Qantas American Express Supplementary Business Credit Card Form

Qantas American Express Supplementary Business Credit Card BASIC BUSINESS CARDMEMBER DETAILS Name of Basic Cardmember D D M M Y Y Date of Birth You must be over 18. American Express Business Card Number Date of Signature Signature of Basic Business Card Applicant By signing below I acknowledge that I have read and agreed to the Declaration overleaf with respect to the Supplementary Applicant. SUPPLEMENTARY BUSINESS CREDIT CARD APPLICANT DETAILS 1 Please send a Supplementary Business Credit Card for the following person* Must be over 18 years of age Please provide the Supplementary Applicant s name as you would like it to appear on their new Card. You can use a maximum of 20 characters including spaces Please spell last name in full Title Mr Mrs Miss Ms Dr First Name Middle Name Surname Their current residential address Please do not provide a PO box no. Unit No* House No* Street Name Suburb Postcode State If the Supplementary Applicant is an existing American Express Cardmember please provide their Card number Mobile Telephone No* and accept liability for all Card Charges. CNTY 872 FEE 2 PDT 857/4 Date PCT 731THG GP S/C L72 1VA 1 Office use only AMXRED1646 DECLARATION Important The Business the Basic Business Card Applicant and the Supplementary Business Card Applicant must read the information and sign overleaf* Invitation by each Basic and Supplementary Business Credit Card Applicant to you We invite you and your agents and your preferred alliance organisations including insurance companies to use our personal information for marketing purposes. This includes contacting us by telephone mail or email to discuss and agree any purchase of goods or services from jointly marketed with American Express. We understand that we can call 1300 366 220 if we want to withdraw this invitation and remove our names from your marketing lists or to cease receiving telemarketing calls. This invitation will remain in place until I withdraw it or until I cease being an American Express Cardmember. 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/we understand American Express needs to Collect personal information about me/us in this application form and from other sources and Obtain my/our agreement in relation to the handling of my/our personal information* If I/we do not provide the information requested or give my/our agreement overleaf I/we understand American Express may decline my/our application* The American Express Privacy Policy Statement sets out policies on management of personal information* In accordance with the Privacy Act any person may access personal information about them held by American Express and advise if they think it is 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 In this section personal information means information about me/us including about my/our financial circumstances my/our creditworthiness credit history credit standing credit capacity my/our use of the Card and conduct of my/our account with you. I/We agree that subject to the Privacy Act you and your agents may do the following and if this application is successful this agreement continues until such time as any credit provided to me/us is repaid Obtain credit reports about me/us from credit reporting agencies to assess this application or to collect overdue payments from me/us and obtain personal information from a business that provides commercial creditworthiness information* Disclose personal information to credit reporting agencies before during or providing credit to me/us. This includes but is not limited to the fact that I/we have applied for a Card and the credit limit and that you are a credit provider to me/us 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/us or Direct Debit requests to my/our financial institution account which I/we have authorised you to make which are more than 100 have been dishonoured more than once your opinion that I/we do not intend to meet my/our credit obligations or that I/we have committed some other serious credit infringement that credit provided to me/us has been paid or otherwise discharged and any other use in conjunction with my account as permitted under the Privacy Act Exchange personal information about you including information from credit reports with any person considering whether to act as a guarantor in relation to this and future applications by you for credit. Report issued by a credit reporting agency. This is for purposes including but not limited to assessing my/our creditworthiness this application and any subsequent application by me/us for credit notifying other credit providers of a default by me/us exchanging information about my/our Card account where I/we am/are in default with other credit providers your approval process as to any transactions I/we wish to make with the Card and your administration of my/our account. Time. This includes for example for the purpose of confirming my/our employment and income details with any employer landlord/mortgagee accountant financial adviser or tax agent named in this application* If I/we am in default under my/our Card account notify and exchange personal information with your collection agent. Transfer personal information confidentially to your related companies and other organisations which issue or service American Express Cards or provide services to you subject to appropriate conditions of confidentiality. This includes transferring personal information to the USA or other countries for data processing and servicing. Monitor and record my/our 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 and research purposes and seek from and exchange with such organisations personal information about me/us. I/We also agree that where I/we have provided you with information about another individual in this application form I/we will make sure that the individual has seen understood and agreed to my/our supplying their personal information to you and the purposes for which you have collected the information 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. Online Statements and Account Information By providing your email address you understand that you have agreed to receive Electronic notification of online statements and may also include product updates and other important information related to your account. You will be notified at your nominated email address when your statement is available to view. By agreeing to receive statements online you understand you will not receive your statements by mail* You can elect to change this nomination or your email address at any time by notifying us on 1300 363 687. Please allow up to 21 working days for application processing* Contact American Express for Card enquiries on 1300 366 220 8am 7pm Sydney time 7 days. GPO Box 1582 Sydney NSW 2001 Registered Trademark of American Express Company. By signing on the previous page the Business the Basic Business Card Applicant and the Cards to each Basic Business Credit Card Applicant and Supplementary Business Credit Card Applicant specified in the application and we each declare and undertake to you that The information given on the application is true and complete. We authorise you to check that information and authorise our accountants to provide and verify to you any further details requested concerning the information* We acknowledge that you rely on all such information and further details to consider the application Each of us is financially solvent and able to pay our respective debts when due If the application is approved we will comply with the Business Credit Card Conditions Financial Table Insurance Conditions and Qantas Frequent Flyer points Conditions that you will send to the Basic Business Credit Card Applicant with their Card receipt of which will be taken to constitute receipt also by the Business and to the Supplementary Business Credit Card Applicant and we will jointly and severally be liable to pay all fees charges and other amounts under the Business Credit Card Conditions and this Declaration If the Business is a partnership or trust the Authorised Signatory who signed this application form is duly authorised to complete this application and has done so with the knowledge and consent of the Business partners/trust beneficiaries We understand that the Business and the Basic Business Credit Card Applicant will be jointly and severally liable for all charges incurred with each Basic Business Credit Card be the responsibility of the Business the Basic Business Credit Card Applicant and the the account of the Business and the Business Credit Card Applicant You may produce this application or a copy or other reproduction of it as evidence of our application for the Card and our agreement to this Declaration* Note The Business and the Basic Business Credit Card Applicant will be jointly and severally liable to American Express for all obligations incurred on each Business Credit Card issued*.