Credit Card Form Block Letters

I have enclosed my current credit card statement please transfer Cardholder s name Credit Card number Card Issuer not American Express Name of landlord/mortgage lender Card type Bankcard UZ 1-S Landlord/lender phone No. 6. SUPPLEMENTARY CARD MUST BE OVER 18 YEARS OF AGE Please send a Supplementary Card for Max 20 characters. 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. 99 p.a. for up to six months subject to our interest rate policy. If less than 5 years at current address please specify previous address. I have enclosed my current credit card statement please transfer Cardholder s name Credit Card number Card Issuer not American Express Name of landlord/mortgage lender Card type Bankcard UZ 1-S Landlord/lender phone No. 6. 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. MOST FREQUENTLY USED CARD NOT AMERICAN EXPRESS Suburb State Time at this address Residential status Own Mortgage Postcode Visa Rent Card Issuer Living with Parents Current Credit Limit MasterCard Diners Store Current Outstanding Home phone No. 5. 6. 99 P. A. BALANCE TRANSFER RATE FOR UP TO SIX MONTHS Mobile phone No. If you wish to receive product and service offers from us via e-mail please provide your e-mail address below. 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 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 and your agents 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 marketed with American Express. PROFESSIONAL DETAILS CONTINUED Please ensure you can say YES to initial approval criteria YES I am over 18 years of age YES I earn over 40 000 p.a. YES I have a regular source of income YES I have a good credit history Title Mr First Name Mrs Miss Ms Time in current job Y Y M M Years Months Annual Salary Before Tax Dr If Current employer is less than 3 years specify previous employer Middle Initial Previous employer Surname - Telephone No. Date of birth D D / M M / 19 Y Y Driver s Licence No. Time in previous job Are you an American Express Cardmember American Express Card number Present Former Never If you are self-employed. I authorise my accountant to provide details to American Express.