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AMERICAN EXPRESS BLUE CREDIT CARD
APPLICATION FORM
• No Annual Card Fee – saving you $35 per year.
• A low 7.99% p.a. Balance Transfer rate until the balance is fully
paid off, when you transfer the outstanding balance from your
other credit card1.
• A competitive 16.49% p.a. interest rate for purchases.
• Discounts and special offers at selected stores.
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IMPORTANT !!
If you already have an American Express personal credit card DO
NOT apply using this application form. Please call American Express,
identify yourself as a Corporate Cardmember calling about the
companion personal card offer.
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Subject to terms and conditions. Fees and charges apply. All interest rates are quoted as an annual percentage
rate. Fees, charges and interest rates are correct as at 24 January 2006, and are subject to change.
1. This promotional rate applies to a balance transfer you request on the attached Credit Card application form only.
Your monthly payments will first repay the balance you have transferred before reducing other amounts, such as
new purchases. Minimum payment requirements apply.
AE5512 D 10/06
THE AMERICAN EXPRESS ® BLUE CREDIT CARD
FOR CORPORATE EMPLOYEES
1. PLEASE COMPLETE THE FOLLOWING APPLICATION USING BLOCK LETTERS 4. PROFESSIONAL DETAILS
To ensure fast processing of your application please complete the following questions.
Professional Status Employed Self Employed Retired
YES I am over 18 years of age YES I earn over $25,000 p.a.
Occupation
Are you an American Express Cardmember? Present Former Never
American Express Card number:
Industry
3 7 - -
Employer/Trading Name
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.
Unit No. Street No.
2. MEMBERSHIP REWARDS™
Street name
If you wish to enrol in Membership Rewards, please select one of the following options:
ASCENT - + OR CHOICES - Suburb
To redeem points for points in frequent flyer To redeem for a wide range of merchandise,
programs plus the benefits of Choices ($80 p.a.) shopping and travel vouchers ($40 p.a.) Phone No. ( )
The annual program fee will appear on your statement. State Postcode
Y Y M M
3. APPLICANT DETAILS Time with business Years Months
Title Mr Mrs Miss Ms Dr Annual Salary Before Tax $ .00
First Name Middle Initial If you are Self Employed please provide accountant details.
Accountant’s Name
Surname
Driver’s Accountant’s Telephone No.
-
Date of birth D D / M M / 19 Y Y Licence No. ✓ I agree for my accountant to provide my details to American Express.
Please provide details of your Current Residential Address (PO Box not acceptable).
5. MOST FREQUENTLY USED CARD (Not American Express)
Unit No. Street No.
Card issuer
Street name Visa MasterCard Diners Store
Current limit $ Current outstanding $
Suburb
6. 7.99% P.A. BALANCE TRANSFER RATE UNTIL THE BALANCE IS FULLY PAID OFF
State Postcode Consolidate your credit cards. Simply transfer the balance^ from your current credit card to
your new Gold Credit Card and pay it off at only 7.99% p.a. until the balance is fully paid off–
Y Y M M subject to our interest rate policy*.
Time at this address Years Months
Residential status Own Mortgage Rent Living with Parents
$
I have enclosed my current credit card statement, please transfer
Card account name
Home Telephone No.
-
Work Telephone No.
-
Card number
Card issuer (not American Express)
Mobile Telephone No.
If you wish to receive product and service offers from us via e-mail, please provide your
e-mail address below. Card type: Bankcard MasterCard Visa Other
E-mail address
7. FREE SUPPLEMENTARY CARD
If less than 5 years at current address, please specify previous address.
Unit No. Street No. Please send a Supplementary Card for the following person.
Title Mr Mrs Miss Ms Dr
Street name How would you like their name to appear on their Card? (Max 20 characters).
Suburb
Relationship to Card Applicant
State Postcode
Name of friend or relative Date of birth D D / M M / 19 Y Y
not living with you
Relationship to you Phone No. ( )
8. PLEASE SIGN
By signing below, I acknowledge that I have read and agreed to the Declaration overleaf.
