epcs Products Application Form

epcs Products Application Form

RBS epcs Products This Application Form is exclusively for use by UK public sector bodies, including Central Government Departments and their Agencies, Non Departmental Public Bodies; NHS Bodies, Local Authorities, Police and Emergency Services, Educational Establishments, Housing Associations and Registered Landlords. If you or your organisation is not a UK public sector body, please contact your Relationship Manager to discuss our other card programmes. Guidelines for completing this form On screen You can complete, save and print using Adobe Reader 9 or above Use the tab key to move between the relevant fields Do not use the return or enter keys By hand Complete in BLOCK CAPITALS and in black ink. Organisations with existing bank accounts with RBS Ensure Section 7 of the form is signed in accordance with your existing signing authorisation(s) Appoint specific Account Signatories for this Commercial Card programme in Section 6 Organisations without existing bank accounts with RBS Appoint Account Signatories in Section 6 Sign in accordance with appropriate Commercial Card Mandate or Board Resolution for Non-Banked Companies (separate form) Please note your application may be delayed if not fully completed. Please place a cross against the product and card type you require Please select card type Card Standard* Black epcs epcs Scottish Plastic RBS epcs onecard MasterCard RBS epcs Purchasing Card VISA RBS epcs Corporate Card VISA RBS epcs Lodge Account VISA RBS epcs onecard Lodge MasterCard RBS epcs Virtual onecard MasterCard RBS epcs Virtual Purchasing Card VISA *Blue for MasterCard, Silver for VISA. Your information For details of how we and others will use your information, please look in the Terms and Conditions for the appropriate product or contact The Royal Bank of Scotland plc, Commercial Cards Division, Cards Customer Services, PO Box 5747, Southend-on-Sea SS1 9AJ. 1 of 9

1. Organisation details Full name of the organisation Trading name (if different from the name above) VAT registration number 2. Programme Administrator Please provide the details of the person who is authorised to manage your card programme on behalf of the organisation. This will be the person to whom statements, cards and correspondence should be sent. The person can also request information about the card programme. The personal information collected here will only be used for identification and security check purposes. By providing this information the organisation confirms that: the person has been advised how their information will be used; and the person consents to such use. If, please specify Date of Birth Business address Line 1 Line 2 Line 3 Town or City Postcode Preferred daytime contact number Business email address (for Cards OnLine e-statement notification) Security password 3. Card Account 3.1. Organisation or Department name (billing unit) of the account 3.2. Organisation or Department name (billing unit) as you wish it to appear on the card (maximum 19 characters including spaces) 2 of 9

3.3. Business address (if different from the address provided in Section 2) Business address Line 1 Line 2 Line 3 Town or City Postcode Business email address 3.4 Payment method: Direct Debit Please complete Direct Debit mandate (back page) If you prefer a different payment method please contact 0370 909 3702* for more details and state your payment method here: * Calls may be recorded. Call charges from residential lines, business lines and mobiles vary and depend on your telephone operator s tariffs. 3.5 Credit limit. The credit limit should be equivalent to 2 months total card spend. Please complete relevant Amendment Form if you require more than one Department account (billing unit). 4. Account Preferences 4.1 Cards OnLine Statements and management information will be provided online. E-statement notifications are sent by email to the Programme Administrator If you prefer paper statements please place a cross in this box If you want notifications to be sent to someone else instead of the Programme Administrator please complete the section below The personal information collected here will only be used for identification and security check purposes. By providing this information the organisation confirms that: the person has been advised how their information will be used; and the person consents to such use. If, please specify Date of birth Business address (if different from the address provided in Section 2) Line 1 Line 2 Line 3 Town or City Postcode 3 of 9

