7/25/2019 CCB Tiramisu Application Form (June 2016)

1/1

ttramisu Credit Card Application Form

Pleasereturn this application formwhen

completed

andsignedtoChina Construction Bank

(Asia)Corporation Limited,G.P.O.Box 165Central, HongKong,orfax itto31116117.

CAPtOOOOl

Credit Card

Cardface

Selection

wishto choose theCredit

Card

Cardface

marked

witha oneitem only):

16ACCT0F1 6AGNI MFN1

^?

Purple 503)

^

Brown

513)

Note: i. Applican ts mustbepermanent residentsofHong Kon gandaged18 orabove,

with

aminimum annual

income

of

no

less

than H KD 150,000. [1.China Constructio n Bank (Asfa) Corporatio n Limi ted

the

'Bank') reserves

the

right

to

issue

any

card

as itmay, In Itssoleandabsolutediscretion,

determine.

NL Ifthe

choice

of

card

faceIs not Indicated, ' Brown'

card

face

w i l l

be

assigned

by

default.

InstantTravel Club

Enrollment

I would liketoenroll

Instant

TravelClub

Note: For terms& conditions of Instant Travel C ub. please refer

t o

our website

or

relate d promotion leaflet.

PersonalData

English

name

as

printed

on

HKPermanentID Car d (Surname first)

Chinese name

Former name/Other name

(tr any

-pleasa provide proof

o

fofmer name/other name

HK

Permanent

ID Cardno.

Nationality

Maritalstatus(N)

Single Married

Divorced

Widowed

Number of

children

Educati on level (N)

Primary

Secondary

Vocationa l institute

University

or

above

Mobile

phone

no.

E-mailaddress

(Required

tof i l lin)

Residential address (Please complete inEnglist;^ block lette rs) P.O. Box

w i l l

not be accepted

FlatIRoom Floor

BIdg./

Estate

N o.

and

name

of

street

District

(Plesse

wcbse pemianentaddressproof andstafeon the

documsnlIf

thepermanent

address.Is

differentromheaboveresidential

address)

Yearsatpre viou s residential address

Typeof

residence

(N) (Pleasemarktheappropriat e b ox)

Live w i t h

parents

Quarters

MortgageIRentpermonth

Public housing Rented

Ownedbyapplicant Mortgaged HKD

Occupation

Name of employer (Please complete in English block letters)

OfficeAddress (Please comple te in English bloc k letters} p . o . O Xwinnot be accepted

Flat/Room Floor

Block

BIdg.

N o.

and

name

o f

street

HK ] K L N NT

District

Office

phone

no.

Nature

ofbusiness

Position

Yearsof service

Years of serviceatprevious job

Monthlybasic

income

H K D

Monthly

Com missi on (If applicable)

H K D

Self-employed DYesDNo

Ifsdf-employed, your yrars of

s w

inr ijrmnt n m f f i f y y n n

Combined

Crediit timiit

(applicabSe

toexistingcardmembers)

The credit

l i m i tof

CCB (Asia) VISA/Master Card Credi t Card

is a

combined credit

l i m i t ,

which w i l l

be

shared

among allpersonal VISA and/or MasterCa rd Credit Card account(s) of

each

erand

have

submitted

credit

l i m i t .

If

you

are an

existing CCB (Asia) VISA/MasterCa rd Credit Card cardmembe

recent

income proof,theBank

w i l l

review and may

increase

your combined

Remark:

1. The

com

Currency

Credit Cards.

CC B (Asia) Unlo nPay Dual

Other

Instructions

B i l l i n g address:

A T M

screen

instructionandSMS alert

language

ifany):

Chinese

O

and SMS alert

language

Oany)

Direct mailing

language:

Chinese

IfthereIs noIndicattonof -

Office [Ol

English 1]

English H

signed

by default.

The Bank mayatrts

sole

discretion permit credit card transactton(s) to beeffjt ed inexcessof the

relevant credit l i n i i t s )andyou shal lbe liable for such transac tion{s)and therelated feesand

charges(includingtheHKD180OverlimitFee). If yo udonot wishtheBanktopermit transaction(s)

made

by the credit card under this applicationto beeffected in

excess

of the re levant cre dit

l i m i t ,

pleasetick this box. Such choi ce w i l l also replaceyour existingoverlimitarrangement of

the

VISA/MasterCard

combined credit l i m i t ifapplicable).

