Touch ʻn Go Reload PIN Acknowledgement of Receipt Form

* Mandatory Fields

I hereby acknowledge the receipt of the following campaign reward.

Campaign Name : SME & COMMERCIAL BANKING CUSTOMERS DEPOSIT & WIN CAMPAIGN

Campaign Reward : TOUCH ‘N GO EWALLET RELOAD PIN

Name (as per IC) *:

NRIC No. *:

Company Name *:

Business Registration Number *:

Designation *:

Date* (In DD/MM/YYYY format e.g. 01/01/2001)

Total TNG eWallet Reload Pin Value *:

By submitting this form, I hereby declare that I fully understand and agree to be bound to the Terms and Conditions of this campaign.

Verified by:

Officer Name (RM/BWM/CWM) *:

Officer Code (Armcode) *:

Remarks: