Bank of China (Australia) Limited ABN 28 110 077 622 AFSL / Australian credit licence 287322 By completing this form, you (the Applicant) are confirming that you are 18 years of age or over, and have a good credit rating. 在 您 填 写 此 申 请 表 前, 请 确 认 您 是 18 周 岁 及 以 上, 且 信 用 记 录 良 好 Great Wall International Credit Card Application Form F.PBD.CCAF.20150724 Please provide your BOC Customer No.(if applicable): 如 您 是 我 行 现 有 客 户, 请 提 供 您 在 我 行 的 客 户 号 : 1. PRODUCT INFORMATION 产 品 类 别 选 择 Which type of card would you like? 请 选 择 您 要 申 请 的 信 用 卡 种 类 Gold credit card (Min income 40,000 p.a) 金 卡 ( 最 低 年 收 入 40,000) Low fee credit card (Min income 15,000 p.a) 低 年 费 卡 ( 最 低 年 收 入 15,000) Low rate credit card (Min income 15,000 p.a) 低 利 息 卡 ( 最 低 年 收 入 15,000) Student credit card (Min deposit 500) 学 生 卡 ( 最 低 保 证 金 存 款 500) If your application for Gold Card is not successful, which would you like to accept? 如 您 的 金 卡 申 请 未 能 获 批, 您 希 望 接 受 以 下 哪 款 产 品? Low rate credit card (Min income 15,000 p.a) 低 利 息 卡 ( 最 低 年 收 入 15,000) Low fee credit card (Min income 15,000 p.a) 低 年 费 卡 ( 最 低 年 收 入 15,000) Maximum Requested Limit 您 期 望 的 额 度 2. APPLICANT'S DETAILS 个 人 资 料 * Please note that your credit limit will depend on your ability to meet your repayment. If you don t specify a credit limit, we will assess you for the maximum credit limit. 请 注 意, 信 用 额 度 将 取 决 于 您 的 还 款 能 力 如 您 没 有 填 写 期 望 额 度, 我 们 将 评 估 后 给 出 最 高 额 度 Title 称 谓 Mr 先 生 Miss 小 姐 Mrs 夫 人 Ms 女 士 Other 其 它 : Gender 性 别 Male 男 性 Female 女 性 Date of Birth 出 生 日 期 DD 日 MM 月 YYYY 年 First Name 名 Surname 姓 Full Name 全 名 Name on Card 卡 面 印 制 姓 名 Australian driver's licence No. 澳 大 利 亚 驾 驶 执 照 号 码 Other ID type 其 它 证 件 类 型 Other ID No. 其 它 证 件 号 码 State No. Marital Status Single 未 婚 Married 已 婚 De facto 事 实 婚 姻 Separated or divorced 分 居 / 离 异 婚 姻 状 况 Widowed 丧 偶 Other (please specify) 其 它 ( 请 说 明 ): Number of dependents under 18 years 供 养 人 数 (18 岁 以 下 ) Nationality 国 籍 Visa expiry date (if NOT an Australian permanent resident) MM 月 YYYY 年 Country of birth 出 生 国 家 如 果 不 是 澳 大 利 亚 永 久 居 民, 签 证 到 期 日 : 3. PERSONAL ADDRESS AND CONTACT DETAILS 个 人 住 址 和 联 系 方 式 Home phone 住 宅 电 话 Mobile phone 手 机 号 码 Email address 电 子 邮 箱 地 址 ( ) ( ) Current home address 当 前 住 址 Years at current address 目 前 地 址 已 居 住 时 间 Years 年 Months 月 Residential status Home owner 自 有 房 产 Renting 租 赁 Living with parents 与 父 母 同 住 居 住 类 型 Other (please specify) 其 它 ( 请 说 明 ): If home owned 如 为 自 有 房 产 Estimated home value 房 产 价 值 Amount owing (if any) 欠 款 余 额 ( 如 有 ) If renting, please provide : Landlord/Agent name 屋 主 / 中 介 名 称 Phone No. 联 系 电 话 如 为 租 赁, 请 提 供 : Please provide previous address if less than 3 years in your current address 如 您 在 当 前 住 址 未 满 3 年, 请 提 供 在 此 之 前 的 住 宅 地 址 : Postcode 邮 编 Postal Address (if different from the above) 通 讯 地 址 ( 如 与 上 面 填 写 的 当 前 住 址 不 同 ) Postal address 通 讯 地 址 Page 1 of 6
4. FOR YOUR SECURITY 您 的 安 全 信 息 Mother's maiden name (surname before marriage) 母 亲 姓 氏 Name of a relative or a friend who lives in Australia (but NOT living with you) 请 提 供 一 个 亲 人 或 者 朋 友 的 联 系 方 式 ( 未 与 您 居 住 在 一 起 ) Name of the contact person 联 系 人 姓 名 Contact phone No. 联 系 人 电 话 Relationship to you 与 您 的 关 系 描 述 Address 当 前 住 址 5. EMPLOYMENT DETAILS 工 作 情 况 Employment Status Full-time 全 职 Permanent part time 兼 职 Self employed 个 体 经 营 / 自 由 职 业 Unemployed 失 业 工 作 类 型 Casual 临 时 工 Home duties 赋 闲 在 家 Retired 退 休 Contractor (specify contract expiry date) 合 同 工 ( 请 注 明 合 同 到 期 日 ) MM 月 YYYY 年 Others 其 它 Occupation 职 业 Industry 行 业 Employer s name or business name if self employed 工 作 单 位 名 称 或 商 业 名 称 ( 如 为 自 雇 人 士 ) Employer s address, or if self-employed, business address (can t be a PO Box) 工 作 单 位 地 址 或 商 业 注 册 地 址 ( 如 为 自 雇 人 士 ), 不 可 为 信 箱 地 址 Work place address 工 作 地 点 地 址 Work contact No. 