I am applying for: Classic
Gold Platinum
Note: You may receive a different card type depending on our credit evaluation
CREDIT CARD APPLICATION
Photocopy of Valid ID with Photo
(for principal and supplementary)
1. Applicant must be between 21 to 65 years old for principal cardholder and at least 18 years old for
a. Passport
Supplementary.
b. Driver’s License
2. Filipino resident or local resident foreigner.
c. Company ID
3. Minimum annual income requirement is P120,000 for Classic MasterCard, P455,000 for Gold MasterCard and d. TIN ID
P1,200,000 for Platinum MasterCard.
e. GSIS E-Card
4. Must have an office or business landline and a residence landline or post paid mobile phone.
f. SSS ID
5. Home or office address must be located within 15 km radius of a Bank of Commerce branch.
g. Other Gov’t Issued IDs
DOCUMENTS REQUIRED
APPLICATION REQUIREMENTS
EMPLOYED
SELF-EMPLOYED
Latest Income Tax Return (BIR Form 2316) (Mandatory)
3 months payslip preceding the date of application
Additional documents that may be required:
Certificate of Employment and Income
Copy of last 2 months credit card billing statements
(must be a Principal cardholder of good standing in the last 12 months)
Letter of Appointment
Latest Income Tax Return with Bank / BIR Stamp (Mandatory)
Copy of Business Registration with SEC or DTI
Audited Financial Statement for the last two (2) years with latest ITR
with BIR Stamp or Bank Stamp
Bank Statement for the last three (3) months (Optional)
PERSONAL INFORMATION
Title:
Last Name:
First Name:
Mr.
Mrs.
Ms.
Name to appear on the card (Limited to 19 characters including spaces)
Birthdate (mm/dd/yyyy):
Place of Birth:
Civil Status:
Gender
Male
Single
Female
Married
Home Address: (PRESENT)
Bldg. / House No.
Permanent Address:
Separated
Widowed
Citizenship:
Middle Name:
Mother’s Maiden Name:
Home Ownership:
Owned
Mortgaged Rented
Used Free Number of Dependents:
Education:
Grade School
Some College
Company Provided
Others
TIN
Street/Brgy.
District/Town
City/Province
High School
College
Graduate School
________________________
SSS ________________________
Zip Code
E-Mail Address:
I authorize the Bank to send updates and
promotional information using my email address
Bldg. / House No.
Street/Brgy.
Years of Stay:
Home Phone Number:
District/Town
City/Province
Mobile Number:
Reference Person/s:
Postpaid
Zip Code
Prepaid
Contact Number/s:
as indicated herein.
Yes
ID Submitted:
Type:
No:
No
Relationship:
Address:
WORK AND FINANCES
Name of Office / Business:
Employed
Self-Employed
Office / Business Phone Number: Fax Number:
Office / Business Address:
Office / Business E-Mail Address:
Years w/ Present Employer: No. of Years Working:
Industry / Business Type:
Real Estate
Banking and Finance
Education
Manufacturing
Insurance Mining
Retail / Wholesale Utilities
Entertainment
Agriculture / Fishery Transport / Shipping BPO
Hotel / Restaurant IT / Telco Others _______
Government
Construction
Medical
Travel Related Other Credit Card:
Deposit Account Maintained with Bank of Commerce Other Credit Card:
Issuing Bank:
Year Issued:
Issuing Bank:
Year Issued:
Branch:
Type of Account:
Card Number:
Card Number:
Deposit Balance:
Credit Limit:
Credit Limit:
Do you own a car?
Gross Monthly Income:
Source of Funds:
Salary
Pension
Interest
Yes, how many?_____ No
Owned
Mortgaged Company Leased
Business Remittance
Others:_______
Employment Type:
Private
Government
Self-Employed
Variable / Commission Based
Retired
Others
Position:
Senior Management Executive
Non-Officer
Teaching / Educational Others:______
ZIP Code:
Director
Supervisor
Professional
Sales
SPOUSE INFORMATION
Title:
Mr.
Mrs.
Ms.
Birthdate (mm/dd/yyyy):
Name of Office / Business
Last Name:
Citizenship:
First Name:
Email Address:
Office Address:
Middle Name:
Mobile Number:
Postpaid
Prepaid
ZIP Code:
Office Phone No.:
Employed
Self-Employed
Years w/ Present
Employer:
SUPPLEMENTARY CARDHOLDER INFORMATION (applicant must be at least 18 years old)
SUPPLEMENTARY CARD 1
Last Name:
First Name:
Middle Name:
SUPPLEMENTARY CARD 2
Last Name:
First Name:
Middle Name:
Name to appear on the card (Limited to 19 characters including spaces)
Name to appear on the card (Limited to 19 characters including spaces)
Relationship to Applicant
Relationship to Applicant
Home Phone Number
Birthdate (mm/dd/yyyy):
Office Phone Number
Credit Limit to be Assigned
P
Mobile Number
Home Phone Number
Credit Limit to be Assigned
Birthdate (mm/dd/yyyy):
Office Phone Number
Mobile Number
P
Sub-limit assignment begins at a minimum of P5,000 and increments of P5,000.The sub-limit given to the Supplementary cardholder is part of the
Principal cardholder’s credit limit. The maximum spending limit of the Supplementary cardholder shall not exceed the approved credit limit of the
Principal cardholder. If no sub-limit is indicated, the default will be 100% of Principal cardholder’s credit limit.
