Qantas Application for the Qantas American Express Card Form

Qantas Application for the Qantas American Express Card YES I would like the Qantas American Express Premium Card and I earn over 40 000 p*a* 25 000 p*a* S/C 6X42613 1 PDT 827/3 PCT 441MC3 QP BT U5 1-S 699 1 MR Y MR C Q 2QFCLA PCT 541MC4 QP BT U6 1-S 699 1 MR C Q 3QFPRE 1. PLEASE COMPLETE THE FOLLOWING APPLICATION USING BLOCK LETTERS PDT 197/3 PCT 571MC5 QP BT U7 1-S 699 1 MR C Q 4QFULT 4. PROFESSIONAL DETAILS Continued Employer/Trading Name To ensure fast processing of your application please complete the following questions. YES I am over 18 years of age Ultimate Card and I earn over 65 000 p*a* YES I have a good credit history Unit No* YES I am a full time Qantas employee Are you an American Express Cardmember Present Former Never Street No* Street name - Suburb Please tick if you would like to cancel your existing American Express Credit Card and have the balance transferred to your new Card upon approval* Membership Rewards points will not be transferred to your new Qantas American Express Card please redeem these within 30 days. 2. QANTAS FREQUENT FLYER MEMBERSHIP State Postcode Time with business You need to be a Qantas Frequent Flyer to earn Qantas Frequent Flyer points. A joining fee applies. Y Years M M Months Annual Salary Before Tax If you are Self Employed please provide accountant details. Accountant s Name Qantas Frequent Flyer Membership number To apply visit qantas. com/frequentflyer 3. APPLICANT DETAILS please enter your name as shown on your passport Title Mr First Name Mrs Miss Ms Accountant s Telephone No* I agree for my accountant to provide my details to American Express. Dr Middle Initial 5. MOST FREQUENTLY USED CARD Not American Express Card issuer Surname Visa Date of birth Current limit Driver s Licence No* D D / M M / 19 Y Y Please provide details of your Current Residential Address PO Box not acceptable. MasterCard Diners Store Current outstanding 6. 5. 99 P. A. BALANCE FOLLOWING APPLICATION BALANCE IS LETTERS Consolidate your credit cards. Simply transfer the balance from your current credit card to your new Qantas American Express Card and pay it off at only 5. 99 p*a* for the life of the balance subject to our interest rate policy. I have enclosed my current credit card statement please transfer Account holder name Time at this address Residential status Own Mortgage Card number Rent Card issuer not American Express Living with Parents David Jones Store Card Home Telephone No* Card type Work Telephone No* Coles Myer Card 1. SUPPLEMENTARY CARD FOLLOWING APPLICATION USING BLOCK LETTERS Bankcard Please send a Supplementary Card for the following person* Mobile Telephone No* If you wish to receive product and service offers from us via e-mail please provide your e-mail address below. Online and not receive your statement by mail* How would you like their name to appear on their Card Max 20 characters. Relationship to Card Applicant If less than 5 years at current address please specify previous address. SIGN By signing below I acknowledge that I have read and agreed to the Declaration overleaf* Basic Applicant s Signature Professional Status Occupation Employed Self Employed Retired Date D D / M M / 200 Y Industry Please return your application form to American Express Reply Paid 5148 Sydney NSW 2001 or FAX to 02 9817 7563 AE4332 Qantas App* 04/06 DECLARATION IMPORTANT THE BASIC CARD APPLICANT MUST READ THE INFORMATION AND SIGN OVERLEAF By signing on the previous page I request you to issue me with the Card specified in the application and I declare that I understand that this is a Card offered issued and administered by American Express Australia Limited The information I have given on this application is true and complete and I authorise you to check that information* I acknowledge that you rely on this information to consider this application I am financially solvent and able to pay all my debts as they fall due If this application is approved I will comply with the Credit Card Conditions Financial Table and the Points Conditions that you will send me with the Card and will pay all fees and charges referred to in the Financial Table Supplementary Card s and You may produce this application or a copy or other reproduction of it as evidence of my application for the Card and my agreement to this Declaration* Invitation I invite you your agents Qantas Airways Limited and your preferred alliance organisations including insurance companies to use my personal information for marketing purposes. This includes contacting me by telephone mail or email to discuss and agree any purchase of goods or services from an any third party providing products jointly marketed with American Express. I remove my name from your marketing lists. Authority to American Express under the Privacy Act To assess this application and if it is approved to establish and manage the Card account I understand American Express needs to Collect personal information about me in this application form and from other sources and Obtain my agreement in relation to the handling of my personal information* If I do not provide the information requested or give my agreement overleaf I understand The American Express Privacy Policy Statement sets out policies on management of personal information* In accordance with the Privacy Act any person may access inaccurate incomplete or out of date. To arrange access to personal information request a copy of the American Express Privacy Policy Statement or enquire generally about privacy matters write to The Privacy Officer American Express 175 Liverpool Street GPO Box 1582 Sydney NSW 2001. In this section personal information means information about me including about my financial circumstances my credit worthiness credit history credit standing credit capacity my use of the Card and conduct of my account with you. I agree that subject to the Privacy Act you and your agents may do the following and if provided to me is repaid Obtain credit reports about me from credit reporting agencies to assess this application or to collect overdue payments from me and obtain personal information from a business that provides commercial credit worthiness information* Disclose personal information to credit reporting agencies before during or providing credit to me. This includes but is not limited to the fact that I have applied for a Card and the credit limit and that you are a credit advice about Card payments at least 60 days