REQUEST FOR ISSUANCE OF REVOLVING CREDIT CARD

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					  REQUEST FOR ISSUANCE OF REVOLVING CREDIT CARD


                                                                                                                                  Form 1
                               Do you want a revolving card?                              Yes           No

                               Do you want a DinaCard revolving card?                     Yes           No

                         Revolving percentage – minimum monthly repayments: __________ %

                       Please specify the way your name and surname will be written on the card:



                                           BASIC INFORMATION ON THE APPLICANT

Name, father’s name and surname: ______________________________________________________________________________

Mother’s maiden name: _______________________________________________________________________________

Date of birth              /           /                                        Place of birth ________________________________

National ID no.                                                                                  Sex:        male        female

Personal ID card number ______________ issued by the Ministry of Internal Affairs ______________________ Citizenship
________________________

Address from personal ID card_________________________________________ no.____, floor ____, apartment ____.

Place ________________________, ZIP code ____________, Municipality __________________________

Residence address _________________________________________ no.____, floor ____, apartment ____.

Place ________________________, ZIP code ____________, Municipality __________________________

I’ve lived on this address since ___/___/______ as owner/co-owner                   member of household              lessee

Phone number: home 0               /          -                 mobile      0         /           -

E-mail: _______________________________________ Occupaton: ____________________________________

Degree of expert education                                                                Marital status
Without primary school education            Higher-level expert education                 Married             Single
Primary school education                    High-level expert education                   Widow/er            Divorced
                        rd
Craft school education 3 degree             Master
High school education                       Doctor

Number of members of household ___, number of employed members ___, number of supported members ___ out of which
the number of children is ___.
Godišta dece _______________________________________________________________________________________

Data on the employed members of family household:
1. _____________________________, employed in ___________________________, salary in RSD ________________.
2. _____________________________, employed in ___________________________, salary in RSD ________________.
Additional income sources from: ________________________________________ in the amount of __________________.

                                            DATA ON PREVIOUS CREDIT DEBITING

Do you have liabilities on the basis of credits          Yes     No         Bank__________________ Amount ____________

Do you have liabilities as co-debtor                    Yes      No         Bank__________________ Amount ____________

Do you have liabilities as guarantor                     Yes     No         Bank__________________ Amount ___________

Do you have liabilities on the basis of leasing contract Yes      No        Bank__________________ Amount ____________
 REQUEST FOR ISSUANCE OF REVOLVING CREDIT CARD




Transfer of income to the current account in KBC Banka

        Yes, I receive personal                  I will transfer the payment              I will not transfer the payment
        income in the Bank                       of personal income in the Bank           of personal income in the Bank

Name of the bank in which you have open current account: ___________________________________________________

Have you previously used the KBC Banka services

        Yes, the following services:
                Current account
                Crerdit use
                Use of credit cards
                ____________________________

        No

I learnt about the products and services of KBC Banka through:

        Media                                               Recommendation of other client          Telemarketing
        Recommendation of the employee in the Bank          Direct mail                             Fair
        Through my employer                                 Internet                                other


                Do you want to use HomeBanking services?                 Yes              No

                Do you want to use SMS services?                         Yes              No


                                  AGREEMENT AND REQUEST TO CREDIT COMMITTEE

The credit applicant agrees that KBC Banka ad Beograd, for the purpose of making the decision on granting the credit, can
obtain the Report from the Credit Committee with the data on the applicant’s history of using the services in other banks up
to date. KBC Banka ad Beograd can use the Report obtained on the basis of this agreement only for the purpose of making
the decision on granting the credit for which the Request was submitted.
At the same time, the credit applicant agrees that KBC Banka ad Beograd can submit to the Credit Committee the data on
his use of all bank services in the Bank and eventual non-adhering to the contracted provisions in the use of these services.

Under material and criminal liability I hereby confirm that the given data are correct.

Signature of the applicant                                                          Stamp and signature of the Bank officer

______________________                                                                    ___________________________

Date ___/___/______
 REQUEST FOR ISSUANCE OF REVOLVING CREDIT CARD



                                                                                                                      Form 2
                                  CONFIRMATION ON EMPLOYMENT AND SALARY AMOUNT

We confirm that _____________________________ national ID no. ________________ from _______________________
With address _____________________________ and personal ID card no. _____________ issued by the Ministry of
Internal       Affairs   ____________________,        occupation     __________________________,            employed        in
__________________________________ (name of Employer) for indefinite period of time, starting from ___/___/______,
on the position of _____________________________, office phone number __________________.

In the moment of issuance of this Confirmation _______________________________________ has realized total years of
service of ________________________.


Average salary of the employee in the last 3 months is:
________________ gross RSD, ________________ net RSD.

From the salary of the person hereby named, the monthly amount of ________________ RSD is extracted for the purpose
of ________________________.