Credit Card Application Form Rev011 FA.indd 1
12/12/14 3:58 pm
Delivery Instructions
MODE OF PAYMENT
Deliver my Statement to:
Home
Office
Your Credit Card will be delivered
to Billing Address
Pay to Bank
Auto Debit my Account
Mode of Payment
If Account Number is not provided, payment mode is “Pay to Bank”
Auto Debit my Bank of Commerce Peso Account No:
Auto Debit my Bank of Commerce Dollar Account No:
Full Amount Due
Full Amount Due
Minimum Amount Due
Minimum Amount Due
If no selection is made, the default will be “Minimum Amount Due”
CREDIT CARD APPLICATION FORM TERMS AND CONDITIONS
By signing this application or supplementary application below, I signify that I am applying for a Bank of Commerce credit card. I hereby acknowledge and agree that by applying, or by calling to request for
card activation, or by signing or using my Bank of Commerce credit card, I signify my understanding of, and my agreement to be governed by, the Terms and Condition for Bank of Commerce credit card. I
warrant that all information given in this application form is true and correct. I authorize you to verify the information in this application and to receive and exchange information about me, including requesting
reports from consumer credit reporting or reference schemes. l also authorize you and your affiliates to contact these sources for information anytime, to use information about me, including information from
this application and from consumer credit reports, for marketing and administrative purposes and to share such information with each other. I further authorize and consent to Bank of Commerce to be the
recipient of these information.
I further authorize Bank of Commerce to conduct random verification with the BIR, any other appropriate government agencies or third parties to establish authenticity of the information declared and
documents submitted (e.g. bank statements, certificate of employment, payslips and ITR) for processing and evaluating my application and hereby further waive confidentiality rules and laws as applicable.
I hereby agree to waive my rights regarding the confidentiality of deposits under R.A. 1405, as amended, as the disclosure is necessary and relevant in the evaluation of my application for the Bank of
Commerce credit card and to ensure a successful debit under an auto debit payment arrangement with my Bank of Commerce bank account should I decide to avail of the auto debit payment facility for my
Bank of Commerce credit card. l hold myself liable for all obligations and liabilities incurred with the use of the Bank of Commerce credit card and supplementary card/s.
In the event my application for Bank of Commerce credit card is disapproved, Bank of Commerce is under no obligation to provide me with the reason for such a decision. I understand that the application
form and documents submitted to the Bank of Commerce will not be returned for whatever reason.
I agree and authorize the Bank to send any form of communication associated with its products to me, unless I expressly notify the Bank otherwise.
I hereby undertake to inform Bank of Commerce immediately of any change in any information/declaration contained herein or in the documents/papers submitted by me.
I further understand that the Bank of Commerce reserves the right to cancel the Bank of Commerce credit card without prior notice if it is later determined that the information being certified by me is false.
Upon demand by Bank of Commerce for payment of the card purchases, any money, deposit or other property of any kind whatsoever to the credit of my account in the books of Bank of Commerce in transit
or in its possession, may without notice, be applied at its sole discretion, to the full or partial payment of Bank of Commerce credit card purchases. I irrevocably authorize Bank of Commerce, without necessity
of prior notice, to apply monies, deposits or other property of any kind whatsoever, to the payment of my indebtedness.
Principal Applicant’s Signature
Supplementary Applicant’s Signature (1)
Annual Membership Fee
Principal Card
Supplementary Card
Finance Charge / Effective
Interest Rate per Month
Supplementary Applicant’s Signature (2)
FEES AND CHARGES
CLASSIC
GOLD
FREE for the 1st Year FREE for the 1st Year
Php1,200
Php2,500
Php600
Php1,250
3.25%
3.25%
PLATINUM
WAIVED
WAIVED
WAIVED
2.95%
Late Payment Fee
5% of minimum amount due or Php500
whichever is higher
5% of minimum
amount due or Php500
whichever is higher;
or 5% of minimum
amount due or $10
whichever is higher
Cash Advance Fee & Interest
5% of the amount
5% of the amount
withdrawn or
withdrawn or Php300
Php300 whichever
whichever is higher
is higher plus 3.25%
plus 3.25% Interest
Interest Charge
Charge which will be
which will be
computed from the
computed from the
date of transaction
date of transaction
until full settlement
until full settlement
of the cash advance
of the cash advance
amount.
amount.
5% of the amount
withdrawn or Php300
whichever is higher
plus 2.95% Interest
Charge which will be
computed from the
date of transaction
until full settlement
of the cash advance
amount.
Cash Advance Service Charge
(Over-the Counter)
Php100
Purchases in foreign currencies will be converted automatically to
Philippine Peso at MasterCard’s foreign currency conversion rate
Foreign Currency Conversion Fee
plus Bank of Commerce currency conversion fee of 2% (consists of
MasterCard’s assessment fee and Bank of Commerce service fee).
Charge Slip Retrieval Fee
Php200 for local and Php300 for International purchases
Card Replacement Fee
Php300 for lost card and Php200 for damaged card
Returned Check Fee
Php1,000
Installment Acceleration Fee
5% of remaining principal amount or Php500 whichever is higher
Closed Account Maintenance Fee
Php200
Gaming Service Transaction Fee
3% of the transaction amount
(FOR BANK USE ONLY)
Reviewed By:
Branch / Source Code:
Agency Name:
Agent Name:
Date:
Doc Image #:
(FOR SALES AGENCY USE ONLY)
CCU 10-18-A (R 12/14)
Credit Card Application Form Rev011 FA.indd 2
Agency Code:
Agent Code:
Doc Image #:
The corporate logo of San Miguel Corporation is a registered trademark of San Miguel Corporation, and is used under license.
12/12/14 3:58 pm