Credit Card Application

Transcription

1 How to apply 1) Apply online at westpac.co.nz/credit-cards/apply-now/ This is the fastest way to apply for a card. 2) Complete this form and take it together with identification and proof of income to your nearest Westpac branch, or 3) Complete this form and mail to Westpac, Private Bag 92503, Wellesley Street, Auckland. If you have any questions or need help to complete this form, please call A: Type of Westpac credit card account Please select one card type and one reward programme per application. The Low Rate MasterCard does not include a reward programme. hotpoints Airpoints Westpac PayTag (optional) Westpac Low Rate MasterCard Westpac MasterCard Westpac Platinum MasterCard Westpac World MasterCard Westpac Airpoints Business MasterCard Westpac BusinessPLUS MasterCard If you select, but do not meet Westpac s current lending criteria for a hotpoints or Airpoints Platinum MasterCard account, a hotpoints or Airpoints MasterCard account will be issued instead (provided you meet the relevant criteria for that card). If you are applying for an Airpoints credit card and already have an Airpoints, please enter it below. If you are not currently an Airpoints member, we ll arrange an Airpoints membership for you free of charge. Your Airpoints will be printed on your credit card and all Airpoints Dollars earned will be credited to your Airpoints account. Airpoints Membership Number B: Principal applicant details Title (please tick one) Mr Mrs Miss Ms Dr Other (please specify) Given name(s) FIRST MIDDLE Surname Date of birth NZ Resident Yes No How would you like your name to appear on your card This must be your given name(s), or initial(s) and surname If you already have a Westpac bank account, please provide the account no. below Home address STREET NO. STREET NAME/BOX NUMBER Time at current address YEARS / MONTHS Postal address (if different from home address given above) STREET NO. STREET NAME/BOX NUMBER TOWN / CITY Best description of your living arrangements (Please tick one) Home owner Rent Live with parents/guardian Board Home phone ( ) NZ driver s licence (5a) Identification word Close friend or relative Are you a US citizen?* Yes No Main country of tax residency** Additional country(s) of tax residency (if any) Foreign Tax Identification Number*** (FIN) Version no. (5b) YOU WILL NEED THIS WORD IF YOU CALL US TO DISCUSS YOUR CARD IN THE FUTURE FULL NAME (MUST BE LIVING IN NEW ZEALAND AND NOT LIVING AT THE SAME ADDRESS) Their phone ( ) THIS IS THE MAIN COUNTRY WHICH HAS THE RIGHT TO TAX YOUR WORLDWIDE INCOME LIST THE ADDITIONAL COUNTRY(S) OF WHICH YOU ARE A TAX RESIDENT YOUR IDENTIFICATION NUMBER FOR TAX PURPOSES IN A PARTICULAR COUNTRY C: Joint/Additional applicant s details Joint application On a joint credit card account, both cardholders are jointly and severally liable for any balance owed on the account. A joint cardholder must be at least 18 years old. Additional cardholder The principal cardholder is liable for all transactions on the credit card account which are made by an additional cardholder as though they had personally made the additional cardholder transactions. An additional cardholder must be at least 16 years of age. There is a $15 charge for each joint and additional card on all cards except the World MasterCard where a $100 charge applies. When a hotpoints World MasterCard is selected there is no charge for the first joint/additional card. Title (please tick one) Mr Mrs Miss Ms Dr Other (please specify) Given name(s) FIRST MIDDLE Surname Date of birth How would they like their name to appear on their card This must be their given name(s), or initial(s) and surname Westpac PayTag (optional) Home address STREET NO. Contact phone ( ) address For joint applicant only Are you a US citizen?* Yes No STREET NAME/BOX NUMBER TOWN / CITY Mobile phone ( ) Work phone ( ) address Main country of tax residency** Additional country(s) of tax residency (if any) Foreign Tax Identification Number*** (FIN) THIS IS THE MAIN COUNTRY WHICH HAS THE RIGHT TO TAX YOUR WORLDWIDE INCOME LIST THE ADDITIONAL COUNTRY(S) OF WHICH YOU ARE A TAX RESIDENT YOUR IDENTIFICATION NUMBER FOR TAX PURPOSES IN A PARTICULAR COUNTRY * You will be a US citizen if you were born in the US or have acquired US citizenship, unless you have formally renounced your US citizenship ** The country listed will determine the tax rate applied to your products. Please contact your tax advisor if you are unsure *** If you are a US citizen or tax resident, the FIN section must be completed with your social security or individual tax identification