Office use only Basic Applicant’s Signature
S/C: 6X9849HØØ1
PCT: 1Ø1D8KØØBP PDT: 87Ø/3 ✘ Date D D / M M / 200 Y
A: BØ3BOTH C: RØ1REWD How would you like your name to appear on your Card (Max 20 characters)
AE5512 D 10/06
CP: 699Ø5 BT: US61–S
1
All payments to your credit card account are applied first to any transferred balances (and/or other amounts) which benefit from promotional interest rates. Minimum
payment requirements of the card account apply to balance transfers. There are no interest free days on balance transfers.
Please return your application form to: Fax: 02 9817 7563 or Post: American Express, Reply Paid 5148, Sydney NSW 2001
DECLARATION
IMPORTANT: THE BASIC CARD APPLICANT MUST READ THE INFORMATION AND SIGN OVERLEAF
To American Express Australia Limited (“you” or “American Express”): development and research purposes, and seek from and exchange with such organisations
By signing on the previous page, I request you to issue me with the Card specified in the personal information about me.
application, and I declare that: I also agree that where I have provided you with information about another individual in this
• The information I have given on this application is true and complete and I authorise you application form, I will make sure that the individual is aware of:
to check that information. I acknowledge that you rely on this information to consider this - my supplying their information to you and the purposes why you have collected the information;
application; - their ability to access that information in accordance with the Privacy Act (and advise you
• I am financially solvent and able to pay all my debts as they fall due; if they think the information is inaccurate, incomplete or out-of-date); and
• If this application is approved, I will comply with the Credit Card Conditions and Financial - the contact details of your Privacy Officer.
Table that you will send me with the Card and will pay all fees and charges referred to in
the Financial Table; Transfers from an American Express Australia issued Credit Card
• If I have requested Membership Rewards, I will comply with the Membership Rewards If you hold an existing American Express Australia issued Credit Card and you have requested
Terms and Conditions that you will send to me; us to close your existing Credit Card account, any outstanding balances, including balance
• I understand and agree that I will be liable for all charges on the Basic Credit Card and all transfers on the existing Credit Card will be transferred to the new Credit Card. From the date
Supplementary Credit Card(s). of transfer, these balances will attract the standard interest rate applicable to the new Credit
• You may produce this application or a copy or other reproduction of it as evidence of my Card. Any promotional Balance Transfer interest rate will not apply to these balances.
application for the Card and my agreement to this Declaration. Balance Transfer Conditions
Invitation Important notes on your application
I invite you and your agents and your preferred alliance organisations (including • You may make 12 balance transfers of your outstanding balances with other credit card
insurance companies) to use my personal information for marketing purposes. accounts in a 12-month period up to 100% of the available Credit Limit (Credit Limit less
This includes contacting me by telephone, mail or email to discuss and agree previous balance less all new Charges) on your American Express Credit Card (“Credit Card”).
any purchase of goods or services from an American Express company or your • You must continue to make payments to the designated credit card issuing companies or
products and of any third party providing products jointly marketed with financial institution until you receive a statement confirming that your account has been
American Express. I understand that I can call 1300 366 220 if I want to withdraw credited. We will not be held liable for any overdue payment or interest incurred.
this invitation and remove my name from your marketing lists. • Payments to the credit card issuing companies or financial institutions will normally be
completed within 14 working days from receipt of your request. We will advise you when
Authority to American Express under the Privacy Act: the payment is made.
To assess this application, and if it is approved, to establish and manage the Card account, I • You will not earn Membership Rewards points on the amount transferred.
understand American Express needs to: • Balance transfer promotional interest rate is only valid for the period stipulated in the offer
• Collect personal information about me in this application form and from other sources; and that you have accepted. After the promotional period, you’ll enjoy our prevailing interest
• Obtain my agreement in relation to the handling of my personal information. rate applicable to you.
