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11.08.17 Credit Card Application Form v2 - EastWest Bank

To ap ply, submit co mpletely filled-out Credit card Application form & docu mentar y requirements via e-mail to card applicatio n@eastwestba MY EastWest Credit card OF CHOIC E (P lea se choose one) Depending on EastWest s evaluation, you may receive a card type other than your ch oice. ARE YOU AN EXISTING EastWest CLIENT? Yes Deposi tor No Borr ower ARE YOU AN EXI STING PRINCIPAL EastWest Credit CARDHOLDER? Yes No EastWest Credit card NUMBER X X X X X X MY PERSONAL INFORMATION FULL NAME (F irst , Middle, Last) Name to Appear on card (M ust not exceed 19 characte rs including spaces) CIT IZ ENSHIP/NATIONALIT Y Filipino Others _____ ACR No. _____ CIVIL STATUS Single Marr ied Widowed Separated NO. OF DEPENDENTS NO. OF CARS OWNED EDUCATION High School Colleg e Some College Post Gra duate BIRTHDATE (M onth/D ay/Yea r)TAX IDENTIF IC ATION NUMBER (TIN) SSS/GSIS NUMBER HOME PHONE NUMBER (I f provincia l, include are a cod e) ALTERNATE E-MAIL ADDRESS PRESENT/HOME ADDRESS (N tre et /Villa ge/Bara ngay/M unici pality/C ity/P ro vince/ZIP Code) HOME OWNERSHIP Owned , Mortgaged

To apply, submit completely filled-out Credit Card Application Form & documentary requirements via e-mail to cardapplication@eastwestbanker.com. MY EASTWEST CREDIT CARD OF CHOICE (Please choose one) Depending on EastWest’s evaluation, you may receive a card type other than your

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Transcription of 11.08.17 Credit Card Application Form v2 - EastWest Bank

1 To ap ply, submit co mpletely filled-out Credit card Application form & docu mentar y requirements via e-mail to card applicatio n@eastwestba MY EastWest Credit card OF CHOIC E (P lea se choose one) Depending on EastWest s evaluation, you may receive a card type other than your ch oice. ARE YOU AN EXISTING EastWest CLIENT? Yes Deposi tor No Borr ower ARE YOU AN EXI STING PRINCIPAL EastWest Credit CARDHOLDER? Yes No EastWest Credit card NUMBER X X X X X X MY PERSONAL INFORMATION FULL NAME (F irst , Middle, Last) Name to Appear on card (M ust not exceed 19 characte rs including spaces) CIT IZ ENSHIP/NATIONALIT Y Filipino Others _____ ACR No. _____ CIVIL STATUS Single Marr ied Widowed Separated NO. OF DEPENDENTS NO. OF CARS OWNED EDUCATION High School Colleg e Some College Post Gra duate BIRTHDATE (M onth/D ay/Yea r)TAX IDENTIF IC ATION NUMBER (TIN) SSS/GSIS NUMBER HOME PHONE NUMBER (I f provincia l, include are a cod e) ALTERNATE E-MAIL ADDRESS PRESENT/HOME ADDRESS (N tre et /Villa ge/Bara ngay/M unici pality/C ity/P ro vince/ZIP Code) HOME OWNERSHIP Owned , Mortgaged Owned , Not Mort gaged Living with Parents/Rel atives Rented YEARS OF STAY PERMANENT ADDRESS (N tre et /Vill age/Bara ngay/M unicipalit y/C ity/P ro vince/ ZIP Code) Plea se ch eck if same as Present/H ome Address Ki ndly indicate if you are re lated to an EastWes t Director, Of ficer or Stock holder (D OSRI)

