Visa Credit Card Application Form 1. YOUR CREDIT LIMIT Credit Limit Requested (please tick)
$2,000
$5,000
4. EMPLOYMENT DETAILS
$10,000
Other
Name of Employer
$
Address
2. PLEASE TELL US ABOUT YOURSELF Given Names
Work phone
Date of Birth
/
(
Member No.
Surname Drivers Licence No.
/
Marital Status
Expiry Date
/
/
Rent
Home phone
Permanent
Casual
Part time
Time there
Board
Buying/Mortgage
Work phone
(
Time there
)
Years / Months
Occupation
Mobile phone
)
5. AUTOMATIC REPAYMENT OPTION
Email
Please arrange for my Minimum Payment Due to be paid monthly from my S1 Access Account
Previous Address (if current address is less than 3 years ) State
Postcode
Yes
Own
Rent
Member No.
Time there Years / Months
Did you
Are you
Previous Employer (if current is less than 3 years)
Years / Months
(
Time in Industry
Address Postcode
Own
Years / Months Years / Months
Current Address
Do you
)
Occupation
No. and Age of Dependants
State
Time there
Board
6. YOUR FINANCES What you Own
Buying/Mortgage
Name of Relative or Friend not living with you (in Australia)
Home
Address
$
Value
Investment Home
Address
$
Value
Motor Vehicle
Model / Year
$
Value
Motor Vehicle
Model / Year
$
Value
Savings
Where
$
Value
Shares
Details
$
Value
Caravan Boat
Details
$
Value
Home Contents
Details
$
Value
/
Other
Details
$
Value
Additional Card Holder Signature
Other
Details
$
Value
Address Phone No.
(
Relationship
)
3. ADDITIONAL CARDHOLDER (OPTIONAL) I wish to apply for an additional card in the following name. The additional cardholder is over 18 years old. Title
Given Names
Surname
Member No.
Date of Birth
/
x
Drivers Licence No.
Sign Here
Date
/
/
Please note, if the Additional Cardholder is NOT a member or signatory to another account, we will contact them to complete the necessary forms & identification procedure prior to the card being issued.
UB&RB VCC-APP.0317
Title
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7. YOUR FINANCES Continued
10. BALANCE TRANSFER & CONSENT CONDITIONS $ Per month
Your Net Wage after Tax
$ Per month
Second Job Net Wage after Tax
$ Per month
Rental Income
$ Per month
Other Income
Expenses
Home Loan Name of Lender
$
Balance
$ Per month
Investment Loan Name of Lender
$
Balance
$ Per month
Car Loan Name of Lender
$
Balance
$ Per month
$
Balance
$ Per month
$
Balance
$ Per month
Personal Loan Name of Lender Rent / Board Name of Agent
$ Per month
Credit/Store Card Details Issued by Limit
$
Balance
$ Per month
$
Balance
$ Per month
$
Balance
Per month
Issued by Limit Issued by $
You must continue to make repayments to the designated credit card issuer until you receive a statement confirming that your account with them has a zero balance. We will not be held liable for any overdue payment or interest incurred. Balance transfers will normally be processed after you have accepted our offer of credit. We will advise you when the payment has been made by us. It is your responsibility to ensure that the payment is received and processed by the designated credit card issuer. We will charge interest on any balance transferred at the applicable interest rate on a daily basis from the date that your balance transfer request is processed by us until you repay the amount in full.
Limit
8. BALANCE TRANSFER FROM ANOTHER CARD Yes. I would like to transfer my balance from another credit/store card. I have enclosed a copy of my most recent statement Card Account Name
Card Issued by
Card Number
We reserve the right to refuse any balance transfer requests. We cannot accept transfers from: v Credit Cards in foreign currencies v Other Unity Bank & Reliance Bank Products v Cards not issued in Australia v A card account that is overdue or over its credit limit. We will not process balance transfer requests: v If any of your credit card(s) is/are not in good standing, overdue or over the credit limit. v If the balance transfer will take your Bank account over its credit limit. In that case we will process the balance transfer request for the amount up to your available credit limit with us.
Consent for fees and charges if Credit Card used in Excess of Credit Limit
I consent to your imposing the following fees and charges if I, or a supplementary cardholder, use the credit card to obtain cash, goods or services in excess of the card’s credit limit. • Overlimit fee - $21 The Overlimit fee is a fixed fee regardless of the amount by which the credit limit is exceeded. You will debit the fee to the account as soon as the credit limit is exceeded. You may vary the Overlimit fee at any time, in accordance with the terms of the credit card contract. You will not charge me a fee for this consent. I understand that I may withdraw my consent at any time by contacting you. Please note that if you revoke this consent we will cancel your credit limit.
Signature Card Type
Visa
MasterCard
Other
Amount to be transferred (minimum of $500) $
9. MEMBERS DECLARATION Have you had any judgments, garnishees or other legal proceedings, including bankruptcy, against you in the last five years? No Details:
Yes
x
Date
/
/
Sign Here
Reliance Bank is a division of Unity Bank Limited. ABN 11 087 650 315 AFSL /Australian Credit Licence 240399.
Unity Bank Limited
Level 7, 217 Clarence St. Sydney NSW 2000 p: 1300 36 2000 f: 02 8263 3277
[email protected] www.unitybank.com.au
Reliance Bank
203-209 Russell St Bathurst NSW 2795 p: 13 24 40 f: 02 6334 8825
[email protected] www.reliancebank.com.au MAILING ADDRESS: PO Box K237 HAYMARKET NSW 1240
UB&RB VCC-APP.0317
Name of Lender
$
Important notes on your application
Restrictions on Transfers
Personal Loan
$
Balance Transfer Conditions
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Key Facts about this Credit Card This information sheet is an Australian Government requirement under the National Consumer Credit Protection Act 2009
ABN 11 087 650 315 AFSL /Australian Credit Licence 240399.
Description of credit cards Product name
VISA Low Rate Credit Card
Minimum credit limit
$1,000.00
Minimum repayments
2% of the outstanding balance or $20.00 whichever is greater
Interest on purchases
10.12% p.a.
Interest-free period
Up to 55 days on purchases only
Interest on cash advances
10.12% p.a.
Promotional interest rate
7.99% p.a.
Balance transfer interest rate
7.99% p.a. for 6 month(s)
Annual fee
$60.00
Late payment fee
n/a
There may be circumstances in which you have to pay other fees. You can only be charged an additional fee for exceeding your credit limit if you separately agree to being charged that fee. A full list of current fees applicable to this credit card can be obtained from www.unitybank.com.au For more information on choosing and using credit cards visit the ASIC consumer website at www.moneysmart.gov.au. The terms on which this credit card is offered can change over time. You can check if any changes have been made by visiting www.unitybank.com.au
UB&RB VCC-APP.0317
Correct as at: 1 March 2017
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