Choose the monthly due date of your VISA D₃ card

Choose your SCB Credit Card

15^th   18^th   29^th

D₃ VISA Classic   D₃ VISA Gold

Should you be unable to tick a box, you will be assigned the earlier due date.

Choose your Credit Card. If you choose more than one, please note that all cards will have a shared limit.

     CLASSIC min. basic annual income: P120,000

     GOLD min. basic annual income: P390,000

VISA Regular

VISA Picture Card

VISA Regular

VISA Picture Card

MasterCard Regular

MasterCard Picture Card

MasterCard Regular

MasterCard Picture Card

For Gold Card Applications:

Requested Credit Limit

If we are unable to process your application
at this time, will you accept a Classic Card?
         Yes No

Are you an existing customer? Yes  No
If yes, please tick Card No.
product availed : EZ Loan Others

 Birthday

 Place of Birth

 Mother’s Full Maiden Name

mm

dd

yy

FIRST

M.I.

LAST

Civil Status

Your Educational Attainment

Sex

SINGLE

WIDOWED

HIGH SCHOOL

COLLEGE

MALE

MARRIED

SEPARATED

SOME COLLEGE

POST GRADUATE

FEMALE

No. of dependents

 E-mail Address

Nationality

FILIPINO

OTHER, Please specify

Years of Stay

 Home Tel. No.

 Best time to call me is at:

Home Ownership

  OWNED (mortgaged)

  OWNED (not mortgaged)

  RENTED Monthly Rent

  LIVING WITH RELATIVES/PARENTS

How many cars do you own?

 Taxpayer’s I.D. (TIN)

 ID/Passport Number

 Social Security No. (SSS)/GSIS No.

Name (relative or friend)

Employer/Business Name

Complete Business Address

Relation to Reference   Relative   Friend    ZIP Code    Bus. Tel. No.

Name

Employer/Business Name

Complete Business Address

ZIP Code    Bus. Tel. No.

Employment

  Private Sector

  Retired

  Unemployed

  Others

  Government

  Self-employed

  Student

If Self-employed, when was business established

 Years with Present

 Total No. of Years of

mm

dd

yy

 Employer/Business
 

 Work/Business Experience
 

Position/Title

Nature of Business

Occupation

001 Clerk

001 Agriculture/Mining

001 Administrator/Executive/Manager

002 Non-Officer/Supervisor

002 Business Services

002 Agricultural

003 Officer-Junior

003 Commercial/Social/Personal

003 Armed Forces

004 Officer-Senior

       Services

004 Clerical

005 Proprietor/Self-Employed

004 Construction

006 Professional/Technical

006 Production Worker

005 Financing/Banking

007 Production/Transport

007 Retired/Unemployed

006 Insurance

008 Sales Workers

008 Overseas Contract Worker

007 Manufacturing

009 Service Workers

009 Religious

009 Real Estate

010 Self-employed

Others

010 Transportation/Communication

005 Others

011 Wholesale/Retail

012 Utilities

008 Others

Employer/Business Name

Business Address

Floor

Building

No.

Street

Village/Brgy./Municipality

City

ZIP Code

Business Tel. No.

 Cellphone No.

Applicant’s Basic Annual Income
P
Basic Annual Income is defined as the monthly basic salary x 13 months

 Other Annual Income
 P

Other Income Source (pls. check)

  Agriculture

  Rental

  Royalty

  Family Business

  Investment

  Others (pls. specify)

Please list down all major cards you own and other information required below:

CREDIT CARD and CARD NUMBER

CREDIT LIMIT

MEMBER SINCE

The Supplementary cardholder must be at least 16 years old.

Supplementary cardholders not living with the applicant must submit one valid ID card. The Bank reserves the right to require additional documents to process the application.

To request for a list of acceptable IDs or to apply for more supplementary cards, kindly call 830-1111.