2 D: Employment and financial details Occupation of principal applicant INSERT YOUR OCCUPATION HERE Current employer of principal applicant Time in current job years months Principal applicant s annual income from all sources (before tax) is Joint applicant s annual income from all sources (before tax) is $ ANNUALLY $ ANNUALLY E: Card Repayment Cover This optional insurance can help you pay your credit card balance should you or any cardholder on your account die or experience total disability, redundancy or bankruptcy before age 66. Do you want to be covered by Yes No Card Repayment Cover? Note: You must be aged between 18 and 65 years. You will be covered on the terms, conditions and exclusions of the Card Replacement Cover policy wording from the date that this application is received by Westpac. A sample copy of the Card Replacement Cover policy wording is attached. I/we agree to be covered by Card Repayment Cover (please sign:) If you re applying for a joint credit card account please combine your financial details for the following questions Total savings and investments with Westpac add up to Total savings and investments not with Westpac add up to $ TOTAL $ TOTAL Monthly home loan, rent or board payments $ MONTHLY TOTAL Monthly repayments for any bank loans, other than home loans (e.g. car & personal) add up to Monthly repayments for non-bank loans (e.g. finance companies, student loans or hirepurchase agreements) add up to $ MONTHLY TOTAL $ MONTHLY TOTAL PRINCIPAL SIGNATURE DATE / MONTH / YEAR Cost of the insurance is 79 cents a month for each $100 of the outstanding balance on your Westpac credit card statement. If you choose Card Repayment Cover, then each month we will charge your premium to your credit card account. We will let you know if the cost of the insurance changes 30 days beforehand. The premiums are collected on behalf of the underwriter Westpac Life-NZ-Limited. Westpac Life-NZ-Limited has an AA- Insurer Financial Strength rating given by Standard & Poors (Australia) Pty Limited on 6 August The rating scale is: AAA Extremely Strong, AA Very Strong, A Strong, BBB Good, BB Marginal, B Weak, CCC Very Weak, CC Extremely Weak, SD or D Default, R Regulatory Supervision, NR Not Rated. Plus (+) or Minus (-) following ratings from AA to CCC show relative standings within the major rating categories. For a full description of the ratings scale go to standardandpoors.com All credit card limits add up to $ TOTAL F: Acknowledgement I/we certify that all information supplied in this application is true, correct and complete. In applying for this credit card, I/we acknowledge that my/our declared income is correct and sufficient to service the credit limit provided. I/we agree that as soon as I/we sign or use my/our card or use any other payment instrument (such as PayTag if requested), to access my/our account I/we will be deemed to have agreed to be bound by: the Credit Card Conditions of Use for the applicable card; the Air New Zealand Airpoints programme terms and conditions (where applicable); the hotpoint terms and conditions (where applicable); and the Westpac PayTag terms and conditions (where a Westpac PayTag has been requested). I/we acknowledge and agree that: I/we are personally responsible for all credit extended by Westpac to me/us, including credit extended under a BusinessPLUS MasterCard or Airpoints Business MasterCard, irrespective of whether a business name appears on the card; where applicable, I must be a member of Air New Zealand s Airpoints programme to be eligible to earn Airpoints and that I can access the Airpoints terms and conditions at airnewzealand.co.nz/aripoints-terms-and-conditions; for a joint credit card account, a notice Westpac sends to one of us will count as a notice to all of us; fees and charges will apply to the use of the card. Details of fees and charges are provided in the Transaction and Service Fees brochure, which will be sent to me; and the Credit Card Conditions of Use for the applicable card, the Westpac PayTag terms and conditions (where applicable), and the hotpoints terms and conditions (where applicable) will be sent to me. Copies of the Credit Card Conditions of Use for the applicable card, the Westpac PayTag terms and conditions, the hotpoints terms and conditions (which are incorporated in the Credit Card Conditions of Use for the applicable cards) and the Transaction and Service Fees brochure are available at any Westpac branch or online at westpac.co.nz. Personal information I/we consent to and authorise the collection, use and disclosure of my/our personal information by Westpac New Zealand Limited and its related companies (Westpac) in the following ways: Westpac may make all necessary enquiries (now or in the future) concerning my/our credit record, residence, employment, financial status, and any information provided by me/us in this application for the purposes related to provision of credit to me/us, from whatever source Westpac considers appropriate, including any credit reporting agency that Westpac has a subscriber agreement with, and any party approached may provide such information to Westpac. Westpac may use all the information that they hold about me/us to make available to me/us the full range of financial services provided by Westpac and to provide me/us with details of products and services that may be purchased with the card. Westpac may provide Credit Information (as defined in the Credit Reporting Privacy Code 2004) about me to credit reporting agencies, who will use that information to update their credit reporting database and who may disclose any information they hold about me/us to their own customers for the purpose of providing credit reporting services.