工 作 单 位 联 系 电 话 Job Title 职 位 名 称 Total time of employment Years 年 Months 月 Time with current employer Years 年 Months 月 总 工 作 年 限 If self employed, please provide ABN 如 为 自 雇 人 士, 请 提 供 ABN 号 码 现 职 工 作 年 限 If self employed/contractor, please give details of your accountant/financial adviser. Name 姓 名 Phone No. 电 话 号 码 如 为 自 雇 人 士, 请 提 供 了 解 您 的 财 务 状 况 的 会 计 师 或 财 务 师 的 联 系 信 息 : 6. FINANCIAL STATUS 个 人 财 务 情 况 Gross annual income/salary (before tax) 税 前 年 收 入 Monthly wage/salary (after tax) 每 月 税 后 净 收 入 Other monthly income (after tax) 其 它 税 后 月 收 入 Account balances held with other financial institutions 在 其 他 金 融 机 构 存 款 账 户 余 额 Value of real estate assets (excluding own home) 房 产 价 值 ( 不 包 括 自 住 房 ) Value of other investments 其 他 投 资 Value of motor vehicles 汽 车 价 值 Your monthly share of residential mortgage/rent 您 每 月 分 担 的 还 款 或 房 租 Your share of monthly general living expenses (e.g. bills, transport) 每 月 分 担 的 生 活 支 出 ( 比 如 账 单 或 者 交 通 费 等 ) Your share of other monthly expenses (other expenses you have not already declared) 每 月 分 担 的 其 他 支 出 ( 未 提 及 的 其 他 支 出 ) Total amount owning on other loan/ credit card 其 他 欠 款 ( 贷 款 或 信 用 卡 ) Total limits on all credit cards and store cards 信 用 卡 总 额 度 Total number of credit cards held 持 有 信 用 卡 数 量 Page 2 of 6
7. BALANCE TRANSFER REQUEST 余 额 转 移 * To transfer from your non-bank of China credit card and store card to your new credit card account with Bank of China if approved, simply complete this section (Minimum 500, no decimal) 您 可 以 将 其 他 银 行 的 信 用 卡 余 额 转 移 到 您 在 我 行 获 批 的 信 用 卡 中 ( 最 低 转 移 金 额 500, 且 需 为 整 数 ) Please read the Balance Transfer Terms and Conditions in the Important Notices below before applying. 请 在 申 请 前 阅 读 下 面 重 要 注 意 事 项 中 余 额 转 移 的 使 用 条 款 1 2 3 Issuing Bank/Financial Institution/store 发 卡 行 / 金 融 机 构 名 称 8. PAYMENT AND OTHER INFORMATION 还 款 及 其 他 信 息 I would like to set up Direct Debit for repayment 我 需 要 建 立 自 动 还 款 If yes, how much would you like to pay? 如 是, 您 希 望 进 行 全 额 还 款, 还 是 最 低 还 款 额 还 款? Full Amount 全 额 还 款 Biller Code Bpay 机 构 编 码 Ref. No Bpay 参 考 号 Details of account to be debited (All details must be supplied) 关 联 还 款 账 户 信 息 ( 均 为 必 填 项 ) Amount To Be Transferred 余 额 转 移 金 额 Minimum Amount 最 低 还 款 额 还 款 Credit Card Number 信 用 卡 卡 号 Bank /Financial institution Name 银 行 / 金 融 机 构 名 称 Account name 账 户 名 称 BSB code 银 行 代 码 Account number 账 户 号 码 I would like to add an additional card holder on my account 我 希 望 在 我 的 信 用 卡 帐 户 上 为 他 人 申 请 附 属 卡 If yes, please go to the next section (section 9) 如 是, 请 填 写 下 一 部 分 信 息 ( 第 9 部 分 ) 9. ADDITIONAL CARDHOLDER'S DETAILS 附 属 卡 持 卡 人 信 息 Title 称 谓 Mr 先 生 Miss 小 姐 Mrs 夫 人 Ms 女 士 Other 其 它 : Gender 性 别 Male 男 性 Female 女 性 Date of Birth 出 生 日 期 DD 日 MM 月 YYYY 年 Relationship to the primary cardholder 与 主 卡 持 卡 人 关 系 Parents 父 母 Spouse 配 偶 Children 子 女 First Name 名 Surname 姓 Full Name 全 名 Name on Card 卡 面 印 制 姓 名 Australian driver's licence No. 澳 大 利 亚 驾 驶 执 照 号 码 Other ID type 其 它 证 件 类 型 Other ID No. 其 它 证 件 号 码 Mobile Phone No. 