Preferred daytime contact number Business email address (for Cards OnLine e-statement notification) Security password 4.2 Statement date Statement notifications will be produced on the same date every month and emailed to the Programme Administrator or the person nominated in Section 4.1 Please choose your preferred date from 3rd to 28th inclusive 4.3 Cardholder statements (Only available if cardholders are responsible for clearing their own card balance. Each such cardholder must be a resident of the UK, Channel Islands, Isle of Man or Gibraltar.) Please place a cross in this box if paper copies of cardholders statements are to be sent to them 4.4 PIN and Card delivery Please place a cross against where you require PIN notifications and cards to be sent: Programme Administrator s address Cardholder s individual address Alternate address below PIN Card Line 1 Line 2 Line 3 Town or City Postcode 5. Spend Controls (Merchant Category Group Blocking) You can opt to block all cardholders from using cards in various types of merchant. Please place a cross in the appropriate boxes below if you wish to take advantage of this facility. 1. Building services 2. Building materials 3. Estates and garden services 4. Utilities and non-automotive fuel 5. Telecommunication services 6. Catering and catering supplies 7. Cleaning services and supplies 8. Training and educational 9. Medical supplies and services 10. Staff temporary recruitment 11. Business clothing and footwear 12. Mail order/direct selling 13. Personal services 14. Freight and storage 15. Professional services 16. Financial services 17. Clubs/Associations/Organisations 18. Statutory bodies 19. Office stationery, equipment and supplies 20. Computer equipment 21. Print and advertising 22. Books and periodicals 23. Mail and courier services 24. Miscellaneous industrial/ commercial supplies 25. Vehicles, servicing and spares 26. Automotive fuel 27. Travel 28. Auto rental 29. Hotels and accommodation 30. Restaurants and bars 31. General retail and wholesale 32. Leisure activities 33. Miscellaneous 34. Cash cash withdrawal facility from ATM cash over the branch counter/foreign currency outlets etc. Please complete relevant Amendments Form if you wish to have different controls for different cardholders. 4 of 9

6. Account Signatories The person(s) nominated on behalf of the organisation as Account Signatories can request information and request changes to the account, including authorising additional cardholders, amending card limits, Spend Controls and account details. By default the instruction must be in writing. If you wish account signatories to be able to provide instructions by phone, fax and/or email please place a cross in the relevant box. Important note: By placing a cross in any of the boxes in Section 6 you accept the terms and conditions of the authority to give instructions by phone, fax or via email shown on page 7. Please provide appropriate details below: Signature If, please specify Date of Birth Security password Instructions may be provided by phone, fax and/or email, subject to the terms and conditions of the authority to give instructions via these channels shown on page 7. Cross if required Signature If, please specify Date of Birth Security password Instructions may be provided by phone, fax and/or email, subject to the terms and conditions of the authority to give instructions via these channels shown on page 7. Cross if required Signature If, please specify 5 of 9

Date of Birth Security password Instructions may be provided by phone, fax and/or email, subject to the terms and conditions of the authority to give instructions via these channels shown on page 7. Cross if required Please state the number of Account Signatories required to authorise documentation Please bear in mind the operational implications when deciding upon the number of Account Signatories required to authorise documentation, e.g. annual leave/unexpected absence, as we will not be able to process changes without the number of signatories that you state. If you wish to nominate more than 3 individuals please complete relevant Amendment Form. PLEASE READ Credit reference agencies We may obtain information about the business** and the proprietors of that business** from credit reference agencies and Group records to check your credit status and identity. The agencies will record our enquiries which may be seen by other companies who make their own credit enquiries. This may affect your ability to obtain credit elsewhere in the near future. We may use credit scoring. Your business application will be assessed using credit reference agency records relating to anyone with whom you have a joint account or similar financial association. If this is a joint application and such a link does not already exist then one may be created now. These links will remain until you file a notice of disassociation at the credit reference agencies. Fraud prevention agencies If false or inaccurate information is provided and fraud is identified or suspected, details may be passed to fraud prevention agencies. We may also obtain information about your business** from fraud prevention agencies. ** Business refers to the organisation throughout the form. Keeping you informed We would like to keep you informed by letter, phone and electronic means (including e-mail and mobile messaging) about products, services and additional benefits that we believe may be of interest to you. If you don t want us to do this, please place a cross in this box. (Information will be sent to the Programme Administrator) Giving your consent By signing this application you are agreeing that we may use your information in the way described in this form (including the Keeping you informed section) and in the associated Terms and Conditions. 7. Authorisation by the organisation The person(s) nominated as Authorised Signatories are authorised, in accordance with your existing signing authorisation(s), to bind the organisation to the Terms and Conditions of the card programme. I/We agree on behalf of the organisation to be bound by the Terms and Conditions of The Royal Bank of Scotland Commercial Cards Programme as amended from time to time and request that the Bank issue cards on this Agreement. I/We confirm that the details provided to the Bank are full and correct and will notify the Bank of any changes. Authorised signatory 1 If, please specify Job Signature Date 6 of 9