3 Westpac may disclose my personal information (including default information) to any person Westpac may appoint to collect any outstanding debt. Westpac may use credit reporting agencies monitoring service to receive updates, if any, of the information they hold about me/us. Westpac and its related companies may obtain, use and/or disclose information held about me/us to enable Westpac and its related companies to comply with any laws, rules or regulations in New Zealand or any other country including any laws, rules or regulations reasonably expected to be implemented (including to enable the government of New Zealand to comply with any agreement between it and any other country). Westpac may disclose and exchange any information held about me/us now or in the future to any party associated with a Westpac credit card rewards programme for the purposes of administration of the applicable rewards programme, provision of related services and for marketing and research purposes. I/we confirm that I/we have the permission of the person named as close friend or relative in this application to disclose their personal details. If I/we have indicated that I/we wish to be covered by Card Repayment Cover ( the Cover ), I/we authorise Westpac to disclose all relevant information held about me/us now or in the future to the underwriters of the Cover for purposes of administrating the Cover. I/we understand that I/we have the right to access and correct my/our personal information held by Westpac subject to the provisions of the Privacy Act I/we acknowledge that I/we have read and accepted the disclosures, terms and conditions set out above. G: Signature(s) I /we also certify that: I/we are New Zealand citizens or have permanent New Zealand residency status and reside in New Zealand. I/we are over 18 years of age (and any additional applicant is over 16 years of age). Please note that you will be required to verify your identity and income as part of the application process or prior to activating your credit card account. All cardholders (principal, joint or additional) are required to verify identification. Suitable forms of ID include one of the following New Zealand drivers licence Current passport New Zealand firearms licence For more details see westpac.co.nz/aml PRINCIPAL SIGNATURE JOINT / ADDITIONAL SIGNATURE Credit cards are both a convenient means of payment and a flexible form of borrowing. Although paying only the minimum monthly payment can help you manage your cash flow from time to time, If you make only the minimum payment each month, you will pay more interest and it will take you longer to pay off your balance. Westpac use only Credit Card Account Number Card Application X X X X X X X X Card account CRS Package type Branch/split code Staff Bank stamp Courier cost Branch Customer 72273WP FTR stamp Special delivery instructions Card Repayment Cover is underwritten by Westpac Life-NZ-Limited, a wholly owned subsidiary of Westpac Financial Services Group-NZ-Limited, which is a wholly owned subsidiary of Westpac Banking Corporation ABN , incorporated in Australia. Neither Westpac Banking Corporation, Westpac New Zealand Limited ( Westpac ), nor any other member of the Westpac Group guarantees the obligations of, or any products issued by, Westpac Life-NZ-Limited. Westpac employs salaried employees whose remuneration is influenced in the long term by the arrangement of Westpac Life-NZ-Limited insurance policies. Westpac will receive commission payments as a result of the arrangement of Westpac-Life-NZ-Limited policies. hotpoints is a registered trademark of Westpac Banking Corporation. MasterCard is a registered trademark of MasterCard International Incorporated.

