Application for BankWest
Business MasterCard
Important: The Privacy statement and consent in section 7 must be read by each person signing this form (including each
cardholder) before they sign the application.
Please complete using BLOCK letters
Section 1 – Applicant Personal Details Section 2 – Business Details
Note: this is the person in whose name the card facility, Full business name
if approved, will be opened and who will be liable for all
transactions made by themselves or any cardholder.
Surname Full name of legal entity carrying on this business
Given name/s Business structure
Sole proprietor Partnership Company
Date of birth Contact number Trust Club or Association
DD/MM/YYYY
Residential address Number of employees Type of industry
Postcode Registered business address
Time at this address
Postcode
Previous address (if less than 2 years at current address) Years trading Business telephone number
Postcode
Business financial details
Time at this address
Current year Previous year 2 years previous
Total assets $ $ $
Current employment status (please tick)
Self Employed Full time Part time Casual Total
liabilities $ $ $
Unemployed Retired Other Shareholder
Are you a permanent Australian resident? funds $ $ $
Yes No
Present employer Years there Total income $ $ $
Earnings
before
Previous employer (if less than 3 years at present) Years there income tax $ $ $
Net profit
after tax $ $ $
Personal Income details (Assets/Liabilities jointly held should
be listed at 50% of their market values) I give authority for my Accountant to be contacted
Gross annual income derived from the borrowing business entity
$ Yes No
Accountant’s name
Other regular annual gross income
(Proof of income may be required) Age of dependants
$ Contact number
Assets
Property/Car/household Goods Savings/Other assets
$ $
Liabilities
Monthly repayments for
property/home loan(s) Current balance
$ $
$ $
Total limit of existing credit/
store cards $
If renting/boarding, and/or paying
family maintenance, what are your
total monthly payments? $
8452B 0408
CIF Key (Bank use only)
Bank of Western Australia Ltd ABN 22 050 494 454 AFSL 236872 Page 1 of 4
Section 3 – Facility Details
Product type (select one)
Low-Rate Large Rewards
Total facility limit required (minimum $5,000/maximum $50,000*)
$
* Please note the limit applied for is subject to the Bank’s credit risk assessment.
Business name on your cards
(Maximum 19 characters, must be in capitals)
Would you also like this name printed across the top of your card?
Yes No
Do you want to participate in the Business Rewards Program?
Yes No
If you wish to nominate a Cardholder to redeem all the points on behalf of the business, details need to be provided below.
If no details are provided, each Cardholder will be entitled to receive Business Reward points in their own name.
Surname Given name/s
Would you like your monthly repayments automatically deducted from your BankWest account on the due date?
Yes No
If ‘Yes’, please provide details below
Account name BSB Account number
Payment amount
(or the minimum
Minimum payment Full closing balance Fixed amount of $ payment, whichever is greater)
Section 4 – Authority and acknowledgement
This section must be signed by the Applicant.
By signing below I:
c
• onfirm that the information contained in this form is in all respects complete and accurate and is not, by omission or otherwise,
misleading;
a
• cknowledge that BankWest will rely on this information when making its decision whether to approve my application;
• consent to the issue of a BankWest Business MasterCard in my name;
c
• onfirm that I understand that if another cardholder is nominated to redeem all the points under the BankWest Business Rewards
Program, I am not eligible to accumulate and redeem any points under that program;
a
• uthorise BankWest to seek any and all further information it may require, and to verify any information I have supplied, by contacting
my accountant and/or my employer and I authorise my accountant and my employer to supply any such information or verification;
c
• onfirm that I have read, understood and agree to the privacy statement and consent in section 7 below and in particular I agree that
BankWest may conduct commercial and consumer credit checks on me.
Signature of applicant Date
/ /
Print name
Section 5 – Business purpose declaration
I declare that the credit to be provided to me by the credit provider is to be applied wholly or predominantly for business or investment
purposes (or for both purposes).
IMPORTANT
You should not sign this declaration unless this loan is wholly or predominantly for business or
investment purposes. By signing this declaration you may lose your protection under the Consumer Credit Code.
Signature of applicant Date
/ /
Print name
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Section 6 – Cardholder Details
This section must be signed by all individuals other than the Applicant to whom the Applicant requests a card is issued.
By signing below I:
• consent to the issue of a BankWest Business MasterCard in my name;
c
• onfirm that I understand that if another cardholder is nominated to redeem all the points under the BankWest Business Rewards
Program, I am not eligible to accumulate and redeem any points under that program; and
• confirm that I have read, understood and agree to the privacy statement and consent in section 7 below.
Cardholder 1
Title (e.g. Mr, Mrs etc) Surname Given name/s
Cardholder 1 signature Date of birth CIF Key (Bank use only) I/D held?
