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Get MY Petron Miles Customer Request Form

CUSTOMER REQUEST FORM 1 Please complete the form in BLOCK LETTERS. All personal particulars are necessary for us to process your requests. 2 Fax the form to us at 03-2161 8233 email to pmiles petronmiles. com.my or drop it at any Petron Esso or Mobil service stations. 2 Fax the form to us at 03-2161 8233 email to pmiles petronmiles. com.my or drop it at any Petron Esso or Mobil service stations. 3 For more information please call the Petron Miles Customer Service Centre at 1 300 888 812. Note For lost/stolen/faulty cards please call the Petron Miles Hotline immediately to block the card. Type of request Please tick where applicable Required fields A New Registration/Change of Details B Retro Claim C Points Transfer Petron Miles Privilege Card No. - Full name as per NRIC New NRIC No. Army or Police ID / Passport No. Address Malaysia Address Only Postcode City Email State Home Tel. No. Office Tel. No. Mobile Tel. No. A Change of Details For change of details kindly complete the above section only. CUSTOMER REQUEST FORM 1 Please complete the form in BLOCK LETTERS* All personal particulars are necessary for us to process your requests. 2 Fax the form to us at 03-2161 8233 email to pmiles petronmiles. com*my or drop it at any Petron Esso or Mobil service stations. 3 For more information please call the Petron Miles Customer Service Centre at 1 300 888 812. Note For lost/stolen/faulty cards please call the Petron Miles Hotline immediately to block the card. Type of request Please tick where applicable Required fields A New Registration/Change of Details B Retro Claim C Points Transfer Petron Miles Privilege Card No* - Full name as per NRIC New NRIC No* Army or Police ID / Passport No* Address Malaysia Address Only Postcode City Email State Home Tel* No* Office Tel* No* Mobile Tel* No* A Change of Details For change of details kindly complete the above section only. Total Purchase RM For transfer of points from Lost/Stolen/Faulty Card/Card Misprinting No* To new Card No* Service Centre at 1 300 888 812 IMMEDIATELY to BLOCK THE CARD. Petron will not be held responsible for points lost if customers fail to notify the Petron Miles Customer Service Centre to block the card. Please allow up to 4 weeks for points transfer. Once points are transferred the old card will be deactivated* You must be the registered owner of all cards. Station A/C No* Operator / Station Stamp Member s Signature For office use only Date Please detach For Cardmember Retention Please Keep This Portion for Reference Old Card No* No* of points to be transferred This retention slip is only applicable for Section C Lost/Stolen/Faulty Terms and conditions apply for all Petron Miles Privilege Card. 2 Fax the form to us at 03-2161 8233 email to pmiles petronmiles. com*my or drop it at any Petron Esso or Mobil service stations. 3 For more information please call the Petron Miles Customer Service Centre at 1 300 888 812. Note For lost/stolen/faulty cards please call the Petron Miles Hotline immediately to block the card. .

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