MasterCard-Visa Card
Visa Classic Debit
Visa Classic Debit
Yes! I would like to apply for the Cathay United Bank Visa Debit Smart Card
Visa Debit Card Application Form
Please read before filing this application Form:
  • Application must be 16 years of age and above.
  • Enclose your ID/Passport
  • You are required to place a fixed deposit of 1 time of the credit limit should your application be approved
  • For non Cambodia: Please furnish us a copy of your employment letter, work permit and entry (Issued by the Immigration Department)
My Personal Details
Fist Name
Last Name
Date Of Birth
Marital Status
ID/Passport No.
Home Address
Oversea Permanent Address
(For Non-Cambodian)
Home Phone
Mobile Phone
Ownership Type
Mother's Maiden Name
(For Security Verification)
Company Name/School
Office/Hoster Address
Annual Income:USD
Telephone & Ext
Bill Statement
Importance: Please Read Before Signing
Please note:
  1. You will have to pick up the card and PIN @ our card center or head office when it's ready for collection.
  2. You can choose either to pick up your monthly statement from our office, or by email.
  3. The Spending limit on your Cathay United Bank Visa Debit Smart Card will be pre-set at USD 1,000
  4. The daily ATM withdrawal limit will be pre-set at USD800.
  5. The annual card fee is USD12 per annum.
  6. You must maintain a minimum balance of USD30 at any time, otherwise a fee of USD1 per month will be chargeable to your account.
Terms & Conditions:
Please issue me with the above mentioned Cathay United Bank Visa Platinum Debit Card ("Card") until I/you terminate the card.

I warrant that all information stated in this application is true and complete in all respects. I authorize you to obtain and verify any information about me as you deem fit at your absolute discretion. I agree to be bound by the Cathay United Bank Visa Platinum Debit Cardholder's Agreement (as maybe amended by you from the time to time), a copy of which will be provided with the card. I understand that if I retain or use any Card issued by you, I shall be deemed to have accepted the Cathay United Bank Visa Debit Smart Card member agreement.

You may decline my application without providing any reasons.

I agree that I am responsible for all liabilities (including annual fees or other charges) which may be incurred in respect of this card.

I confirm that at the time of this application, I am not an undischarge bankrupt and no statutory demand has been served on me nor any legal proceedings commenced against me.

If my primary account for the Cathay United Bank Visa Platinum Debit Card is thumbprint-operated, I agree to convert it to signature-operate with immediate effect, regardless of the application. The relevant signature will be as set out at below.
Privacy & Security

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