If I do not provide the information requested or give my agreement overleaf, I understand
American Express may decline my application. Restrictions on transfers
The American Express Privacy Policy Statement sets out policies on management of personal • We reserve the right to refuse any balance transfer requests.
information. In accordance with the Privacy Act, any person may access personal information • We cannot accept transfers from:
about them held by American Express, and advise if they think it is inaccurate, incomplete or - credit cards in foreign currencies;
out of date. - other American Express Cards, except for Cards issued by independent American
To arrange access to personal information, request a copy of the American Express Privacy Express Network Partners;
Policy Statement or enquire generally about privacy matters, write to The Privacy Officer, - cards not issued in Australia; and
American Express, 175 Liverpool Street, GPO Box 1582, Sydney NSW 2001. - a card account that is in overdue or over credit limit status.
• We will not process balance transfer requests:
In this section, ‘personal information’ means information about me, including about my - for amounts less than $100. Transfer amounts will be rounded up to the nearest dollar.
financial circumstances, my credit worthiness, credit history, credit standing, credit capacity, - if any of your Credit Card(s) is/are not in good standing or in overdue or over credit limit status.
my use of the Card and conduct of my account with you. - if at the time of the request, you have drawn the maximum cash advance permitted on
I agree that, subject to the Privacy Act, you and your agents may do the following (and if this your Credit Card account.
application is successful, this agreement continues until such time as any credit provided to • If an increase in your credit limit is required to complete your balance transfer, you request
me is repaid): us to make an increase by up to 50% of your current credit limit (unless a specific increase
• Obtain credit reports about me from credit reporting agencies to assess this application or offer is made by us). Any increase will be subject to a review of your Credit Card account
to collect overdue payments from me, and obtain personal information from a business and we reserve the right to decline your balance transfer application should we decide not
that provides commercial credit worthiness information. to increase your limit. Any increase will be advised in your next statement and will be
• Disclose personal information to credit reporting agencies before, during or providing rounded up to the nearest $100.
credit to me. This includes, but is not limited to: Conditions applying once a balance is transferred
- he fact that I have applied for a Card and the credit limit, and that you are a • We will charge interest on any balance transfer at the applicable annual percentage rate
creditprovider to me; on a daily basis from the date that your balance transfer request is approved until you
- advice about Card payments at least 60 days overdue and which are in collection (and repay the transferred amount in full.
advice that payments are no longer overdue); • If your Credit Card account is not maintained in good standing at anytime, we may adjust
- advice that cheque(s) drawn by me, or Direct Debit requests to my financial institution the interest rate applied to the balance transfer.
account which I have authorised you to make, which are more than $100 have been • All payments to your Credit Card account are applied first to transferred balances,
dishonoured more than once; including transferred balances benefiting from promotional interest rates. Minimum
- your opinion that I do not intend to meet my credit obligations or that I have committed payment requirements of the Credit Card account apply to balance transfers. There are no
some other serious credit infringement; interest free days on balance transfers.
- that credit provided to me has been paid or otherwise discharged. • The Terms and Conditions contained herein form part of the Credit Card Conditions
• Exchange personal information with credit providers named in this application or in a credit governing the use of the Credit Card and shall be interpreted accordingly.
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; ^Your monthly payments will first repay the balance you have transferred before reducing
- notifying other credit providers of a default by me; other amounts such as new purchases.
- exchanging information about my Card account where I am in default with other credit providers; *Our interest rate policy describes how we intend to adjust credit card interest rates based
- your approval process as to any transactions I wish to make with the Card; and on your payment history. Under this policy we intend to maintain this special low rate for the
- your administration of my account. promotional period if you make your minimum payments on time.
• Exchange personal information with any person whose name I give you from time to 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 Contact American Express for Card enquiries on 1300 366 220
named in this application. Monday to Sunday, 8.00am - 7.00pm Sydney time
• If I am in default under my Card account, notify and exchange personal information with GPO Box 1582, Sydney NSW 2001
your collection agent. americanexpress.com.au
• 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 USA or other countries for data processing and servicing.
• 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 American Express Australia Limited (ABN 92 108 952 085)
®Registered Trademark of American Express Company.
on this application or on the Card issued to me for marketing, planning, product AE5512 A 10/06
