Credit Card Application

Transcription

1 Credit Card Application How to apply 1. Apply online at westpac.co.nz/credit-cards/apply-now This is the fastest way to apply for a card. 2. Complete this form and take it together with identification and proof of income to your nearest Westpac branch, or 3. Complete this form and mail to Westpac, Private Bag 92503, Wellesley Street, Auckland. If you have any questions or need help to complete this form, please call A. Type of Westpac credit card account Please select one card type and one reward programme per application. The Low Rate Mastercard does not include a reward programme. Westpac Low Rate Mastercard N/A N/A hotpoints Airpoints Westpac PayTag (optional) Westpac Mastercard Westpac Platinum Mastercard Westpac World Mastercard Westpac Airpoints Business Mastercard N/A Westpac BusinessPLUS Mastercard N/A Requested Limit $ Balance transfer Yes No Primary purpose of debt General Living Expenses / Cash flow Debt Consolidation Large one off purchase (e.g. car, boat, holiday) Back-up / Emergency If you select, but do not meet Westpac s current lending criteria for a hotpoints or Airpoints Platinum Mastercard account, a hotpoints or Airpoints Mastercard account will be issued instead (provided you meet the relevant criteria for that card). If you are applying for an Airpoints credit card and already have an Airpoints number, please enter it below. If you are not currently an Airpoints member, you can sign up for an Airpoints membership at airnewzealand.co.nz/airpoints. Your Airpoints number will be printed on your credit card and all Airpoints Dollars earned will be credited to your Airpoints account. Airpoints Membership Number B. Principal applicant details Name FIRST MIDDLE LAST Mr Mrs Miss Ms Other (please specify) Date of birth DD / MM / YYYY NZ Permanent Resident Yes No Resides in NZ? Yes No Number of dependents (18 years or younger) Current employment (please select) Employed (salary/wage) Self-employed Not currently employed Current employer Your industry Time in current employment Year(s) Month(s) If less than 6 months, time at previous job Year(s) Month(s) How would you like your name to appear on your card This must be your given name(s), or initial(s) and surname. If you already have a Westpac bank account, please provide the account no. below Postal Address NUMBER & STREET TOWN/CITY SUBURB POSTCODE Time at current address Year(s) Month(s) If less than 6 months, time at previous address Year(s) Month(s) Best description of your living arrangements (Please tick one) Home owner Rent Live with parents/guardian Board Phone Number HOME MOBILE WORK address NZ driver s licence number (5a) Version no. (5b) * You will be a US citizen if you were born in the US or have acquired US citizenship, unless you have formally renounced your US citizenship ** The country listed will determine the tax rate applied to your products. Please contact your tax advisor if you are unsure *** If you are a US citizen or tax resident, the TIN section must be completed with your social security number or individual tax identification number Identification word You will need this word if you call us to discuss your card in the future Close friend or relative Full name (must be living in New Zealand and not living at the same address) Their phone number Are you a US citizen?* Yes No Main country of tax residency** THIS IS THE MAIN COUNTRY WHICH HAS THE RIGHT TO TAX YOUR WORLDWIDE INCOME Additional country(s) of tax residency (if any) LIST THE ADDITIONAL COUNTRY(S) OF WHICH YOU ARE A TAX RESIDENT Foreign Tax Identification Number*** (TIN) YOUR IDENTIFICATION NUMBER FOR TAX PURPOSES IN A PARTICULAR COUNTRY If you do not have a TIN, please select the reason: TIN not issued by this country Country has not issued a TIN to me (e.g. I am under age) NOTE: We cannot open your account until we have received your TIN, unless one of the above reasons is applicable. 1 of 4

2 C. Joint/Additional applicant s details Joint application On a joint credit card account, both cardholders are jointly and severally liable for any balance owed on the account. A joint cardholder must be at least 18 years old. Additional cardholder The principal cardholder is liable for all transactions on the credit card account which are made by an additional cardholder as though they had personally made the additional cardholder transactions. An additional cardholder must be at least 16 years of age. There is a $15 charge for each joint and additional card on all cards except the World Mastercard where a $100 charge applies. When a hotpoints World Mastercard is selected there is no charge for the first joint/additional card. Name FIRST MIDDLE LAST Mr Mrs Miss Ms Other (please specify) Date of birth DD / MM / YYYY NZ Permanent Resident Yes No Resides in NZ? Yes No Number of dependents (18 years or younger) Current employment (please select) Employed (salary/wage) Self-employed Not currently employed Current employer Your industry Time in current employment Year(s) Month(s) If less