HSBC CREDIT CARD APPLICATION FORM

Transcription

1 To: The Hongkong and Shanghai Banking Corporation Limited, Macau Branch Branch Please return the completed application form together with support documents to any HSBC branch Date day / month / year HSBC CREDIT CARD APPLICATION FORM Please fill in the form in BLOCK LETTERS and put a P in the box. To expedite processing of your application, please fill in the mandatory fields. * If your full name on your Macau ID card occupies more than 19 characters, including blanks for breaks between names, please shorten your given names to fit within the 19-space limit. Please delete as appropriate. Not applicable to the Bank s existing customers. Account information (For existing banking customers only) Account type Account number Choice of credit card (Mandatory field) MOP Visa Gold Card # HKD Visa Gold Card # MOP Visa Classic Card HKD Visa Classic Card # Note: If my credit card application is not approved, I would wish to accept a Classic card (for Gold card applicants). (Please refer to note 5 under the Important Notes ) Personal information (Mandatory field) Mr Mrs Miss Ms *Name (Surname) (Given name) (Other name) (In block letters with surname first as per your Macau ID card/passport) Name in Chinese Date of birth Place of birth Nationality (dd) (mm) (yyyy) Macau ID Card/Passport no. (Please enclose copy. For applicants who are not holders of Macau Permanent ID Card, please fill in the Passport no. and enclose copy of Macau ID Card and the Passport/permanent HKID) Place of issue Macau Others (Please specify) Education level primary secondary tertiary post graduate Marital status single married divorced/separated others (Please specify) Residential address (Please enclose proof) Room/Flat Floor Block Name of building/estate No. and name of street/road District Postal code (For overseas address only) Country Residential tel. no. Mobile phone Years and months at present address Member HSBC Group Page 1/7

2 Personal information (continued) (Mandatory field) Residential type with parents mortgage owned quarters rented-private rented-public others (Please specify) address (Maximum 35 characters) Are you maintaining a mortgage with other financial institutions? No Yes (Please fill in the boxes in the next row.) Joint Mortgage No Yes Total monthly mortgage repayment amount MOP Please enclose permanent address proof if the permanent address is different from the above residential address. Occupation (Mandatory field) Full-time Employed Part-time Employed Self Employed Student Housewife Retired Not Currently Employed Name of present employer Nature of business Address of present employer Room/Flat Floor Block Name of building/estate No. and name of street/road District Business tel. no. Present position Years and months of service Time with previous employer Monthly basic salary MOP/HKD x months Other income (e.g. bonus, allowance) MOP/HKD x months If your salary is paid by autopay, please give bank s name and account no. Bank name Account no. Bank and credit references Other credit facilities Bank name Outstanding Monthly instalment Personal instalment loan Mortgage Hire Purchase Other Other credit cards in your possession Bank name Card number Credit limit Member since Page 2/7

3 Correspondence address (Mandatory field) Please send monthly statement and any correspondence to my: Residential address Business address Card collection instructions I/We would like to collect my/our primary/additional card(s) from branch. I/We may wish to have my credit card(s) collected by a person authorised by me, to be confirmed in writing in each instance. Relationship with Director/Employee of the Bank 1. Are you and/or the joint applicant a relative or spouse/former spouse of, or related in any way to, any director or employee with lending authority of The Hongkong and Shanghai Banking Corporation Limited (HSBC) or any of its branches (including the Macau Branch)? (You may request the Bank for a list of such branches.) No # Yes [Please state his/her name (in English/Chinese):. Relationship: and answer Question 3.] 2. Are you and/or the joint applicant a director/full-time/part-time/temporary staff/international Manager/International Contract Executive/International Secondee/Short Term Assignee of HSBC or its branches? No # Yes [Please state your Staff No: and answer Question 3.] 3. Do you and/or the joint applicant have any other unsecured facilities with a HSBC branch (local or overseas) or its subsidiary which is a bank (whether inside or outside of Macau and including Hang Seng Bank)? What is the total facility amount? No # Yes [Please state total facility amount:.] # Note: You (and the joint applicant) hereby confirm that, as the date of this application, you have no (never had) relationship with any director or employee of HSBC, other than as stated above. You agree to notify the Bank promptly in writing if the information given above is no longer true and correct. Standing instructions Please debit my/our account with HSBC on the monthly due date and make the following payment to my/our credit card(s): Account with HSBC Percentage of monthly payment # : % (5%-100%) # Note: If no payment percentage is specified by the applicant, or the percentage chosen is less than the minimum payment due, the monthly payment will be processed as the minimum payment due. Page 3/7

