ttramisu Credit Card Application Form

CAPtOOOOl

Please return this application form when completed and signed to China Construction Bank
(Asia) Corporation Limited, G.P.O. Box 165 Central, Hong Kong, or fax it to 3111 6117.

Credit Card Cardface Selection

16ACC T 0 F 1 6 A G N I M FN1

I wish t o choose the Credit Card Cardface marked

with a
(one item only):

Combined Crediit timiit (applicabSe to existing cardmembers)

^?

The credit limit of CCB (Asia) VISA/MasterCard Credit Card is a c o m b i n e d credit limit, which will
b e s h a r e d a m o n g all p e r s o n a l V I S A a n d / o r M a s t e r C a r d C r e d i t C a r d a c c o u n t ( s ) ^ o f e a c h

Purple (503)

If you are an existing CCB (Asia) VISA/MasterCard Credit Card c a r d m e m b e r a n d have submitted
recent i n c o m e proof, the Bank will review a n d m a y increase your c o m b i n e d credit limit.
I C C B (Asia) U n l o n P a y D u a l

R e m a r k : 1. T h e c o m !
Currency Credit Cards.

Brown (513)

Other Instructions
Note: i . Applicants m u s t be permanent residents of Hong K o n g a n d aged 18 o r a b o v e , w i t h a m i n i m u m annual income of
no less t h a n HKD 150,000. [1. China Construction Bank (Asfa) Corporation L i m i t e d (the ' B a n k ' ) reserves t h e right to issue
any c a r d as it may, In Its sole a n d absolute discretion, d e t e r m i n e . NL If t h e c h o i c e of c a r d face Is n o t Indicated, ' B r o w n '
card face will be assigned by default.

Billing address:
A T M screen instruction a n d S MS alert language (if any):
and S M S alert language Of any)
Direct mailing language:

Chinese

Office [Ol
English 1]

Chinese

English H
signed by default.

If there Is no Indicatton of -

Instant Travel Club Enrollment

I would like to enroll Instant Travel Club
Note: For terms & conditions of Instant Travel C!ub. please refer t o our website o r related promotion leaflet.

The Bank may at rts sole discretion permit credit c a r d transactton(s) t o be e f f j t e d in excess of the
relevant c r e d i t liniit(s) a n d y o u shall be liable f o r s u c h transaction{s) a n d t h e r e l a t e d fees a n d
charges (including t h e HKD180 Overlimit Fee). If y o u d o not wish t h e Bank t o permit transaction(s)
made by t h e credit card under this application t o b e effected in excess of t h e relevant credit limit,
please tick
this box. S u c h choice will also replace your existing overlimit arrangement of t h e
VISA/MasterCard combined credit limit (if applicable).

Please n o t e : Even if y o u h a v e r e q u e s t e d f o r t h e related a r r a n g e m e n t , c r e d i t c a r d t r a n s a c t i o n

a m o u n t c a n still e x c e e d c r e d i t limit under c e r t a i n c i r c u m s t a n c e s (such a s O c t o p u s A u t o m a t i c
A d d Value Service, p u r c h a s e o f m o v i e t i c k e t s w h i c h d o n o t r e q u i r e a u t h o r i z a t i o n f o r e f f e c t i n g
payment) a n d y o u shall be liable for such transaction a n d Overlimit Fee.

Personal Data
Relationship with our Bank

English name as printed o n H K Permanent ID C a r d (Surname first)

Chinese name

Former

name/Other

name

HK Permanent ID Card no.

(tr any -pleasa provide proof of fofmer name/other name)

Nationality

A r e / w e r e y o u (1) ( w i t h i n t h e p a s t 12 m o n t h s ) a d i r e c t o r / a s u b s t a n t i a l s h a r e h o l d e r / c h i e f
executive/employee of any member of China Construction Bank Group ("CCB Group") or 'relative of or
trustee for any such director/substantial shareholder/chief executive/employee? or (2) Are/will you
become in any way connected with: (i) a director of us or of any of our subsidiaries and/or associated
companies; or (ii) an entity controlling 10% or more of the shares of us or any director of such entity; or
(iii) an indirect controller of us or any director of such indirect controller?
Yes. (Please state the name In both Chinese and English of the relevant person or company/entity)

Relationship with that related person or company/entity _

Marital status (N)
Single

M arried

Divorced

Number of
children

Widowed

No. I confirm that, as at the date of this application, I am not related t o CCB Group or your Bank as
mentioned in paragraphs (1) and (2) above. If I am so related after the date of this application, I shall
notify you \x\ writing at once.

