SmartPay Account Application

Application forms:


Bahasa Malaysia

Please complete the application form and submit it with the supporting documents to:

Marketing Section
Cards Business and Marketing
Customer Experience Department
PETRONAS Dagangan Berhad
A-1-1, Hampshire Place Office
157 Hampshire, No 1
Jalan Mayang Sari
50450 Kuala Lumpur.

Guide to Filling in Cardholder and Vehicle information

1. Company Particulars
Please fill in your company details as accurately as possible, as per your company registration details.

2. Financial Reference
Please indicate your bank or finance institution with the account type and account number.

3. Declaration and Endorsement
Please sign, initialize and chop with your company stamp

4. Vehicle information

Card Type
A - Please fill in the cardholder's particulars under the cardholder's information and the cardholder’s designated vehicle particulars under the vehicle information.

C - Dual Card. Please fill the fleet driver's particulars under the cardholder's information and the company vehicle particulars under the vvehicle information.

Vehicle type and Model
State vehicle type and model.

Vehicle Registration Number
State vehicle registration number e.g. XYZ 8888

Product Category Allowed
Please tick the product/ service category authorized for each vehicle including designated vehicle.

Purchase Limit
Specify the purchase limit per day in the multiple of 50(max RM3000) and purchase limit per month in the multiple of 100 (max RM3000)

5. Cardholder Information

Name to Appear on Card
Name to be embossed on card (max 25 characters)

PIN (Personal Identification Number)
Please indicate if PIN is required by ticking the appropriate column.

Department/ Cost Centre
Fill in the department or cost centre name



Required Documents:
Public Listed Company
• Latest Audited Company

Berhad / Sdn Bhd
• Latest Audited Account
• Form 8 OR 9 (or 13)
• Form 24 & 49
• Memorandum & Article of
• Latest Annual Report or Audited
• Latest 3 months bank statements

Sole Proprietor / Partnership
• Form A or B
• Business Registration Certificate
  (Form D)
• Latest Audited Account OR Income
  Tax Form J
• Latest 3 months bank statements

• Form 8 or 9 or Business Registration
  Certificate (Form D)
• Banker's Cheque