4 Claims Procedure If you wish to make a claim, you must notify Westpac Life-NZ-Limited within 30 days of the event that prompted the claim. You must also provide us with medical reports or other information that we may ask for, at your expense. All proceeds of approved claims will be paid to your credit card account. Notices Any notices may be made by ordinary post (to the last postal address notified by you to us) or by facsimile or electronic means (to the facsimile/ address provided by you to us). You are responsible for promptly informing us of any change to your personal details (including your name, address, telephone, mobile or facsimile s and address). Underwriter Westpac Card Repayment Cover is underwritten by Westpac Life-NZ-Limited, a wholly owned subsidiary of Westpac Financial Services Group-NZ-Limited. Westpac Financial Services Group-NZ-Limited is a wholly owned subsidiary of Westpac Banking Corporation ABN , incorporated in Australia. Westpac New Zealand Limited ( Westpac ) does not guarantee the obligations of, or any products issued by Westpac Life-NZ-Limited. Westpac will receive commission payments as a result of the arrangement of Westpac Life insurance policies. Your policy will be included in the Westpac Life-NZ-Limited Statutory Fund No.1. We will pay your benefits from this fund. Statutory Funds are regulated pursuant to the Insurance (Prudential Supervision) Act Definitions Commencement date means the date on which your cover under the Master Policy commenced which is the date that your application for Card Repayment Cover was received by Westpac. Outstanding balance means the amount of debt on your Westpac credit card account at the date of any event for which a claim is made under this policy. The amount of debt will exclude: any amounts shown as Past Due on your credit card statement together with accompanying interest, or any purchases or cash advances you made when you knew of the likelihood of the event giving rise to a claim, which, in our opinion, are outside the normal conduct of your credit card account. We/our/us/Westpac Life means Westpac Life-NZ-Limited. You/your means the cardholder (including any joint cardholder and additional cardholders) who is the holder of a credit card issued by Westpac and obtained for private use, who has made an application and has paid the required premium each month. Policy Enquiries and Complaints If at any time you have an enquiry or complaint about Card Repayment Cover, please contact Westpac Life in writing at PO Box 27031, Wellington or call Westpac Life on Westpac Life is a member of the Banking Ombudsman Dispute Resolution Scheme. If you are not satisfied with the way we resolve the enquiry or complaint, we can let you know how to refer the matter to the Banking Ombudsman. Insurer Financial Strength Rating Westpac Card Repayment Cover is underwritten by Westpac Life-NZ-Limited which has a AA- Insurer Financial Strength Rating given by Standard & Poor s (Australia) Pty. Limited. The rating scale is: AAA Extremely Strong BBB Good CCC Very Weak R Regulatory Supervision AA Very Strong BB Marginal CC Extremely Weak NR Not Rated A Strong B Weak SD or D Default Plus (+) or minus (-) signs following ratings AA to CCC show relative standings within the major rating categories. For a full description of the rating scale go to: Westpac Life-NZ-Limited PO Box 934, Shortland Street Auckland 1140 Freephone: Facsimile: Card Repayment Cover This is your Card Repayment Cover Policy Wording. Please read this wording and then keep this document in a safe place. The terms and conditions for Westpac Card Repayment Cover may vary from time to time. Westpac New Zealand Limited 72540WP

5 The Policy Westpac New Zealand Limited, has been appointed by Westpac Life-NZ- Limited to provide Westpac Card Repayment Cover. Westpac Life-NZ-Limited is referred to as the Company in the Master Policy. This document sets out in full the terms of the insurance cover provided by Master Policy NZWP1037 for your protection in the event of: death; total disability; unemployment arising from redundancy; bankruptcy. At the date of any event for which a claim is made, you must be between the following ages to be eligible for the protection: 18 and 65 years (inclusive) for the Total Disability, Redundancy and Bankruptcy benefits 18 and 79 years (inclusive) for the Life Insurance benefit. Life Insurance We will pay the outstanding balance on your credit card account as at the date of death, up to $50,000. You are not covered under this policy for death arising from: suicide, within 13 months of the commencement date, or any injury, sickness or disease which existed at the commencement date whether diagnosed or not, or Total Disability This is any disability resulting from bodily injury, sickness or disease which directly and independently of any other cause, totally prevents you from engaging in your normal or usual business, occupation or work (including normal household duties if that is your primary occupation). Where total disability continues beyond 30 consecutive days, we will make monthly payments of 10% of the outstanding balance as at the date that you stopped work or sought medical advice, whichever is the earlier. The maximum payment period is 24 months. The amount paid will not exceed $50,000. Payment will be calculated on the of days from the date you stopped work or sought medical advice, whichever is the earlier, until the date of your recovery, but in no event will payments continue beyond 24 months. If your disability becomes permanent we may pay the remainder of the 24 month total disability benefit as a lump sum. Such payment will be in full settlement of the total disability claim. Cover under the policy will then cease for this cardholder for total disability recurring from the same accident or illness. 