Education level (N)

Primary

Secondary

Vocational institute

ReSnder of Required Documents

University o r above

Please attach copies of the following documents t o facilitate our processing. Documents submitted and
this application form will not be r etur ned.

Mobile phone no.

HK Permanent Identity Card of card applicant (if you are not a permanent resident of HK, copies of

E-mail address (Required to fill in)

HK Identity Card and a valid passport of your origin or visa are r equir ed.)
n

Curr ent r esidential pr oof dated within the latest 3 months, e.g. electr icity bill, r ates demand note,
bank statement

Residential address (Please complete in Englist;^ block letters) P.O. Box will not be accepted

and any one of the following documents:

i)
Flat I R o o m

Floor

Latest 1 month's (latest 6 months' - if your main stream of income is on commission or overtime

BIdg. / Estate

allowance basis) salary slip{s) showing your name; or

ii)

No. a n d name o f street

Latest 3 months' bank statement/bank passbook showing your name, account number and salary; QL

iii) Latest 1 month's Mandatory Provident Fund statement shoving your name; or
iv) Latest income Tax/Profits Tax Demand Note (withIn 1 year from the date of issuance); or

District (Plesse wcbse pemianent address proof and stafe on the documsnl If the permanent address.Is differentfromthe above residential address)

Years at previous residential address

if you are a sole proprietor of, or a partner in, a business.

The Bank may require the applicant to provide additional documents for approval.

DecBaratiion a n d Signatur
Type of residence (N) (Please mark t h e appropriate b o x )
Live with parents

Quarters

Public housing
O w n e d b y applicant

Rented
Mo r t g a g e d

o r t g a g e I Rent per m o n t h

HKD

Occupation
Name of employer (Please complete in English b l o c k letters)

Office Address (Please complete in English b l o c k letters} p.o. BOX win not be accepted

Flat / R o o m

Floor

Block

BIdg.

No. a n d name of street

HK

]KLN

NT

District
Office phone n o .

Nature o f business

I do not wish the Bank to make use of my personal data for its own direct marketing (excluding
credit card products).
I do not wish the Bank to make use of my persona) data for its own direct marketing on credit card
products. (I understand that if I choose this option, I will NOT receive any Credit Card promotional
information
ormation sent by the Bank, including but not limited to concerts eexclusive priority bookings,
merchants promotion and other spending promotion programs.)
Please mark a ' V as appropriate
I understand that the above choice (replaces previous one, if any) applies to the direct marketing of
the classes of products, services and/or subjects, kinds of personal data may be used and classes of
persons t o w h i c h my personal data may be provided in direct marketing as set out in t h e Bank's
"Notice to Customers relating to the Personal Data (Privacy) Ordinance". I understand that it takes
time to update the above choice.
By signing Ihis application below, I confirm a n d acknowledge that;
(1) I have r e a d , u n d e r s t a n d a n d agree t o b e b o u n d by:i) the terms and conditions in this
application a n d t h e CCB (Asia) Credit Card C a r d m e m b e r Agreement (key provisions of w h i c h are
summarized overleaf); a n d (ii) t h e attached "Notice t o Customers relating t o t h e Personal Data
(Privacy) Ordinance", set out overleaf; (2) no loan/credit card under m y name h a s been cancelled
due t o a default in payment a n d : (i) I currently have no overdue payment(s) e x c e e d i n g 3 0 days in
respect of any loan indebtedness; a n d (ii) n o bankruptcy order has ever been m a d e against m e
and I am n o t petitioning or planning t o petition for bankruptcy; a n d (3) all information provided in
this application is correct a n d complete, a n d I authorize you to c o n f i r m or verify this information
and my credit record in any w a y you choose.

Position

Years o f service

Years of service at previous job

Monthly basic income

Monthly C o m m i s s i o n (If applicable)

HKD

HKD

Signature of card applicant

Self-employed

DYes D N o

If sdf-employed, your yrars of

s w in r i jrmnt n m f f i f y y n n

For Office Use Only