手 机 号 码 State No. Please provide additional cardholder s BOC Customer No. (if applicable) 如 您 是 我 行 现 有 客 户, 请 提 供 客 户 号 Postal Address (if different from the above) 通 讯 地 址 ( 如 与 上 面 主 卡 申 请 人 提 供 的 通 讯 地 址 不 同 ) Postal address 通 讯 地 址 Maximum monthly usage limit for additional card (multiples of 100) 每 账 单 周 期 最 大 使 用 限 额 ( 需 为 100 的 整 数 倍 数 ) * * if you do not specify an amount, default will be the entire credit limit of the primary card account. 如 果 您 没 有 说 明 具 体 金 额, 我 们 将 默 认 附 属 卡 共 享 所 有 主 卡 的 信 用 额 度 additional cardholder could not exceed this limit in every single statement cycle. 每 个 账 单 周 期, 附 属 卡 持 卡 人 的 交 易 金 额 不 能 超 过 此 限 额 10. IMPORTANT NOTICES 重 要 注 意 事 项 Credit Reporting Collection Statement (credit card facility) Bank of China Limited, Sydney Branch ABN 29 002 979 955 and Bank of China (Australia) Limited ABN 28 110 077 822 (we/us/our) collect, use and disclose personal information and Credit-Related Information about individuals as set out below. Our Policies Privacy Policy Personal information is treated in accordance with our Privacy Policy. This policy contains information on: how we manage your personal information; how you may: o access your personal information held by us o seek correction of that information o make a complaint about a breach of the Australian Privacy Principles or about how we deal with such complaints. whether it is likely that we will disclose your personal information to entities that do not have an Australian link and, if so, the countries in which those entities are likely to be located. Page 3 of 6
Our Privacy Policy may be obtained by visiting our website at www.bocau.com.au or by contacting us on 1-800-092-009 (toll free) or +61 2 8235 5812 between 9:00 am and 5:00 pm Monday to Friday AEDT (not available during NSW holidays). Credit Reporting Policy Credit-Related Information is treated in accordance with our Credit Reporting Policy. This policy contains information on: how we manage your Credit-Related Information; how you may: o access your Credit Eligibility Information held by us; o seek correction of your Credit Information or Credit Eligibility Information held by us; and o complain about a failure by us to comply with the credit reporting provision of the Privacy Act 1988 (Cth) (Privacy Act) or the Credit Reporting Code and how we will deal with such complaints; and whether it is likely that we will disclose your Credit Information or Credit Eligibility information to entities that do not have an Australian link and, if so, the countries in which those entities are likely to be located.our Credit Reporting Policy may be obtained by visiting our website at www.bocau.com.au or by contacting us on 1-800-092-009 (toll free) or +61 2 8235 5812 between 9:00 am and 5:00 pm Monday to Friday AEDT (not available during NSW holidays). Defined terms For the purpose of this Credit Reporting Collection Statement: Credit Reporting Body (CRB) is an entity that collects, holds, uses and discloses personal information about an individual for the purpose of providing other entities with information about the credit worthiness of an individual, for permitted purposes. Credit Reporting Information refers to Credit Information or CRB Derived Information. This information is generally held by a Credit Reporting Body and disclosed to a credit provider in the form of a credit report. Credit-Related Information refers to Credit Information, Credit Eligibility Information and CRB Derived Information (those terms are defined in the Privacy Act and as summarised in section 2 of our Credit Reporting Policy). Personal information is defined