©2016 Citibank. Citi, Citibank and Citi and Arc Design are registered service marks of Citigroup Inc. Citibank Singapore Limited Co. Reg. No. 200309485K. Printed on 04/2016 Version 4-June-12
Citibank Singapore Ltd
International Personal Bank
Robinson Road P.O.Box 0361
Singapore 900711
Co. Reg. No. 200309485K
24-Hour CitiPhone Banking
T: +65 6224 5757
F: +65 6632 4759
www.ipb.citibank.com.sg
CHANGE OF ADDRESS AND CONTACT DETAILS FORM
Name (as it appears on account): _____________________________________________________________________________
Effective date of change: _______________________ (mm/dd/yy) Account/ Relationship number: _______________________
Please update:
All my Citibank Accounts/Relationships All my Credit Card Accounts Only
All my Banking and Investment Accounts Only Others: _________________________
New Mailing Address Update*
Country: Postal Code:
Country of Residence & Current Residential Address* (Mandatory to select one of the options below)
(Residential address is where you are currently residing, and should not be a care-of or P.O. Box address)
Same as Mailing Address
Different from Mailing Address, please provide Current Residential Address in space below:
Country: Postal Code:
New Contact Number Update
New Email Update *
Type
Country
Code
Telephone No.
Preferred Email address:
Home *
Office *
Primary Mobile *
Alternate Email address:
Additional No.
Home Fax *
Office Fax *
* The new information provided herewith will replace the existing information in the Bank's record.
Please ensure that all the relevant details in the form are duly completed (or struck out, if not applicable) prior to affixing your signature to this form.
Customer Signature:
Name:
Customer Signature:
Name:
Customer Signature:
Name:
Note on Signature Requirements: For Joint account, please ensure that the form is signed in accordance to the signatory requirements in the Bank’s records.
For Bank Use Only
Face-To-Face
Customer Met & ID Sighted By: __________________________________
(Name & Initial)
Independent Verification: _______________________________________
(CM met/ID sighted, signature witnessed/verified) (Name & Initial)
Mail / Fax
Signature Verified By: __________________________________________
(Name & Initial)
Callback By: _________________________________________________
(Name & Initial)
Date/ Time/ Extn: _____________________________________________