daily News [ ] S$26.90

Berita Harian &

Berita Minggu

[ ] S$18.90 [ ] S$19.90

Tamil Murasu [ ] S$17.90 [ ] S$22.90 PDF Version

September 2019

The prices and charges (subscription costs of the newspapers, delivery costs, and costs of any supplemental services) shall be subject to revision from time to time in

SPH’s sole discretion, with at least one month notice given by SPH prior to such revision. The prevailing subscription rate at the time of submission of this form will

apply. Visit www.sphsubscription.com.sg for full Terms and Conditions. *Monthly subscription rates exclude delivery fees which will be charged once per subscriber

account every month. ^All-in-One package refers to both print and access to all digital platforms (online, smartphone and tablet).

All Digital Package refers to access

to all digital platforms (online, smartphone and tablet). Lianhe Wanbao, Shin Min Daily News and Tamil Murasu All Digital refers to access to the PDF version only.