in the Privacy Act as information or an opinion about an identified individual, or an individual who is reasonably identifiable: whether the information or opinion is true or not; and whether the information or opinion is recorded in a material form or not. Collection of information We collect personal information and Credit-Related Information from the individual applicant(s) named in this Application (you), including information obtained in this Application and during the term of any credit provided by us. The information that we collect is required to: assess this Application for credit and if the Application is successful, to enable us to establish and manage any credit or facilitate the provision of credit to you (or your related company or other entity); or is required to be collected under the Anti-Money Laundering and Counter-Terrorism Financing Act 2006.Information may also be required: for any other purposes which relates to or arises out of requests or complaints made by you; and to take any action we are required or authorised by law to take. We collect personal information and Credit-Related Information from Credit Reporting Bodies listed below and other credit providers named in this Application: for the purpose of assessing this application for credit and for future management of the customer or credit, including collection of overdue payments; or this collection is authorised under the Privacy Act 1988 (Cth), If we are unable to collect your personal or Credit-Related Information, we may be unable to process this Application and therefore unable to provide the products and services required. Disclosure of information We may disclose your personal information and Credit-Related Information to our related companies and to third parties, including debt collectors, our brokers, credit management agencies, persons involved in securitisation arrangements with us, mortgage insurers, other credit providers, Credit Reporting Bodies and government bodies and regulatory authorities (where required or authorised by law). We also disclose Credit-Related Information to third parties who provide services to us or who provide services to you on our behalf. Further details are set out in our Credit Reporting Policy. Information provided to Credit Reporting Bodies We provide your Credit-Related Information to Credit Reporting Bodies. The information that we provide may be used by a Credit Reporting Body to include in reports provided to credit providers to assist them to assess your credit worthiness. If you fail to meet payment obligations in relation to consumer credit or if you commit a serious credit infringement, we may be entitled to disclose this to the Credit Reporting Body. The Credit Reporting Body that we may disclose your information is: Veda Advantage Ltd 1300 762 207 Level 15, 100 Arthur Street North Sydney NSW 2060 www.veda.com.au You can obtain a copy of the credit reporting policy of any Credit Reporting Body (about the management of your Credit-Related Information by the Credit Reporting Body) that we disclose your Credit-Related Information to. If you would like to obtain their credit reporting policy, you should contact them directly using the contact details set out above. You also have a right to: request that credit reporting bodies do not use any credit-related information held by them for the purposes of pre-screening any direct marketing by credit providers; and request that credit reporting bodies do not to disclose your credit-related information in circumstances where you reasonably believe that you Page 4 of 6