than 6 months, time at previous job Year(s) Month(s) How would you like your name to appear on your card This must be your given name(s), or initial(s) and surname. Westpac PayTag (optional) Postal Address NUMBER & STREET TOWN/CITY SUBURB POSTCODE Phone Number HOME MOBILE WORK * You will be a US citizen if you were born in the US or have acquired US citizenship, unless you have formally renounced your US citizenship ** The country listed will determine the tax rate applied to your products. Please contact your tax advisor if you are unsure *** If you are a US citizen or tax resident, the TIN section must be completed with your social security number or individual tax identification number Time at current address Year(s) Month(s) If less than 6 months, time at previous address Year(s) Month(s) address Identification word You will need this word if you call us to discuss your card in the future For joint applicant only Are you a US citizen?* Yes No Main country of tax residency** THIS IS THE MAIN COUNTRY WHICH HAS THE RIGHT TO TAX YOUR WORLDWIDE INCOME Additional country(s) of tax residency (if any) LIST THE ADDITIONAL COUNTRY(S) OF WHICH YOU ARE A TAX RESIDENT Foreign Tax Identification Number*** (TIN) YOUR IDENTIFICATION NUMBER FOR TAX PURPOSES IN A PARTICULAR COUNTRY If you do not have a TIN, please select the reason: TIN not issued by this country Country has not issued a TIN to me (e.g. I am under age) NOTE: We cannot open your account until we have received your TIN, unless one of the above reasons is applicable. D. Financial details Gross Income Annual Salary/Wage earners/beneficiaries $ Self-employed/Business income $ Overtime and allowances $ Commissions $ Pension/Super/Regular Annuity $ Interest/Dividends/Other Investment $ Child Maintenance/Support $ Rental Income $ Boarders/Flatmates $ Debts Balance Limit New Westpac Home Loan $ $ Existing Westpac Home Loan $ $ Other Lender / Home Loan $ $ Personal Loan $ $ Hire purchase $ $ Student Loan $ $ Credit / Store Card $ $ Overdraft $ $ Other Lending $ $ Fixed commitments Weekly Essential Living Costs Weekly Rent/Board $ Child/Support Maintenance Payments $ Rates/Property Insurance/Body Corporate $ Long Term Super/KiwiSaver $ Loan Repayments $ Food and Groceries $ Transport/Vehicle Running costs $ Power/Gas/Water/Internet/Phone $ State Education/Childcare $ Medical costs $ 2 of 4

3 D. Financial details Continued Discretionary Living Costs Weekly Private School Fees/Education $ Personal Life/Health/Income Insurances $ Entertainment $ Regular Donations $ Savings and Investment Balance Westpac Savings Account $ Westpac Term Deposit $ Non-Westpac Savings Account $ Non-Westpac Investments $ E. Card Repayment Cover This optional insurance can help protect your credit card repayments should the unforeseen occur. It covers you for death, total disability, redundancy and bankruptcy between ages (inclusive), and after that for death only until your 80th birthday. Do you want to be covered by Card Repayment Cover? Yes No For full details of the terms, conditions, exclusions and limits that apply, please refer to the sample Card Repayment Cover policy document attached. You will be covered from the date that this application is received by Westpac. Insurer Financial Strength Rating Westpac Life-NZ-Limited ( Westpac Life ) has an A+ Insurer Financial Strength rating given by Standard & Poor s (Australia) Pty Limited. A summary of the rating scale is as follows: AAA Extremely Strong, AA Very Strong, A Strong, BBB Good, BB Marginal, B Weak, CCC Very Weak, CC Extremely Weak, SD or D Default, R Regulatory Supervision, NR Not Rated. Plus (+) or Minus (-) following ratings from AA to CCC show relative standings within the major rating categories. A full description of the rating scale is available at every office of Westpac Life or by visiting Acknowledgement I/we acknowledge and agree that: Card Repayment Cover is arranged by Westpac and underwritten by Westpac Life-NZ-Limited ( Westpac Life ) which is a wholly owned subsidiary of Westpac Financial Services Group-NZ-Limited which is a wholly owned subsidiary of Westpac Banking Corporation ABN , incorporated in Australia none of Westpac Banking Corporation, Westpac or any member of the Westpac group of companies guarantee the obligations of, or any products issued by Westpac Life. Westpac will receive commission payments as a result of the arrangement of Westpac Life insurance policies. terms, conditions, exclusions and limits apply and more details can be found in the Card Repayment Cover policy document, and that any payment is subject to my claim being accepted. I/we agree to be covered by Card Repayment Cover (please sign) PRINCIPAL SIGNATURE DD / MM / YYYY Cost of the insurance is 79 cents per $100 (or part thereof) of the outstanding monthly balance on your Westpac credit card statement. If you choose Card Repayment Cover, then each month we will charge your premium to your credit card account. We will let you know if the cost of the insurance changes 30 days beforehand. The