4 Additional card I hereby request and authorise you to issue a combined additional card (subject to the terms and conditions contained in the Credit Card Cardholder Agreement, Information on your Credit Card, Terms and Conditions for Using the Services of the Credit Cards Customer Service Hotline, the ATM Card Enrolment Terms and Conditions, and the Bank Tariff Guide for HSBC Retail Banking and Wealth Management Customers) to the person identified below, who is over 16 years of age (for children)/18 years of age (for other relationships). I understand the transactions made on this additional card will be billed on my statement. Mr Mrs Miss Ms *Name (Surname) (Given name) (Other name) (In block letters with surname first as per your Macau ID card/passport) Name in Chinese Date of birth Place of birth Nationality (dd) (mm) (yyyy) Relationship with primary cardholder Macau ID Card/Passport no. (Please enclose copy. For applicants who are not holders of Macau Permanent ID Card, please fill in the Passport no. and enclose copy of Macau ID Card and the Passport/permanent HKID) Place of issue Macau other (Please specify) Residential tel. no. Mobile phone Business tel. no. Occupation (Maximum 35 characters) Please enclose residential address proof if additional card applicant s residential address is different from that of primary card applicant. Please also provide permanent address proof if it is different from the residential address. Free ATM facility I/We wish to access the account(s) listed below with my/our credit card(s) by using the free ATM facility. Primary cardholder Additional cardholder Account(s) with HSBC: Account(s) with HSBC: Language on screen: English Chinese Language on screen: English Chinese If you want to use your Credit Card at an ATM outside Macau for cash withdrawal services (including cash advances), you are required to set your overseas ATM daily cash withdrawal limit and corresponding activation periods in advance. You have to set the limit and periods through one of the channels designated by the Bank from time to time. Please call HSBC Customer Service Hotline on (853) for details. Page 4/7

5 Important Notes 1. All primary card applicants must be Macau Special Administrative Region residents and aged 18 or above. 2. To be eligible for the credit card, primary card applicant s annual income must meet the following requirements: Visa Gold card MOP150,000 or above; Visa Classic card MOP60,000 or above. 3. Your new card provides free use of phonebanking service. A personal identification number (PIN) will be mailed to you separately upon card issuance. Please note that without the PIN, cardholders will not be able to access the phonebanking service. You can link the phonebanking service with your account via credit card service hotline (853) The following fees and charges apply as appropriate and may change from time to time: a) Finance charge: If the Cardholder fails to pay the Bank the whole of the Statement Balance by the Payment Due Date, a finance charge will be applied (a) to each Card Transaction (excluding cash advance) making up the Statement Balance, as well as each new transactions (excluding cash advances) entered into by the Cardholder since the last Statement Date, from the transaction date and (b) to any other amounts making up the Statement Balance from the last Statement Date, until the Statement Balance is paid in full. The finance charge will accrue daily and be calculated at the interest rate of 2.33% per month. b) Late charge: If the minimum payment due is not received by the Bank on or before the payment due date, a late charge of 5% of the minimum payment (subject to a minimum of MOP/HKD80 and maximum of MOP/HKD200) will be levied on your card account. c) Overlimit handling fee: If the statement balance exceeds the credit limit for the time being assigned to the card amount, an overlimit handling fee of MOP/HKD130 will be debited to the card account on the statement date. d) Cash advance fee: Cash advances include all cash withdrawals made from the Card Account including withdrawals from funds credited to the Card Account. They will be subject to a handling fee of 3% on the amount of advance (a minimum of MOP/HKD70 for an over-the-counter cash advance and a minimum of MOP/HKD30 for an advance made from an ATM or through any other channel) plus a cash advance fee of 2% on the amount of advance. The charges are flat and shall be debited to the card account as at the date of the advance. If you require any additional services (such as card replacement, extra copies of monthly statement, etc.) other fees and charges may apply. For details and up-to-date charges, please refer to Bank Tariff Guide for HSBC Retail Banking and Wealth Management Customers available on our website and at any HSBC branch in Macau. 5. We may, at our sole discretion, decide whether to approve your application, and whether to issue a Visa Gold or Classic card. If your application is not approved, we may issue to you a Visa Classic card (for Visa Gold card applicants). 6. Applications from the Bank s staff will be subject to HSBC s staff policy. Declaration My/Our information 1. I/We confirm that the information given in this application form is correct and complete. I/We authorise The Hongkong and Shanghai Banking Corporation Limited, Macau Branch (the Bank ), among other members of the HSBC group as described in the Credit Card Cardholder Agreement, to obtain and verify information relating to me/us from or with any other person or source at any time and from time to time as the Bank may decide. 2. By signing this application form, I/we agree that the Bank, among other members of the HSBC group as described in the Credit Card Cardholder Agreement, may use and disclose all personal data about me/us that the Bank currently or subsequently holds for the purposes as set out in the Credit Card Cardholder Agreement. Annual fee 3. I/We accept that the annual fee of each credit card to be charged by the Bank is as follow and may be amended from time to time (as shown in the Bank Tariff Guide for HSBC Retail Banking and Wealth Management Customers.): (i) Visa Gold primary card MOP/HKD480; (ii) Visa Classic primary card MOP/HKD220; (iii) Visa Gold additional card combined account MOP/HKD240; (iv) Visa Classic additional card combined account MOP/HKD110 My/Our employment and financial status 4. I/We declare that: (i) I am/we are currently employed as indicated on this application form; (ii) I am/we are not delinquent in repaying any credit facilities from any financial institution or lender; (iii) I am/we are not a bankrupt or discharged bankrupt; (iv) I/we have no intention to declare bankruptcy; and (v) I am/we are not aware of any bankruptcy proceedings made against me/us. Page 5/7