2 NAME RELATIONSHIP MY WORK AND FINANCES SOURCE OF FUNDS Salary/Benefits Allowances Busi nes s Inco me Remittance Ret iremen t/S eparation Ot hers_____ EMPLOYMENT Pri vate Gover nmen t Sel f-Employed Ret ired Ot hers _____ POSIT ION/RANK Clerk Of ficer-Ju nior/ Superviso r Of ficer-Senior/Manager Execu tive (AVP & up) Sel f-Employed /P ro priet or Ot hers JOB TITLE/OCCUPATION COMPANY/BUSINESS NAME NATURE OF PRESENT BUSINESS Agricultur al/Mining Banking BPO Business/Commerci al Services Community/Social/Personal Construction Financing Government Insurance Manufactur ing Real Estate Transportation/Communication Utilities Wholesale/Retail Others _____ DEPARTMENT NO. OF YEARS WIT H PRESENT EMPLOYER/BUSINESS COMPANY/BUSINESS ADDRESS (Floor/B ld age/B arangay/M unicip ality/C ity /P ro vin ce/Z IP Code) COMPANY/BUSINESS PHONE NUMBER (I nclu de loc al/e xte nsion and if p ro vincia l, include are a cod e) GROSS ANNUAL INCOME (S hould matc h income d ocument submitted) MY Credit card REFERENCES (Please indicat e al l major pri ncipal cre dit cards you own.)

3 Mus t be ac tive and at least 1 year.) Noting your cr ed it card ref erences will expedite pro cess ing of your applica tion. card ISSUER card NUMBER MEMBER SINCE Credit LIMIT NAME OF SPOUSE (F irs t, Middle, Last) COMPANY/BUSINESS ADDRESS (Floor/B ld /S treet/Vill age/B arangay/M unicip ality /City/P ro vince/Z IP Code) COMPANY/BUSINESS NAME COMPANY/BUSINESS PHONE NUMBER MOBIL E PHONE NUMBER GROSS ANNUAL INCOME MY PERSONAL/MY PERSONAL/TRADE REFERENCE FULL NAME (F irs t, Middle, Last) COMPANY/BUSINESS NAME CONTACT NUMBER MY BI LLING PREFERENCE MY STATEMENT OF ACCOUNT Send my card to my: Prese nt /Home Address Company /Busi ne ss Address Your card , Statement of Acc ount (SOA) and other co mmunica tions may be del ivered to the alternative address if we are not able to deliver to your pref erred address.

4 Go green, Go paperless! In suppor t of th e global eff or t to sa ve Mother Ea rth , you r cr edit card Sta te ment of Accoun t (S OA) will be se nt to your e-mail address on record th rough our electr onic Sta te ment of Accoun t (e-SOA) Faci lity . It s convenient , se cure and earth-friend ly. Your e-SOA will be se nt to your primary e-mail address in a password protected PDF file. With an e-SOA, you ca n view your SOA any ti me and keep th e file with out th e paper cl ut te r. An SMS adviso ry will be se nt to your mob ile nu mber on record to let you know th at your SOA ha s been se nt . Should you pre fer to rece ive your SOA in yo ur bill ing address, please tick this box: Send my SOA to my bill ing addressAGREEMENT FOR BANK USE ONLY SOURCE C ODE MCSC100000000000 MCSC200000000000 BL/WL/AMLB60 DUP AML RATING NR HR EVALUATION NFIS PHX IMPORTANTIMPORTANTIMPORTANTIMPORTANTIMPO RTANTIMPORTANTIMPORTANTIMPORTANT EastWest Platinum Mastercard EastWest Visa Platinum EastWest EveryDay Titanium Mastercard EastWest Dolce Vita Titanium Mastercard EastWest Visa Gold EastWest Gold Mastercard Hyundai Mastercard EastWest Visa Classic EastWest Practical Mastercard Ot her Cards _____EastWest Classic MastercardPLACE OF BI RTH MOTHER S FULL MAIDEN NAME (F irs t, Middle, Last )(City, Town, Province and Country)

5 GENDERMale FemaleIMPORTANT MOBIL E PHONE NUMBER Your mobile number will be used for sending of cardholder notices, marketing promos, your one-time-password, security alerts, SPOUSE S INFORMATIONU pdate d a s of November 2 017 EastWest is regulated by the Bangko Sentral ng Pilipinas. For inquiries or complaints, you may call EastWest 's 24-Hour Customer Service at (02) 888-1700 or e-mail Similarly, you may contact the BSP Financial Consumer Protection Department at (02) hereby certify that all information and documents given in this Application are complete, true and correct and that my signature/s herein is/are genuine. Disclosure and Sharing of Informationa. Processing of applicationI hereby consent and authorize EastWest , any of its offices, branches, subsidiaries, affiliates, agents, representatives and third parties, to conduct random verification with the BIR, any other appropriate government agency or third party including banks and financial institutions to establish the authenticity of the information I declared and the documents I submitted in relation to my Application as it may be necessary for the processing and evaluation of my Application and I hereby waive any rights on the confidentiality of my income information as required by BSP Circular 622, as amended by BSP Circular 855.