premiums are collected on behalf of the underwriter Westpac Life. F. Acknowledgement I/we certify that all information supplied in this application is true, correct and complete this application may be declined and/or I/ we may be liable to Westpac or any of its related companies (the Westpac Group ) or in the case of tax information, to the IRD. In applying for this credit card, I/we acknowledge that my/our declared income is correct and sufficient to service the credit limit provided. I/we agree that as soon as I/we sign or use my/our card or use any other payment instrument (such as Westpac PayTag if requested), to access my/our account I/we will be deemed to have agreed to be bound by: the Credit Card Conditions of Use for the applicable card; the Air New Zealand Airpoints programme terms and conditions (where applicable); the hotpoint terms and conditions (where applicable); and the Westpac PayTag terms and conditions (where a Westpac PayTag has been requested). I/we acknowledge and agree that: I/we are personally responsible for all credit extended by Westpac to me/us, including credit extended under a BusinessPLUS Mastercard or Airpoints Business Mastercard, irrespective of whether a business name appears on the card; where applicable, I must be a member of Air New Zealand s Airpoints programme to be eligible to earn Airpoints and that I can access the Airpoints terms and conditions at airnewzealand.co.nz/airpointsterms-and-conditions; for a joint credit card account, a notice Westpac sends to one of us will count as a notice to all of us; fees and charges will apply to the use of the card. Details of fees and charges are provided in the Transaction and Service Fees brochure, which will be sent to me; and the Credit Card Conditions of Use for the applicable card, the Westpac PayTag terms and conditions (where applicable), and the hotpoints terms and conditions (where applicable) will be sent to me. I/we acknowledge that I/we have an obligation to notify Westpac of a change in circumstances that would affect the tax residency information provided. Copies of the Credit Card Conditions of Use for the applicable card, the Westpac PayTag terms and conditions, the hotpoints terms and conditions (which are incorporated in the Credit Card Conditions of Use for the applicable cards) and the Transaction and Service Fees brochure are available at any Westpac branch or online at westpac.co.nz. 3 of 4

4 G. Personal Information I/we consent to and authorise the collection, use and disclosure of my/our personal information by Westpac New Zealand Limited and its related companies (Westpac) in the following ways: Westpac may make all necessary enquiries (now or in the future) concerning my/our credit record, residence, employment, financial status, and any information provided by me/us in this application for the purposes related to provision of credit to me/us, from whatever source Westpac considers appropriate, including any credit reporting agency that Westpac has a subscriber agreement with, and any party approached may provide such information to Westpac. Westpac may use all the information that they hold about me/us to make available to me/us the full range of financial services provided by Westpac and to provide me/us with details of products and services that may be purchased with the card. Westpac may provide Credit Information (as defined in the Credit Reporting Privacy Code 2004) about me to credit reporting agencies, who will use that information to update their credit reporting database and who may disclose any information they hold about me/us to their own customers for the purpose of providing credit reporting services. Westpac may disclose my personal information (including default information) to any person Westpac may appoint to collect any outstanding debt. Westpac may use credit reporting agencies monitoring service to receive updates, if any, of the information they hold about me/us. Westpac and its related companies may obtain, use and/or disclose information held about me/us to enable Westpac and its related companies to comply with any laws, rules or regulations in New Zealand or any other country including any laws, rules or regulations reasonably expected to be implemented (including to enable the government of New Zealand to comply with any agreement between it and any other country). Westpac may disclose and exchange any information held about me/ us now or in the future to any party associated with a Westpac credit card rewards programme for the purposes of administration of the applicable rewards programme, provision of related services and for marketing and research purposes. I/we confirm that I/we have the permission of the person named as close friend or relative in this application to disclose their personal details. If I/we have indicated that I/we wish to be covered by Card Repayment Cover ( the Cover ), I/we authorise Westpac to disclose all relevant information held about me/us now or in the future to Westpac Life for the purposes