have been a victim of fraud or identity theft. If you would like to make either of these requests, you should contact the credit reporting bodies using the contact details set out above. We may also disclose your Credit-Related Information to our related companies or branches located world wide and third party service providers that are located in one or more overseas countries or hold information in overseas countries. where we will disclose information to our related companies or branches will be located include Bahrain, Belgium, Cambodia, China, Dubai, France, Germany, Hong Kong, Hungary, Indonesia, Italy, Japan, Korea, Luxembourg, Macau, Malaysia, Mongolia, Netherlands, Philippines, Poland, Republic of Khazakhstan, Russia, Singapore, Sweden, Taiwan, Thailand, United Arab Emirates, UK, USA, Vietnam and other countries which we may notify you of from time to time (including at the time of collecting your information); and where we will disclose information to third party service providers include British Virgin Islands, Cayman Islands, China, Hong Kong and New Zealand and other countries which we may notify you of from time to time (including at the time of collecting your information). Please refer to our current Credit Reporting Policy on our website at www.bocau.com.au for current information on the countries where such overseas recipients are likely to be located. Your rights to access or request for correction of information or to make a complaint You have a right to access the personal information and Credit-Related Information that we hold about you, to correct that personal information and Credit-Related Information and to make a complaint about our handling of your personal information and Credit-Related Information. Our Privacy Policy and Credit Reporting Policy provide more information on how you can exercise these rights. Marketing and other purposes In addition to the purposes stated above we may use your personal information for marketing and research purposes. To opt out of direct marketing from us, call us on 1-800-092-009 (toll free) or +61 2 8235 5812 between 9:00 am and 5:00 pm Monday to Friday AEDT (not available during NSW holidays) or write to us as follows: Compliance Officer, Bank of China Ltd. 39-41 York Street, SYNDEY, NSW 2000. Your acknowledgment and consent (must be signed by each individual applicant) : By signing this Application you: confirm that you are aged 18 or above; acknowledge that you have received and read our Privacy Policy and Privacy Collection Notice; acknowledge that you have received and read our Credit Reporting Policy and the Credit Reporting Collection Statement; agree that we may exchange your Credit-Related Information with the credit reporting body(bodies) named in the Credit Reporting Policy (as permitted by the Privacy Act 1988 (Cth)) and to obtain a credit report from them, including may provide information to a Credit Reporting Body for each review; of your facility and we may obtain a credit report from a Credit Reporting Body for the purpose of such agree that we may collect, hold, use and disclose your personal information and Credit-Related Information for the purposes set out in the Credit Reporting Collection Statement, Credit Reporting Policy, Privacy Collection Notice and Privacy Policy; unless you have