Authorised signatory 2 If, please specify Job Signature Date 8. Organisation Checklist Have all relevant sections been completed in full, e.g. full name details? Y N If you wish to pay by Direct Debit, has the mandate (back page) been completed? Y N Have the persons nominated to be Account Signatories signed Section 6? Y N Have the persons authorised to bind your organisation signed Section 7? Y N Has an epcs order form been completed and signed? Y N Authority to accept Phone, Fax and Email Instructions The organisation agrees and confirms that: 1. RBS be authorised to accept instructions to or from any Commercial Card accounts in the organisation s name, received by phone, fax or email ( the Instructions ) provided that such Instructions reasonably appear: A) (if sent by fax or email) to be signed by any of the Authorised Users detailed in section 6 or by any of the Authorised Signatories detailed in section 7; B) (if provided by telephone) to be given by an Account Signatory or Authorised Signatory as identified by agreed security questions. RBS is requested to and it is understood will check the Instructions by asking the person calling by telephone for written confirmation of the Instructions from an Account Signatory or Authorised Signatory if the person calling by telephone cannot be identified by the usual security questions. 2. Provided the instructions are received in accordance with paragraph A or B above, RBS may assume the accuracy of the instructions and comply with them. 3. The organisation will notify RBS of changes to the individuals specified above. Such notifications must be signed in accordance with the organisation s prevailing authorisation; 4. The provisions of this Authority are in addition to and not in substitution for the provisions of the organisation s prevailing authorisation and the appropriate product Terms and Conditions. For Royal Bank of Scotland use only Failure to complete all sections could lead to the application being delayed or returned to you 1. KYC undertaken Confirmation obtained from Corporate Office Completed by Transaction Services Origination 2. Customer Identification Number (CIN) 1 or 3. Counterparty Identification System (CIS) Code 4. Payment Due Date 7 days 14 days 21 days 25 days 28 days 5. Billing type Centrally billed Individually billed 7 of 9

6. Number of cards required 7. Confirmation that customer received product pricing in writing 8. Confirmation that the customer is a UK public sector body 9. Confirmation that an epcs order form has been completed, signed and filed (attach copy with this application) 10. If you are a Business and Commercial Manager please provide your Portfolio code: 11. Please place a cross for the appropriate product and ASC below Mark for appropriate product Product Channel CDF Select appropriate ASC Lot 1 Lot 2 Project RBS epcs onecard Corporate S6 RBS epcs onecard SME RBS epcs Virtual onecard Corporate S1 RBS epcs Purchasing Card Corporate E3 EPCS01 EPCS02 EPCS03 RBS epcs Purchasing Card SME RBS epcs Virtual Purchasing Card Corporate S1 RBS epcs Corporate Card Corporate B4 RBS epcs Lodge Account Corporate S3 RBS epcs onecard Lodge Corporate Corporate S6 EPCSLD EPCSL2 EPCSL3 12. Relationship Manager details: Name: My ISV number: Email: Phone: Signed for and on behalf of The Royal Bank of Scotland plc 8 of 9 The Royal Bank of Scotland plc. Registered in Scotland No. SC90312. Registered Office: 36 St Andrew Square, Edinburgh EH12 2YB. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority No. 121882.

Please fill in the whole form using a ball point pen and send it to: The Royal Bank of Scotland plc Commercial Cards Division Cards Customer Services PO Box 5747 Southend-on-Sea SS1 9AJ Instruction to your Bank or Building Society to pay by Direct Debit Service user number 9 1 4 6 2 3 FOR THE ROYAL BANK OF SCOTLAND PLC OFFICIAL USE ONLY This is not part of the instruction to your bank or building society. Name(s) of Account Holder(s) We will use your card number/billing number as your reference Bank/Building Society account number Branch Sort Code Name and full address of your Bank or Building Society To: The Manager Bank/Building Society Address Instruction to your Bank or Building Society Please pay The Royal Bank of Scotland plc Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Instruction may remain with The Royal Bank of Scotland plc, and if so, details will be passed electronically to my bank/building society. Signature(s) Postcode Date Reference Banks and building societies may not accept Direct Debit Instructions from some types of account This guarantee should be detached and retained by the payer The Direct Debit Guarantee This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits. If there are any changes to the amount, date or frequency of your Direct Debit The Royal Bank of Scotland plc will notify you 3 working days in advance of your account being debited or as otherwise agreed. If you request The Royal Bank of Scotland plc to collect a payment, confirmation of the amount and date will be given to you at the time of the request. If an error is made in the payment of your Direct Debit by The Royal Bank of Scotland plc or your bank or building society you are entitled to a full and immediate refund of the amount paid from your bank or building society. If you receive a refund you are not entitled to, you must pay it back when The Royal Bank of Scotland plc asks you to. You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us. 9 of 9