FIRST

MIDDLE

LAST

 Birthday

 Place of Birth

 Nationality

 Sex

  FILIPINO

  M

mm

dd

yy

  OTHER, Please specify

  F

Relationship to Primary Applicant (Please check one)

   Spouse

  Son/Daughter

  Parent

   Brother/Sister

  In-law: parent, child, sibling

  Other

Living with Principal Applicant YES   NO

I. CREDIT LIFE – Credit Life is an insurance that pays your credit card’s Total Outstanding Balance (up to P600,000) in case of death or permanent disability. Credit Life protects you until your reach the age of 70 years old.

Do you wish to enroll for Credit Life?

Yes! I am interested in enrolling for the Credit Life Insurance Package.

I declare that I am years of age, actively performing the daily, normal chores in life. I am in good health. I have not had any personal application for Life, Accident or Medical insurance declined, postponed or modified. I do not have any deformity or other physical defects. During the past 5 years, I have not had any injury, ailment or disease, consulted or been treated by any physician or medical practitioner, any surgical operations, any medical check-up or examination.

In the event that any of the declarations above is untrue, I have the following explanations.)

I understand and agree that the insurance on this application is based on truth of the foregoing representation and is subject to the provisions of the Insurance Policy issued by the Sun Life of Canada (Philippines), Inc. to Standard Chartered Bank. I further agree to pay the required premium of P0.36 per P100 of my insured outstanding balance if my application of Credit Life is approved.

Signature over Printed Name

I wish to enjoy the following Insurance Package with the use of my Standard Chartered Bank Credit Card.

   • Higher insurance coverage for Gold cardholders

   • Insurance premiums will be automatically billed annually to Cardholder’s Card Account every renewal period.

Insurance Package

Classic Cardholder

Gold Cardholder

 • Travel covering the following:
   ·Travel Accident
   ·Replacement of Travel Documents
   ·Travel Inconvenience
   ·Burial Benefit
   ·Reimbursement of Medical Expenses
 • Purchase protection
 • Vehicular Towing

P 550/Year

P 800/Year

I confirm that the information given by me is true and correct. I authorize Standard Chartered Bank to verify and investigate the information provided from whatever sources it may consider appropriate, including but not limited to the Bureau of Internal Revenue.

I understand that falsifying any of the information herein or on the enclosed documents is sufficient ground for legal action and the rejection of my application. By signing on my Credit Card, I signify my agreement to the Standard Chartered Bank Terms and Conditions for Credit Cards. If this application is denied, I acknowledge that the Bank is not obliged to provide the reason for denial or to return any document.

I understand further that the instructions, requests and other correspondences and documents sent (or purportedly sent) by me to the Bank through facsimile shall be considered valid and blinding and that the Bank may act upon instructions conveyed through this method. The bank shall be entitled (but not bound) to take such steps in connection with or in reliance upon such communication as the Bank may in good faith consider appropriate. The Bank may use copies or facsimile transmissions as evidence in any court of law.

I also confirm that I have read, understood and accept the applicable interest, other Fees and Charges as provided in this application form.

\/
	SIGNATURE OF PRINCIPAL APPLICANT		DATE

PLEASE TRANSFER THE OUTSTANDING BALANCE(S) WITH THE FOLLOWING CARD ISSUER(S) AND DEBIT MY STANDARD CHARTERED BANK CREDIT ACCOUNT WITH THE AMOUNT SPECIFIED, PROVIDED THE TOTAL AMOUNT TRANSFERRED IS WITHIN 80% OF MY AVAILABLE CREDIT LIMIT.

Information on other bank’s card(s) from which the balance will transferred:

These Terms and Conditions govern this application (“Application”) and the Balance Transfer program (the “Program”) of Standard Chartered Bank (“The Bank”):

1.

This Application is not transferable.

2

New applicants in good standing are eligible to apply for a transfer to their Standard Chartered Bank credit card, of peso-denominated outstanding balances is their credit card accounts, except Standard Chartered Bank credit cards or co-branded credit cards owned by the Bank. Such credit cards shall hereinafter be referred to as “Non-Standard Chartered Bank Credit Cards.” Outstanding balances shall include principals, accrued interests, finance and other charges on the principal and any supplementary credit card.