overdue and which are in collection and advice that payments are no longer overdue advice that cheque s drawn by me or Direct Debit requests to my financial institution account which I have authorised you to make which are more than 100 have been dishonoured more than once your opinion that I do not intend to meet my credit obligations or that I have committed some other serious credit infringement that credit provided to me has been paid or otherwise discharged* Exchange personal information with credit providers named in this application or in a credit report issued by a credit reporting agency. This is for purposes including but not limited to assessing my credit worthiness this application and any subsequent application by me for credit notifying other credit providers of a default by me exchanging information about my Card account where I am in default with other credit providers your approval process as to any transactions I wish to make with the Card and your administration of my account. Time. This includes for example for the purpose of confirming my employment and income details with any employer landlord/ mortgagee accountant financial adviser or tax agent named in this application* If I am in default under my Card account notify and exchange personal information with your collection agent. Transfer personal information confidentially to your related companies and other you subject to appropriate conditions of confidentiality. This includes transferring Monitor and record my telephone conversations with you from time to time in order to train your staff and control your service quality. Provide personal information to any organisation whose name logo or trademark appears on this application or on the Card issued to me for marketing planning product development and research purposes and seek from and exchange with such I also agree that where I have provided you with information about another individual in my supplying their information to you and the purposes why you have collected the their ability to access that information in accordance with the Privacy Act and advise you if they think the information is inaccurate incomplete or out-of-date and the contact details of your Privacy Officer. Transfers from an American Express Australia issued Credit Card If you hold an existing American Express Australia issued Credit Card and you have requested us to close your existing Credit Card account any outstanding balances including balance transfers on the existing Credit Card will be transferred to the new Credit Card. From the date of transfer these balances will attract the standard interest rate applicable to the new Credit Card. Any promotional Balance Transfer interest rate will not apply to these balances. Balance Transfer Conditions Important notes on your application You may make 12 balance transfers of your outstanding balances with other credit card accounts in a 12 month period up to 100 of the available Credit Limit Credit Limit less previous balance less all new Charges on your American Express Credit Card Credit Card. You must continue to make payments to the designated credit card issuing companies or banks until you receive a statement confirming that your account has been credited* We will not be held liable for any overdue payment or interest incurred* Payments to the credit card issuing companies or banks will normally be completed within 14 working days from receipt of your request. We will advise you when the payment is made. You will not earn Qantas Frequent Flyer points on the amount transferred* accepted* After the promotional period you ll enjoy our prevailing annual percentage rate applicable to you. Restrictions on transfers We reserve the right to refuse any balance transfer requests including requests received after any expiration date on this application form* We cannot accept transfers from a* credit cards in foreign currencies b. Other American Express Cards except for Cards issued by independent American Express Network Partners c* cards not issued in Australia d. A card account that is in overdue or over credit limit status and e. business cards non-credit card accounts such as overdraft savings and personal loan accounts. We will not process balance transfer requests a* for amounts less than 100. Transfer amounts will be rounded up to the nearest dollar b. If any of your Credit Card s is/are not in good standing or in overdue or over credit limit status c* if at the time of the request you have drawn the maximum Cash Advance permitted on your Credit Card Account d. If you have already made 12 balance transfers in a 12 month period. Conditions applying once a balance is transferred We will charge interest on any balance transferred at the applicable annual percentage rate on a daily basis from the date that your balance transfer request is approved until you repay the transferred amount in full* If your Credit Card Account is not maintained in good standing at anytime we may adjust the interest rate applied to the balance transfer. If an increase in your current credit limit is required to complete your balance transfer you request us to make an increase by up to 50 of your current credit limit unless a specific increase offer is made by us. Any increase will be subject to a review of your Account and we reserve the right to decline your balance transfer application should we decide not to increase your limit* Any increase will be advised in your statement and will be rounded up to the nearest 100. All payments to your credit card account are applied first to transferred balances including transferred balances benefiting from promotional interest rates. This will result in the balances subject to a lower interest rate being paid off first. Minimum payment requirements of the card account apply to balance transfers. There are no interest free days on balance transfers. The Terms and Conditions contained herein form part of the Credit Card Conditions governing the use of the Credit Card and shall be interpreted accordingly. Our interest rate policy describes how we intend to adjust credit card interest rates based on your payment history. Under this policy we intend to maintain this special low rate for the promotional period if you make your minimum payments on time. Contact American Express for Card enquiries Qantas American Express Card 1300 727 065 Monday to Friday 8. 00am-7. 00pm Sydney time Registered Trademark of American Express Company AE4332 QANTAS STAFF 04/06.