1. Absence from work due to pregnancy, childbirth or abortion, or 2. Disability caused or resulting from: any injury, sickness, disease or degenerative condition which existed at the commencement date, or sickness, disease or degenerative condition which first made itself known within 28 days of the commencement date, or a deliberately self-inflicted injury or attempted suicide, or travel by air other than as a passenger on a licensed commercial or chartered aircraft, or you being addicted to alcohol or a drug, or you being under the influence of alcohol, poison or drugs, other than a drug taken on the advice of a legally qualified medical practitioner, or Redundancy This is loss of employment resulting from your position becoming superfluous to the needs of your employer. Loss of employment as a result of resignation, dismissal or voluntary redundancy is not covered by the Master Policy. Where unemployment resulting from redundancy continues beyond 30 consecutive days, we will make monthly payments of 10% of the outstanding balance, as at the date you were first notified that you would be made redundant. The maximum payment period is six months. The amount paid will not exceed $50,000. Payments will be calculated on the of days from the date you became unemployed, until the date of your new employment commencing, but in no event will payments continue beyond six months. Cardholders who are self-employed or in seasonal or casual work or contract work, or loss of employment as a result of resignation, dismissal or voluntary redundancy, or unemployment which was in existence at the commencement date or occurred within 28 days of the commencement date, or if you knew or ought to have known, at the commencement date, that it was likely or possible that you would be made redundant, or if you have just completed a specific task or specific period of employment, or if you were made redundant from employment outside New Zealand, or if you were a director where you had control over your employees or if you were employed by a direct member of family (spouse, parents or children), or Bankruptcy This is when you have been declared bankrupt as a result of your creditors applying to a New Zealand Court to do so. If you are a self-employed cardholder and you become bankrupt more than six months after applying for cover, we will pay the outstanding balance, as at the date you were first notified that your creditors had applied to the Court to start bankruptcy proceedings. The amount paid will not exceed $10,000. Cardholders who are not self-employed, or voluntary bankruptcy, or Exclusions applying to all cover (life insurance, total disability, redundancy & bankruptcy) Any claim resulting from: riot or civil commotion, strike, lockout, war, civil war, rebellion, revolution, insurrection, the use of military or usurped power or if you were committing a materially unlawful act, or injury, sickness or disease you sustained outside New Zealand if you have been outside New Zealand for over six months immediately preceding the date of the event which resulted in a claim. Premiums The premium payable by you for this insurance is 79 cents per $100 of your outstanding monthly credit card account balance as at the date of your monthly statement. This will cover all cardholders on your account aged between 18 and 65 years (inclusive) for the Total Disability, Redundancy and Bankruptcy benefits, and all cardholders on your account aged between 18 and 79 years (inclusive) for the Life Insurance benefit. The premium is charged to your credit card account each month. If there is a nil balance on your credit card account as at billing date, no premium will be payable for that month. We can amend the premium by giving you not less than 30 days notice. Policy and benefits Only one benefit is payable for total disability or redundancy during the same period or for the same event. The rights and benefits you receive under the Master Policy cannot be assigned or charged to another person. The policy does not have a surrender value. Termination of the insurance cover You can terminate your cover at any time by giving written notice to Westpac Life-NZ-Limited. If you terminate the cover within 30 days of the commencement date we will refund any premiums paid in full. We can amend or terminate the cover at any time by giving you not less than 90 days notice in writing. Examples of when we may exercise this right to amend include if our legal or regulatory requirements change, to allow us to respond to market changes or medical advances or to enable changes that are reasonably necessary for Westpac Life s other legitimate business purposes. Cover will terminate immediately if the premium is unpaid or your Westpac credit card account is cancelled. Cover for the Total Disability, Redundancy and Bankruptcy benefit will cease on your 66th birthday. Cover for the Life Insurance benefit will cease on your 80th birthday.