3.

The applicant must submit to the Bank this Application, together with two of the latest credit card statements issued by Non-Standard Chartered Bank Credit Cards. The Bank shall not process any Application with incomplete documents.

4.

The Bank shall not be liable for any claim in connection with the loss of any document in transit. The Bank shall not be obligated to return any documents submitted in connection with this Application.

5.

The Bank reserves the right to approve or disapprove any Application and the Bank shall have no obligation to provide the reason for disapproval. The Bank may approve a balance transfer in full or in part only.

6.

If the Bank approves an Application, it will specify the outstanding balance approved for transfer under the Program. The applicant shall pay the Bank interest thereon at the applicable monthly add-on rate specified in this Application. Such approved outstanding balance and the applicable interest shall be referred to as the “Total Amount Payable.”

7.

The monthly add-on rate will only be applied to the Balance Transfer transaction. If the Cardholder chooses to pay only a portion of the Minimum Amount Due (as stated on Statement of Account), the monthly Balance Transfer installment shall be further subjected to a finance charge at the prevailing interest rate.

The following is a sample computation of monthly Balance Transfer installments due for the first year. Should you need a complete computation for 48 months, please call Costumer Service Hotline at 830-1111.

The computation of the principal and interest due per installment shall be based on an effective yield computation method.

8.

The Cardholder agrees to pay the Bank interest on the Total Principal Amount on the dates specified in the Statement of Amount at the applicable monthly add-on rates applied to the Total Principal Amount:

9.

The applicant acknowledges that each Balance Transfer installment shall form part of his monthly Minimum Amount due and must be paid in full; finance charges apply to Balance Transfer installment due but not paid by the applicant on time.

10.

The applicant also acknowledges the he is liable to make payments on his Non-Standard Chartered Bank Credit Cards until the Bank approves and pays the outstanding balance applied for. The Bank shall not be liable for finance charges or interest on overdue payments as a result of the applicant’s failure to make payments on his Non-Standard Chartered Bank Credit Cards.

11.

In the event that the applicant pre-terminates his enrolment in the Program, he shall pay a pre-termination fee of Php1,500 or 5% of the outstanding balance whichever is higher. Such balance shall be subjected to regular interests and other charges.

12.

The applicant represents that the outstanding balance is free from any encumbrance.

13.

The applicant waives any disputes or charge back transactions on the outstanding balance.

14.

The applicant may consent to these Terms and Conditions verbally or in writing. The Bank reserves the right to modify the applicable charges and these Terms and Conditions. Such modifications shall apply upon proper delivery notice of the applicant.

15.

The Terms and Conditions for Credit Cards apply; in case of conflict between the Terms and Conditions for Credit Cards and these Terms and Conditions, the latter shall prevail in respect of the Program.

16.

These Terms and Conditions shall be governed by Philippine law.

17.

The applicant agrees that instructions, notices and other correspondence sent or purportedly sent, now or hereinafter, by the applicant to the Bank through fax shall be considered valid and binding on the applicant. The Bank shall be entitled (but not bound) to act on such documents and/or to take steps in connection with or in reliance upon them as the Bank may in good faith determine. The Bank may use documents transmitted by fax as evidence in a court of law.

18.

The applicant authorizes the Bank to perform all acts necessary to verify the information contained in this Application and the documents submitted and/or made available by the applicant in connection thereto.

By signing below, the applicant acknowledges that he has read and understood these Terms and Conditions and agrees to be bound thereby.

Important Note: For succeeding balance Transfer, please fill-out another balance Transfer application form or call Standard Chartered bank Customer Service at 830-1111

ACCOUNT NAME

UTILITY

SVC ID NO/ACCOUNT NUMBER

MOBILE NUMBER

You can enroll the following utilities to your credit card account:

• Globe Telecom  • Meralco  • PLDT  • Smart

EZ bills Terms and Conditions

This confirms your enrollment to the EZbills Facility of Standard Chartered Bank (“the Bank”) under the following Terms and Conditions:

1.