of administering the Cover. I/we understand that I/we have the right to access and correct my/our personal information held by Westpac subject to the provisions of the Privacy Act I/we acknowledge that I/we have read and accepted the disclosures, terms and conditions set out above. H. Signature(s) I /we also certify that: I/we are New Zealand citizens or have permanent New Zealand residency status and reside in New Zealand. I/we are over 18 years of age (and any additional applicant is over 16 years of age). Please note that you will be required to verify your identity and income as part of the application process or prior to activating your credit card account. All cardholders (principal, joint or additional) are required to verify identification. Suitable forms of ID include one of the following New Zealand drivers licence Current passport New Zealand firearms licence For more details see westpac.co.nz/aml PRINCIPAL SIGNATURE DD / MM / YYYY JOINT / ADDITIONAL SIGNATURE DD / MM / YYYY Credit cards are both a convenient means of payment and a flexible form of borrowing. Although paying only the minimum monthly payment can help you manage your cash flow from time to time, If you make only the minimum payment each month, you will pay more interest and it will take you longer to pay off your balance. Westpac use only Credit Card Account Number Card Number X X X X X X X X CRS Number Application Number Card Account Number Package type Branch/split code FTR stamp Bank stamp Staff Number Courier cost Branch Customer Special delivery instructions 72273WP hotpoints is a registered trademark of Westpac Banking Corporation. Mastercard is a registered trademark of Mastercard International Incorporated. 4 of 4

5 Exclusions applying to all cover (life insurance, total disability, redundancy & bankruptcy) There is no cover for any claim resulting from: riot or civil commotion, strike, lockout, war, civil war, rebellion, revolution, insurrection, the use of military or usurped power or if you were committing a materially unlawful act, or injury, sickness or disease you sustained outside New Zealand if you have been outside New Zealand for over six months immediately preceding the date of the event which resulted in a claim. The cost of Westpac Card Repayment Cover The premium payable by you for this cover is 79 cents per $100 (or part thereof) of your outstanding monthly credit card balance as at the date of your monthly statement. If there is a nil balance on your credit card account as at billing date, no premium will be payable for that month. We can amend the premium by giving you not less than 30 days notice. How are premiums charged? The premium will be automatically charged to your credit card each month. This charge will appear as an item on your credit card statement. Interest may be payable on the premium. If you re close to your credit limit, your premium payment could put you over the credit limit and you may incur additional fees. Cancelling or amending your cover When can you cancel your cover? You can cancel your cover at any time by giving written notice to Westpac Life-NZ-Limited. If you cancel within 30 days of the commencement date we will refund any premiums paid in full. When can we cancel or amend your cover? We can cancel or amend your cover at any time by giving you not less than 90 days notice in writing. Examples of when we may exercise this right to amend include if our legal or regulatory requirements change, to allow us to respond to market changes or medical advances or to enable changes that are reasonably necessary for Westpac Life s other legitimate business purposes. When will your cover cease automatically? Your cover will terminate immediately if: the premium is unpaid, or your Westpac credit card account is cancelled. Cover for the Total Disability, Redundancy and Bankruptcy benefits will cease on the cardholder s 66th birthday. Cover for the Life Insurance benefit will cease on the cardholder s 80th birthday. How to make a claim If you wish to make a claim, you must notify Westpac Life within 30 days of the event that prompted the claim. You must also provide us with copies of medical reports or other information that we ask for, at your expense. We will pay the proceeds of approved claims to your credit card account. To make a claim, call , Monday to Friday 8.30am to 5pm. Enquiries and Complaints If at any time you have an enquiry or complaint about your cover, please contact Westpac Life in writing at PO Box 27031, Wellington or call Westpac Life on Westpac Life is a member of the Banking Ombudsman Dispute Resolution Scheme. If you are not satisfied with the way we resolve the enquiry or complaint, we can let you know how to refer the matter to the Banking Ombudsman. Notices Any notices may be made by ordinary post (to the last postal address notified by you to us) or by facsimile or electronic means (to the facsimile/ address provided by you to us). You are responsible for promptly informing us of any change to your personal details (including your name, address, telephone, mobile or facsimile numbers and address). Underwriter Westpac Card Repayment Cover is underwritten by Westpac Life-NZ-Limited ( Westpac Life ), a wholly owned subsidiary of Westpac Financial Services Group-NZ-Limited. Westpac Financial Services Group-NZ-Limited is a wholly owned subsidiary of Westpac Banking Corporation ABN , incorporated in Australia. Neither Westpac Banking Corporation nor Westpac New Zealand Limited ( Westpac NZ ) guarantee the obligations of, or any products issued by Westpac Life. Westpac NZ will receive commission payments as a result of the arrangement of Westpac Life insurance policies. Westpac NZ employs salaried employees whose remuneration is influenced in the long term by the arrangement of Westpac Life policies. The Master Policy will be included in the Westpac Life-NZ-Limited Statutory Fund No.1. We will pay your benefits from this fund. Statutory Funds are regulated pursuant to the Insurance (Prudential Supervision) Act Definitions Commencement date means the date on which your cover under the Master Policy commenced which is the date that your application for Card Repayment Cover was received by Westpac. Master Policy means Master Policy NZWP1037 issued by Westpac Life-NZ- Limited. Outstanding balance means the amount of debt on your Westpac credit card account at the date of any event for which a claim is made under this cover. The amount of debt will exclude: any amounts shown as Past Due on your credit card statement together with accompanying interest, and any purchases or cash advances you made when you knew of the likelihood of the event giving rise to a claim, which, in our opinion, are outside the normal conduct of your credit card account. We/our/us/Westpac Life means Westpac Life-NZ-Limited. You/your/cardholder means the cardholder (including any joint cardholder and additional cardholders) who is the holder of a credit card issued by Westpac and obtained for private use, who has made an application and has paid the required premium each month. Westpac Card Repayment Cover. This is an important document detailing the terms of your Westpac Card Repayment Cover. Please read this document carefully and keep it in a safe place. The terms and conditions for Westpac Card Repayment Cover may vary from time to time. Westpac New Zealand Limited 72540WP

6 Introduction to your cover This document sets out the full terms, conditions and exclusions of your cover under Master Policy NZWP1037 for your protection in the event of: death; total disability; redundancy; bankruptcy. Your rights and benefits under the Master Policy are personal to you and cannot be assigned or charged to any other person. This cover does not have a surrender value. Things to note Please note that the information in this document does not take into account your personal objectives, financial situation or needs. In deciding whether this cover is right for you, you should consider the information in this document having regard to your own personal circumstances. Terms, conditions, exclusions and limits apply to your cover under the Master Policy. Please ensure you read the What s covered? and What s not covered? sections. Any injury, sickness or disease which existed at the commencement date or any sickness, disease or degenerative condition which first makes itself known within 28 days of the commencement date is excluded from cover. Only one benefit is payable for total disability or redundancy during the same period or for the same event. Who is the insurer? Westpac Card Repayment Cover is underwritten by Westpac Life-NZ- Limited ( Westpac Life ). Westpac New Zealand Limited ( Westpac NZ ) has been appointed by Westpac Life as agent for Westpac Card Repayment Cover. Westpac Life has a A+ Insurer Financial Strength Rating given by Standard & Poor s (Australia) Pty. Limited. The rating scale is: AAA Extremely Strong BBB Good CCC Very Weak R Regulatory Supervision AA Very Strong BB Marginal CC Extremely Weak NR Not Rated A Strong B Weak SD or D Default Plus (+) or minus (-) signs following ratings AA to CCC show relative standings within the major rating categories. The full rating scale is available for inspection at every office of Westpac Life and How to contact us: You can contact us by: calling , or writing to Westpac Life, PO Box 27031, Wellington, day free look If you change your mind, you can cancel your cover within 30 days of the commencement date and receive a full refund of any premiums you ve paid. Interest charged on the premium amount is not refundable. You cannot exercise your rights under the free look period if you have already made a claim under your cover. Am I eligible for Westpac Card Repayment Cover? At the date of any event for which a claim is made, you must be between the following ages to be eligible for this cover: 18 and 65 years (inclusive) for the Total Disability, Redundancy and Bankruptcy benefits 18 and 79 years (inclusive) for the Life Insurance benefit. What s covered? Cover under