Pleasenot e: Even if you

have requested

fo rtherelated

arrangement,

credit card transaction

amount can s t i l l

exceed

credit l i m i t under certain

circumstances

(suchas Octopus Automatic

A d d

Value Service,

purchase

ofmovie tickets whichdo notrequire a uthorization for effecting

payment)andyou shallbeliable for such transact ion and

Overlimit

Fee.

ReSnder

of

Required Documents

Pleaseattach copiesof thefollowing

documents

tofacilitate our processing. Documents sub mitted and

this applicationform wi l lnotbe returned.

HKPermanentIdentity Card of card applicant if youarenota

permanent

residentofHK,copiesof

HK Identity Card andavalidpassportof youroriginor visa are required. )

n Current residential proofdated

within

the latest months, e.g. electricity b i l l , rates demand note,

bank

statement

and anyoneof the following documents:

i Latest 1 month's (latest6months'- if your main streamofincomeison commissionorovertime

allowancebasis)salaryslip{s)showing yourname;or

ii Latest months bank statement/bank passbook showing your name, account number an d salary; QL

Latest 1 month's Mandatory Provident Fundstatementshoving yourname;or

iv) Latest income Tax/Profi ts Tax Demand Note(withIn1yearfromthedateofissuance);or

if

youare asoleproprietor of,or apartner

in ,

abusiness.

The Bank may require the applicant to provide additional

documents

for approval.

DecBaratiion

and

Signatur

Idonot wishtheBanktomakeuse ofmy personal dataforitsown direct marketi ng (excluding

credit card products).

Idonot wis htheBanktomakeuseof my

persona)

datafor its own direct marketingoncredit card

product s. (I understand that ifIchoosethis option,I w i l lNOT receive any Credit Card promotiona l

information sentby the Bank, includingbut notlimitedtoconcerts exclusive priority bookings,

rmation sentby the Bank, includingbut notlimitedtoconcertse

merchants

promotion and other spending promotion programs.)

Pleasemarka V as appropriate

I

understand that theabovechoice(replacesprevi ous one, if any) appliest othe dire ct marketingof

the

classes

of products,services and/or subjects, kinds of personal datamaybeusedand

classes

of

persons

towhich my personal data maybeprovided in direct marketingas set outintheBank's

Noticeto

Customers

relatingto the

Personal

Data (Privacy) Ordinanc e . I under stand that ittakes

time toupdateth eabove choice.

By signing Ihis application below, I

confirm

andacknowledge that;

1) Ihave read, understand and agreeto be bou nd by:i)thetermsand conditions in this

applicationand the CCB (Asia) Credit Card Card member Agreement (key provi sionsof whichare

summarized overleaf);and(ii)the

attached

NoticetoCustomers relatingto thePersonal Data

(Privacy) Ordinance , setout overleaf; (2)noloan/credit car d under mynamehasbeen cancelled

due t o adefault in payment a nd: (i) I currentlyhavenooverdue payment(s) excee ding 30daysin

respectof anyloanindebtedness;and(ii)nobankruptcy orderhasever been made againstme

and Iam notpetitioningorplanningto petition for bankruptcy;and (3) all informatio n providedin

this application

is

correct

and

complete,

and

I authorize you

to

confirm

orverify

this information

and my credit record in any way youchoose.

X

Signature of card applicant

For

Office

Use Only

RelationshipwithourBank

Are/were

you (1)

(within

thepas t 12

months)

a

direc tor/a substantial shareholder/c hief

executive/employee of any member of China Construction Bank Group ( CCB Group )orrelative ofor

trusteef oranysuch director/substantial shareholder/chief executive/employee? or(2) A r e / w i l lyou

becomein any way connected w i t h : i)adirectorof us orof any of our subsidiaries and/or associated

companies; or

ii)

anentity controlling 10%ormore of the

shares

of usor any direct or of such entity;or

iii)anindirect controller ofusor any director of such indir ect controller?

Yes.(Please statethenameIn bothChineseand Engli sh of the rele vant

person

orcompany/entity)

Relationship w i t hthat related

person

or company/entity _

No. I

confirm

that,as atthedateof this application, I am not relatedto CCB Grouporyour Bankas

mentioned inparagraphs(1) and (2) above. IfIamsorelated after thedateof this application, Ishall

notifyyou \x\writingatonce.