opted out, that we may use your personal information for marketing or research purposes; you consent to us disclosing your Credit-Related Information to other credit providers for the purposes set out in the Credit Reporting Collection Statement or other purposes permitted by the Privacy Act 1988 (Cth); consent to us using your Credit-Related Information to assess this Application by you for consumer credit or commercial credit and for future management of the consumer credit or commercial credit, including collection of overdue payments and you consent to the Credit Reporting Body disclosing Credit-Reporting Information to us for such purposes; and confirm you have obtained the consent of any individual whose personal information you have disclosed to us in this Application and you have informed the individual of the information in this Credit Reporting Collection Statement. Page 5 of 6
11. CREDIT LIMIT INCREASE INVITATION CONSENT 许 可 银 行 主 动 邀 请 您 增 加 信 用 卡 限 额 We cannot send you credit limit increase invitations from time to time in relation to your credit card unless you have provided your consent to receive them. If we send you an invitation, you have the choice whether to apply for an increase of your credit limit. If you choose to apply, we will decide whether to grant any increase following our assessment of your application. You may give or withdraw your consent at any time. 除 非 获 得 您 的 许 可, 否 则 银 行 将 不 再 向 您 定 期 寄 送 信 用 额 度 增 加 邀 请 函 如 果 银 行 向 您 寄 送 该 邀 请 函, 您 可 选 择 是 否 提 出 申 请 如 果 您 选 择 接 受 我 们 的 邀 请 函, 我 们 将 根 据 您 的 申 请 评 估 结 果 决 定 是 否 批 准 增 加 额 度 您 可 以 随 时 撤 销 您 的 许 可 Would you like to provide consent to us making credit limit increase invitations to you from time to time? 您 愿 意 许 可 银 行 在 任 何 时 间 向 您 寄 送 信 用 额 度 增 加 邀 请 函 吗? Yes, we provide our consent to you making credit limit increase invitations to you from time to time. 是 的, 我 们 许 可 银 行 在 任 何 时 间 寄 送 信 用 额 度 增 加 邀 请 函 No, please do not send me any credit limit increase invitation. 不, 请 不 要 向 我 寄 送 信 用 额 度 增 加 邀 请 函 12. PLEASE SIGN HERE 请 签 字 I have read and understand the Important Notices above, this application, the Key Facts Sheet attached to this application and the Bank s Privacy Policy Statement which have been given to me. I acknowledge that all information provided in this application form is true and correct. I declare that I do not foresee any significant adverse change to my financial conditions. If you do foresee such a change, please call us on 1800 026 228 to discuss your circumstances before submitting your application. 我 已 阅 读 和 理 解 上 面 的 重 要 注 意 事 项 本 次 申 请 本 次 申 请 的 附 件 - 关 键 信 息 披 露 及 银 行 提 供 的 隐 私 条 款 我 声 明 在 本 申 请 表 中 提 供 的 信 息 均 真 实 正 确 我 申 明 近 期 我 的 个 人 财 务 状 况 不 会 发 生 任 何 不 可 预 见 的 改 变 一 旦 您 预 见 这 样 的 变 化, 您 可 以 在 递 交 申 请 之 前 致 电 1800026228 进 行 沟 通 Signature of Applicant 主 卡 申 请 人 签 名 : DD 日 DD 日 MM 月 YYYY 年 DD 日 Additional Cardholder's Signature 附 属 卡 申 请 人 签 名 : DD 日 MM 月 YYYY 年 How would you like to pick up the card? 您 希 望 如 何 领 取 卡 片? At branch 网 点 领 取 By direct mail 直 邮 CC( 营 销 活 动 代 码 ) BH( 分 行 网 点 ) IN( 营 销 人 员 代 码 ) FOR BANK USE ONLY 银 行 专 用 栏 Banking Haymarket Parramatta Hurstville Melbourne Chatswood Box Hill Perth Brisbane PN( 联 名 机 构 代 码 ) EX / PL ( 代 理 机 构 码 ) CA( 客 户 类 型 ) Submitted By: Checked By: Credit Card Customer No.(GCS): Credit Card Account No.(GCS): Application Ref. No. : Input By: Approved By: FW( 年 费 减 免 码 ) Staff VIP CCE Home Loan FOR CARD CENTRE USE ONLY 卡 中 心 专 用 栏 1 2 3 Other Page 6 of 6