Docstoc

Credit Card Application - DOC

Document Sample
Credit Card Application - DOC Powered By Docstoc
					                                    PERSONAL INFORMATION SHEET
                                                                             MAIN INFORMATION
Cardholder’s Name (First Name, Middle Initial, Last Name)                                         Cell Phone Number [ Optional ]:


                                                                                                  Mother’s Maiden Name: (First Name, Middle Initial, Last Name)

Birth date : ( MM/DD/YYYY )                                                   Spouse First Name:                                              Position:
                                                                              Spouse’s Current Employer:
Gender                                                                        Home Address:

(   ) Male                      (   ) Female
Civil Status:
( ) Single                      (   ) Separated
( ) Married                     (   ) Widowed
Educational Attainment :                                                                         Area Code                                    Home Phone Number:
( ) College                     (   ) Primary School
( ) Secondary School            (   ) Tertiary
                                                                                                 Home Ownership:
                                                                                                 ( ) Owned / Not Mortgaged                    ( ) Living with Parents
                                                                                                 ( ) Owned / Mortgaged                       ( ) Others: __________________
                                                                                                 ( ) Rented
TIN:                                           No. of Dependents


SSS [Optional]
Applicant E-mail Address [ Optional ]:                                                           Years of Stay: (YY/MM)



                          COMPANY INFORMATION                                                                              FINANCES
Employment Status                                                             [ Finances ]
( ) Private ( ) Government          (       ) Self-Employed
                                                              <E) Retired
                                                               (              Applicant’s Gross Annual Income :
Company Name :                                                mp
                                                              loy             Applicant’s Other Income [ Optional ]:

Type of Industry :                                            me              Spouse’s Gross Annual Income :
                                                              ntR
                                                                              Spouse’s Other Income [ Optional ]:
Company Address :
                                                              etir
                                                              ed
                                                              >
                                                                              Accounts in Union Bank : [ Optional ]
                                                                              ( ) None                                              (   ) Savings Only
                                                                              ( ) Both Savings & Checking                           (   ) Checking Only
                                                         Zip Code:


                                                                              Accounts in Other Bank : [ Optional ]
Area            Company Phone Number                     Local No.
Code                                                                          ( ) None                                              (   ) Savings Only
                                                                              ( ) Both Savings& Checking                            (   ) Checking Only

Occupation / Position :                                                                                                CREDIT CARD INFO
                                                                              Credit Card Information
Occupational Group :                                                          Card Name                          Card Number                      Date Issued      Credit Limit
( ) Professional / Executive            (    ) Business Owners                                                                                    (MM & YY)
( ) Staff / Skilled Workers             (    ) Others:
( ) Manager / Semi-Prof.

Length of Service ( YY/MM )


                  ALTERNATIVE BILLING ADDRESS                                                               SUPPLEMENTARY CARD INFO
Alternative Billing Address [ Optional ]                                                            Supplementary Information [ Optional ]

                                                                                                    Supplementary Name:


                                                                                                    Supplementary Birth date:
                                                                                                    Supplementary Relationship to Applicant :



                               REFERENCE                                                                             OTHER INSTRUCTIONS
Reference [ Optional ]                                                        Billing Address:               (   )   Home Address
Reference Name:                                                                                              (   )   Company Address
Reference Address:                                                            Card Delivery Address:         (   )   Home Address
Reference Phone Number:                                                                                      (   )   Company Address
                                                                            FOR BANK’S USE ONLY
                              
Solicitation Code:             Agent Name :   Application Date :
                         -
                      -