EZbills refers to the Bank’s automated payment facility wherein the Cardholder settles his periodic utility bills/charges/statements of account (“Bills”) through hi Standard Chartered Credit Card (“Card”)

2.

The Bank has absolute discretion to approve or reject the EZBills enrollment application without the obligation to provide the reason therefore and without the need of notifying the Cardholder in case of rejection.

Upon approval of the EZBills application, the Cardholder authorizes the Bank to automatically charge monthly to the Credit Card the total amount of the applicable Bills.

4.

The Cardholder represents that all Bills shall be paid only through EZBills. Payment through other means, including but not limited to direct payment, shall be made only if the Bank rejects any EZBills payment or cancels the EZBills enrollment.

5.

The Cardholder understands that the Bank has absolute authority to reject any EZBills payment or cancel the EZBills enrollment on grounds such as but not limited to non-availability of credit in the Card, delinquency of the Card account or default of the Cardholder in respect of any obligation in favor of the Bank. In such case, the Cardholder shall not hold the Bank liable for any damage that the Cardholder might suffer, directly or indirectly, by reason of such rejection or cancellation.

6.

The Bank may, without need of notice to the Cardholder, process late payments of the Bills arising from late payment instructions, late delivery of Bills or computer error. In such event, the Bank shall be held responsible for any penalty, inconvenience, delay, damage, liability, loss or other consequences arising from such late payment including but not limited to, disconnection or interruption of utility services. The Bank may impose such fees and charges on the Card for services rendered to it under EZBills.

7.

The Bank shall inform the Cardholder in case the collection agreement between the Bank and the billing company is terminated. On the other hand, if the Cardholder decides to cancel the enrollment to EZBills, the Cardholder shall notify the Bank and the billing company in writing of such cancellation.

8.

The Terms and Conditions of the Credit Cards are hereby incorporated by reference and shall form an integral part hereof.

By signing below, the applicant acknowledges that he has read and understood terms and conditions for EZBills and agrees to be bound hereby.

MINIMUM PAYMENT DUE - Minimum amount you need to pay on or before due to avoid late charges. This amount is P200 or 5% of balance, whichever is higher.

FINANCE CHARGE - A Finance Charge is the interest billed to the costumer’s account if cardholder pays an amount less than the Statement Balance. The finance charge calculated on an average daily basis will be applied to the Statement Balance until payments are credited to the Card Amount and thereafter on the reduced balance. This shall be equal to the aggregate of any unpaid outstanding charges which have been billed to the Card Amount whether or not these have been reflected in the Statement of Account, less any credits on the Card. The interest rate shall be 3.5% per month. However, the Bank may vary the interest rate for certain customer segments as it sees fit. The daily outstanding balance is multiplied by the applicable interest rate to arrive at the daily finance charge. At the end of the billing cycle, the daily finance charges are added up. This amount is reflected on your Statement of Account as part of the charges.
 
LATE CHARGE - If the Minimum Payment Due is not received by the Bank on or before the Payment Due Date, a Late Charge will be reflected on your account which is equal to 7.5% of the Minimum Payment Due or P600, whichever is higher. An additional late fee of P100 will be charged once your card account reaches 60 days past due.

OVER LIMIT FEE - For every purchase/transaction exceeding your assigned credit limit (inclusive of retail purchases, cash advances, fees and other charges), an over limit fee of P500 will be charged to your card account.

CASH ADVANCE FEE - Each cash advance transaction will be charged a Cash Advance Fee which is equivalent to 3% of the transaction amount or P300, whichever is higher. Finance charge on cash advance is computed from the date of transaction to the statement date.

Subject to change without prior notice. Please call SCB Customer Service at 830-1111 or our Domestic Toll Free number 1-800-1-888-1188 or 1-800-8-830-1111 (for Globe subscribers only) for further details.

FOR BANK USE ONLY
All information contained is this applications form is valid as of March 2007