6 My/Our linked account for ATM facilities 5. I/We confirm that: (i) my/our signature(s) provided on this application form is/are the same as on each of my/our savings or current accounts for which ATM facilities are requested; (ii) each such savings or current account is a single name account in the name of the related cardholder, or is operated by the related cardholder singly if it is a joint or multiple names account; and (iii) I/we will use the ATM facilities subject to the ATM Card Terms and Conditions. 6. A PIN mailer for ATM cash advance and my/our banking account access (if applicable) will be sent to me/us upon credit card issuance. If I/we do not wish to use the ATM and facilities, I/we should call HSBC Credit Card Service Hotline on (853) for arrangement. I/We understand that without an ATM PIN, I/we will not be able to access the ATM facilities (including the credit card cash advance function through ATM). Additional card(s) 7. I/We understand that if an additional card is applied for in this application form: (i) the primary cardholder will be liable for the use of both the primary card and the additional card while the additional cardholder will only be liable for the use of his/her additional card; (ii) an additional card may be terminated by either the primary or additional cardholder by giving the Bank written notice and returning the additional card to the Bank; (iii) use of an additional card may be suspended by the Bank upon the report of loss, theft, disclosure or unauthorised use of the primary card, the additional card or any related personal identification number; and (iv) until the additional card is returned to the Bank or the Bank is able to implement the necessary procedures following a report in (iii) above, the primary cardholder may be liable for any transactions and payments arising from the use of the additional card. Terms and conditions governing credit card(s) 8. I/We acknowledge that the provision and use of the credit card(s) are subject to the terms and conditions of the Credit Cards Cardholder Agreement, Information on your Credit Card, Terms and Conditions for Using the Services of the Credit Card Customer Service Hotline, the ATM Card Enrolment Terms and Conditions, and the Bank Tariff Guide for HSBC Retail Banking and Wealth Management Customers (Terms and Conditions). I/We understand that the Terms and Conditions are available on our website and printed copies will be given to me/us with my/our credit card(s) upon approval of this application. 9. By signing this application form, I/we confirm that I/we have read and understood the following documents related to this application and agree to be bound by them: (i) the Important Notes and Declarations set out in this application form (ii) promotional offer terms and conditions (if applicable); and (iii) the Terms and Conditions. 10. I/We understand that a card collection notification will also be sent to me/us once this application has been approved, notifying me/us that the approved credit card and a welcome pack are available for collection. The Welcome Pack shall include the Terms and Conditions. 11. I/We will read the contents of the Welcome Pack and in particular the Credit Card Cardholder Agreement and any other terms and conditions governing the provision and use of the credit card(s). Authorisation for collection and signing 12. I/We understand that I/we may authorise a person in writing to collect my/our credit card(s) on my/our behalf in the form of the delegation letter available from the Bank or I/We agree that: (i) each person collecting my/our card(s) has authority to sign acknowledgement of receipt of the card(s) on my/our behalf; and (ii) I/we will be responsible for any misuse of the card(s) or other consequences arising from this arrangement. Discretion of the Bank 13. I/We agree that the Bank has the right to accept or reject this application without giving reasons. Page 6/7

7 Documents attached and Signature (Mandatory field) I/We confirm that all required supporting documents have been supplied with this application form. I/We understand and agree that all documents supported (including the application form) will not be returned to me/us. If you are an existing HSBC customers with payroll account in HSBC and hold a Macau Permanent ID Card, no supporting document is required. Other customers, please provide: 1. Identification proof for primary and any additional card applicant(s): (a) Macau Permanent ID cardholder copy of Macau Permanent ID Card. (b) Macau Non-Permanent ID cardholder copy of Macau ID Card, passport/permanent HKID and employment contract with a contract period of at least 12 months from the date of application submission. (c) Passport holder copy of passport and Employee contract with a contract period of at least 12 months from the date of application submission or work permit (blue card) with a valid period at least 12 months from the date of application submission. 2. Address proof for primary and any additional card applicant(s): (waived for existing HSBC customers) Latest Macau residential address proof within latest 3 months i.e. utility bill/electricity bill/bank statement/personal tax return. If you have a permanent residential address, please also provide the permanent residential address proof. 3. Income/Asset proof: (a) Income Earner/Part-timer: latest 3 months bank book/statement/estatement/online transaction history (showing applicant s name, account number and monthly income), or latest 3 months salary slip. (b) Self-Employed: latest tax demand note, or latest 3 months bank book/statement/estatement/online transaction history in Macau (showing company name, account number and transaction history) and current Business Registration Certificate and proof of ownership of business and latest Tax Return. (c) Others: latest 3 months bank deposit/bank book/statement/estatement online transaction history in Macau (showing applicant s name, account number and transaction history) or regular monthly rental income credited to applicant s bank account and the signed tenancy agreement. X Signature of primary cardholder Date X Signature of additional cardholder Date Bank use only: Branch: Sales ID Public Page 7/7