DD/MM/YYYY Yes
Cardholder 2
Title (e.g. Mr, Mrs etc) Surname Given name/s
Cardholder 2 signature Date of birth CIF Key (Bank use only) I/D held?
DD/MM/YYYY Yes
Cardholder 3
Title (e.g. Mr, Mrs etc) Surname Given name/s
Cardholder 3 signature Date of birth CIF Key (Bank use only) I/D held?
DD/MM/YYYY Yes
Section 7 – Privacy statement and consent to use your information
This statement explains how the Bank (“we/us”) collects, uses and discloses personal information.
When you give us personal information about another person, an accountant or employer, you represent that you are authorised to do so
and agree to inform that person who we are, that we will use and disclose that information for the relevant purposes set out in parts B and C
below and that they can access the information we hold about them.
The following Part A applies only to the Applicant and not to any individuals named in section 6 who will be cardholders.
A. Credit checks
You agree to us:
(a) obtaining a report about your commercial activities or commercial credit worthiness from any business which provides information about
the commercial credit worthiness of persons and, if you so agree in section 2, from your accountant;
(b) obtaining from a credit reporting agency a credit report containing information about your personal credit worthiness for the purpose of
assessing this application and for the purpose of assisting in collection of overdue payments in respect of the credit card facility applied
for if it is approved;
(c) giving to and obtaining from any credit provider named in a credit report on you issued by a credit reporting agency, information about
your credit arrangements for the purposes of:
(i) assessing your application or notifying a default by you;
(ii) allowing another credit provider to ascertain the status of your obligations to us, where you are in default with one or more other credit
providers; and
(iii) generally assessing your credit worthiness.
You understand the information exchanged can include any information about your personal and/or commercial credit worthiness, credit
standing, credit history or credit capacity which the Privacy Act allows credit providers to give to or receive from each other.
You understand that the Privacy Act allows us to give a consumer credit reporting agency certain personal information about you and this
credit application including, to the extent applicable:
• permitted information about you which will allow you to be identified;
• cheques drawn by you for $100 or more which have been dishonoured more than once; and
• in specified circumstances, that in our opinion you have committed a serious credit infringement;
• the fact that you have applied for credit and the amount of credit applied for;
• the fact that we are a current credit provider to you;
• payments which have become overdue by more than 60 days and for which collection action has commenced; and
• that credit provided to you by us has been paid or otherwise discharged.
This information may be given before, during or after the provision of credit.
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The following Parts B, C and D apply to every person signing this form, including cardholders.
B. Other purposes for which we collect and use personal information
You agree that personal information about you provided to us at any time in regard to a facility may be held and used by us to assess and
process the application for the facility, establish, provide and administer the facility, execute your instructions and, as relevant, comply with
legislative/regulatory requirements, consider other applications you make, perform administrative tasks including systems development,
testing, credit scoring and training, manage our rights/obligations regarding external payment systems, conduct market/customer
satisfaction research, develop and administer arrangements (e.g. rewards programs) with organisations for the promotion, administration
and use of our and their products/services, develop and identify products/services that may interest you, and tell you about them (unless
you ask us not to). The Applicant consents to our collection of sensitive personal information (e.g. about health or criminal record).
We are obliged to collect certain information about you, and comply with reporting requirements, under the Anti Money Laundering and
Counter Terrorism Financing Act 2006 (Cth) and related regulations and rules.
If you fail to provide any information requested in this form, or any other information we request, we may not accept this application.
C. Other disclosure of personal information
You agree we may collect personal information about you from, and disclose personal information about you to, as appropriate, our
rewards program administrator, merchants and card scheme organisations, debt collecting agencies, our related bodies corporate,
assignees and prospective assignees and their advisers and representatives, our agents, contractors and external advisers and service
providers, organisations for verifying your identity, your agents, advisers, referees, executor, administrator, trustee, guardian or attorney,
law enforcement, regulatory and government bodies, anyone who introduces you to us, your franchisor, payment systems operators,
your and our insurers or prospective insurers and their underwriters and your current and prospective co borrowers. You also agree to
such disclosure to an organisation overseas even if it is not subject to privacy obligations equivalent to those applying to us.
D. Access to your personal information, contacting us and contacting you
You may access most personal information we hold about you. Sometimes that will not be possible, in which case you will be told why.
Unless you ask us, by calling 13 17 18, not to contact you about products and services and not to disclose your information to others
for that purpose, you consent to us contacting you by your home or personal mobile telephone while you hold any facility with us
notwithstanding registration at any time of the relevant telephone number on the Do Not Call Register. Your telephone calls with us may be
monitored and recorded for quality training and verification purposes.
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