We hereby agree that this confirmation can be used for the checking of paid taxes and contributions.

This confirmation is issued for purpose of submitting the credit card request in KBC Banka ad Beograd, Head Office,
Požeška 65b, and cannot be used for other purposes.

                                               DATA ON THE COMPANY

Company name ____________________________________________________________________________________

Type of ownership

           State                                          Public                             Multinational company
           Private entrepreneur                           Local private company


Place, Zip code and address of company__________________________________________________________________
Phone number of company _____________________________ Registration number of company ____________________
Company account ___________________________________________________________________________________
Contact person in the Salary Calculation Unit ______________________________________________________________
Phone number ______________________________________________________________________________________

This confirmation is issued under the full material and criminal liability.


In ____________________, on ___/___/______.



____________________________                                                            ____________________________
                                                           Stamp
____________________________                                                            ____________________________
(name, surname, function, signature)                                                     (name, surname, function, signature)
 REQUEST FOR ISSUANCE OF REVOLVING CREDIT CARD


                                                                                                                             Form 3
Company stamp _______________________
Decision number _______________________
Date _________________________________




On the request of the employee ______________________________________ from _________________________,
residence address in _________________________________St, employed in ___________________________________
on the position of ___________________________, that the administrative ban to be placed on his salary in favour of KBC
Banka ad Beograd for purpose of securing the debt repayment on the basis of credit card expenses, interests and
accompanying costs, on the basis of the Contract no. ____________________________ dated ___/___/______, we pass
the following:



                                            DECISION ON ADMINISTRATIVE BAN

The administrative ban is hereby placed on the salary of employee _________________________________ in favour of
KBC Banka ad Beograd, Branch____________________, for purpose of securing the debt repayment on the basis of credit
card expenses, interests and accompanying costs, on the basis of the Contract no. __________________________ dated
___ /___ /_____.


On the basis of this administrative ban, the amount of __________ RSD shall be extracted from the personal income of the
employee in favour of KBC BANKA A.D. Beograd, for purpose of debt repayment on the basis of credit card expenses, and
up to the repayment of the total amount of approved limit in the amount of RSD ______________ and shall be paid in
favour of the account in KBC Banka ad Beograd no. ____________________________________ .

We are hereby obligated not to remove this ban until we receive written report from KBC BANKA A.D. Beograd that the debit
is fully repayed.

In case of cancellation of labour relation of the employee in this company and statutory changes in the company, we are
obligated to inform you and transfer the administrative ban to the Employer where the hereby named employee establishes
labour relation.

By submitting of this decision we are hereby obligated to fully execute all the liabilities stipulated in it, under the full material
and criminal liability and in accordance with the regulation in force.

This confirmation is issued by the authorized persons, under the full material and criminal liability.




_______________________________                                                           _______________________________

Signature of the head of Accounting Unit                                                       Signature of the authorized person


                                                              Stamp
REQUEST FOR ISSUANCE OF REVOLVING CREDIT CARD



                                                                                                                             Form 3
Company stamp _______________________
Decision number _______________________
Date _________________________________




On the request of the employee ______________________________________ from _________________________,
residence address in _________________________________St, employed in ___________________________________
on the position of ___________________________, that the administrative ban to be placed on his salary in favour of KBC
Banka ad Beograd for purpose of securing the debt repayment on the basis of credit card expenses, interests and
accompanying costs, on the basis of the Contract no. ____________________________ dated ___/___/______, we pass
the following:



                                            DECISION ON ADMINISTRATIVE BAN

The administrative ban is hereby placed on the salary of employee _________________________________ in favour of
KBC Banka ad Beograd, Branch____________________, for purpose of securing the debt repayment on the basis of credit
card expenses, interests and accompanying costs, on the basis of the Contract no. __________________________ dated
___ /___ /_____.


On the basis of this administrative ban, the amount of __________ RSD shall be extracted from the personal income of the
employee in favour of KBC BANKA A.D. Beograd, for purpose of debt repayment on the basis of credit card expenses, and
up to the repayment of the total amount of approved limit in the amount of RSD ______________ and shall be paid in
favour of the account in KBC Banka ad Beograd no. ____________________________________ .

We are hereby obligated not to remove this ban until we receive written report from KBC BANKA A.D. Beograd that the debit
is fully repayed.

In case of cancellation of labour relation of the employee in this company and statutory changes in the company, we are
obligated to inform you and transfer the administrative ban to the Employer where the hereby named employee establishes
labour relation.

By submitting of this decision we are hereby obligated to fully execute all the liabilities stipulated in it, under the full material
and criminal liability and in accordance with the regulation in force.

This confirmation is issued by the authorized persons, under the full material and criminal liability.




_______________________________                                                           _______________________________

Signature of the head of Accounting Unit                                                       Signature of the authorized person


                                                              Stamp

				
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