your Westpac Card Repayment Cover will begin on the commencement date. It s important to understand how and when we ll pay benefits under your Westpac Card Repayment Cover if you need to make a claim. Please refer to the sections What s covered? and What s not covered? for the full terms, conditions, exclusions and limits that apply to your cover under the Master Policy. Life Insurance We will pay the outstanding balance on your credit card account as at the date of death, up to $50,000. Total Disability This is any disability resulting from bodily injury, sickness or disease which directly and independently of any other cause, totally prevents you from engaging in your normal or usual business, occupation or work (including normal household duties if that is your primary occupation). Where total disability continues beyond 30 consecutive days, we will make monthly payments of 10% of the outstanding balance as at the date that you stopped work or sought medical advice, whichever is the earlier. The maximum payment period is 24 months. The amount paid will not exceed $50,000. Payment will be calculated on the number of days from the date you stopped work or sought medical advice, whichever is the earlier, until the date of your recovery, but in no event will payments continue beyond 24 months. If your disability becomes permanent we may pay the remainder of the 24 month total disability benefit as a lump sum. Such payment will be in full settlement of the total disability claim. Cover under the Master Policy will then cease for this cardholder for total disability recurring from the same accident or illness. Redundancy This is loss of employment resulting from your position becoming superfluous to the needs of your employer. Loss of employment as a result of resignation, dismissal or voluntary redundancy is not covered by the Master Policy. Where unemployment resulting from redundancy continues beyond 30 consecutive days, we will make monthly payments of 10% of the outstanding balance, as at the date that you were first notified that you would be made redundant. The maximum payment period is six months. The amount paid will not exceed $50,000. Payments will be calculated on the number of days from the date you became unemployed, until the date of your new employment commencing, but in no event will payments continue beyond six months. Bankruptcy This is when you have been declared bankrupt as a result of your creditors applying to a New Zealand Court to do so. If you are a self-employed cardholder and you become bankrupt more than six months after applying for cover we will pay the outstanding balance, as at the date you were first notified that your creditors had applied to the Court to start bankruptcy proceedings. The amount paid will not exceed $10,000. What s not covered? There are some exclusions that apply to your cover. Life Insurance You are not covered for death arising from: suicide, within 13 months of the commencement date, or any injury, sickness or disease which existed at the commencement date whether diagnosed or not, or the exclusions detailed under the Exclusions applying to all cover heading. Total Disability There is no cover under the Total Disability benefit for: 1. Absence from work due to pregnancy, childbirth or adoption, or 2. Disability caused or resulting from: any injury, sickness, disease or degenerative condition which existed at the commencement date, or sickness, disease or degenerative condition which first made itself known within 28 days of the commencement date, or a deliberately self-inflicted injury or attempted suicide, or travel by air other than as a passenger on a licensed commercial or chartered aircraft, or you being addicted to alcohol or a drug, or you being under the influence of alcohol, poison or drugs, other than a drug taken on the advice of a legally qualified medical practitioner, or the exclusions detailed under the Exclusions applying to all cover heading. Redundancy There is no cover under the Redundancy benefit: for cardholders who are self-employed or in seasonal or casual work or contract work, or for loss of employment as a result of resignation, dismissal or voluntary redundancy, or for unemployment which was in existence at the commencement date or occurred within 28 days of the commencement date, or if you knew or ought to have known, at the commencement date, that it was likely or possible that you would be made redundant, or if you have just completed a specific task or specific period of employment, or if you were made redundant from employment outside New Zealand, or if you were a director where you had control over your employees or if you were employed by a direct member of family (spouse, parents or children), or for the exclusions detailed under the Exclusions applying to all cover heading. Bankruptcy There is no cover under the Bankruptcy benefit for: Cardholders who are not self-employed, or voluntary bankruptcy, or the exclusions detailed under the Exclusions applying to all cover heading.