6 I further consent and authorize the disclosure of information pursuant to Republic Act No. 10173 or the Data Privacy Act of 2012, its Implementing Rules and Regulations, and other rules and regulations relating to data Account Maintenance and ServicingI hereby authorize the transfer, disclosure and communication of EastWest of any information relating to my account/s with EastWest as well as all of the documents submitted for this Application to any of its offices, branches, subsidiaries, affiliates, agents, representatives and third parties for Application processing, data processing/storage, customer satisfaction surveys, and for any other purpose as EastWest may deem appropriate, and as may be required by law or regulation. I hereby also authorize the regular submission and disclosure to any and all Credit information service providers, such as, but not limited to, Credit card Association of the Philippines, Credit Information Corporation, BSP, Anti-Money Laundering Council, Banker's Association of the Philippines, of any information, whether positive or negative, relating to my basic Credit data (as defined under No.)

7 9510) with EastWest , as well as any update or correction thereof. The foregoing constitutes my written consent for any such submission and disclosure of information relating to my account/s for the purpose indicated above and under applicable laws, rules and agree to hold EastWest free and harmless from any and all liabilities that may arise from any transfer, disclosure or storage of information relating to my Marketing and Sales Offers I hereby authorize the transfer, disclosure and communication of EastWest of any information relating to my account/s with EastWest as well as all of the documents submitted for this Application to any of its offices, branches, subsidiaries, affiliates, agents, representatives and third parties for product and service offers to be made to me through mail/e-mail/fax/SMS, telephone or through other forms of media.

8 And for any other purpose as EastWest may deem appropriate, unless I expressly notify EastWest otherwise through the following contact information: Customer Service: (02) 888-1700 E-mail: I understand that this Application is subject to EastWest 's Credit policies and procedures. I understand and agree that should my Credit card Application be approved, my card may be delivered activated subject to EastWest s activation policy and guidelines. In case of disapproval of my Application , I understand that EastWest is under no obligation to disclose the reason/s for such disapproval unless required by law or regulation. The accomplished Application form and requirement/s I submitted become the property of EastWest and EastWest is under no obligation to return the said documents to me regardless of the outcome of the Application . By signing below, I agree to abide by the Terms and Conditions Governing the Issuance and Use of EastWest Credit Cards as found in the Bank s website.

9 I also agree to be bound by any and all amendments thereto as well as all laws, rules, regulations and official issuances applicable to EastWest which may hereinafter be issued, as well as such other terms and conditions governing the use of other facilities, benefits, products or services which shall be made available to me. I also agree that EastWest may change any of the provisions in its Terms and Conditions and the fees and charges for its products and/or services from time to time and I agree to be notified of such changes through notice sent to me through any of the following means, at the discretion of EastWest unless I request otherwise: (i) mailed and/or e-mailed notices (sent to my mailing or e-mail addresses indicated in EastWest s records), (ii) notices posted at EastWest s branches or (iii) notices in its website. d. card DeliveryI authorize EastWest or EastWest s official courier to deliver the card to me, to any member of my household, to any of my officemate/co-employee or to any other person that I may authorize through an authorization letter, subject to the existing delivery policy of EastWest .

10 I agree to hold EastWest free and harmless from any claim, loss or liability, whatsoever arising from the delivery of the card to my authorized representative. PRINCIPAL APPLICANT S SIGNATUREBy signing in this section, I agree that this Application form may also serve as my Application for other products of EastWest , such as, but not limited to home loan, auto loan, personal loan, EEL, among others, as I may subsequently request from EastWest or if I am deemed qualified by EastWest . I undertake to submit additional documents as may be required by EastWest for the processing of my Application . I understand that the issuance of additional product/s of EastWest shall be subject to Credit evaluation and the approval shall be subject to the discretion of EastWest and that the availment of additional products is my option.


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