CITI CARD APPLICATION FORM Cake ce ek) cuiRewaree Ciné CRICathBack Card Ct Pramritles Card ‘it Smottys Cars Shel ctiCard Mercury rua Ct card omndecanth snare st you tat i inne a you rma eed v= WV “tame to appear on Card (matin 6 spaces) Sout Bit Vomer tle For A rasa? ener ae Fema tes rao wane a a rie wr ic ih Cont Pion AN City or Municipality VP retemty Sittin ‘others, ls. specity Fitpe ots pls. specity ‘ownea mortgaged ‘Owned, net morigagea aoe soreness Cisne Geo Ea tinea heer of psssnseriarmo ne yore a cases Seater ia ima AMG OSS (Pee dang are Crete as) Zocate ‘Home Phan Mo. A tire *Eimall Adress for Ct Electronic Statements and Adviee/# ona ed ployment Sector Private Publ Seltempioyed others. No.of Years with ‘Yeats in Business Present Employer eareasarat semployer/Business Name Peston sob Tite ese/Industey tal no of Years Work! 'Seures/t ef pasbers income) nhrkarce ‘ffl income Fande SATERment —yestment_—_Speue/Preal Pererasaargs sem i spa suey — Sle of Property Local Vi at tee Spi tna ne Pe credit Cords With Other Sents (excuding supplementary cards cards) ‘Cara: Bank name card 2: bask name ears Poa ‘Are you a relative er business partner of any fice, director orstocktolder ofchibank.NA? Yee No if ys. indicate relatonenip Ene cenit het an ne ner ses bee Rs kal st es teva Toqpiesse cneck one i ‘ot more than Php3 millen ‘more than Pgs miion to Paps ition ‘nore than Pats millon to Phot00 milion ‘Acatenuly(or such business whose iota assets nave value Feting under more {an Pap mtn to Php mln’ or more than PRDIS milion PAPI olin ‘eters tat buns: asbres Geese wthappromiate >veranent Soencles Further hereby certily thot Lam eware of ard wl compy with the ational (docunreary requirements as stetedn BSP Ccuar 62s amended by BSP ‘Crealar 855, uncerstand tet sor-complnce with he requirements suticert Ground for reectonofmy aplctin, ejector of urnerextenson fered on Iny account or termintion of account. | oeelare thatthe above information are LV _Siotussttingn tons eesrsehnane, v vs(oe a In this application form, the term “Card” means any credit card Issued by Citibank, N.A. Philippine Branch ("Bank"). The terms “I", “my", “me”, and “applicant” refer to the person who has applied for one or mare Cards and/or for with the Bank, whose application may or may not be approved. The term “Cardholder” means the person who has been issued by the Bank one or more Cards, including 2 Supplementary Card. Moreover, once my application is approved, | agree, as a Cardholder customer, to pay these fees, as applicable, to be determined by the Bank for the use of the Card or other facilities end services and/or for the maintenance and administration of any Card balance or transaction. The feos will be charged to my Citi Card line or on such fund as may be avaliable on my Account. flows te tabi of CR Card Fees and Charges a of November 207. CITI CREDIT CARD FEES AND CHARGES Annual Membership Fees saa ‘Card Type Principal Caré Supplementary Cord Mereryorusii | Php2,000 Php900 ‘hat Php2,500 Phpt,200 Ct Reads Php2,500 Phpt,250° Cuisimrctye | embersniptee | Membennipree Citi Cash Back Php3,500 Php1,750 ctiprenierwies | Phps,o00 | Php2,500* Interest Rates ‘Retail Monthly Etfectve Interest Rate! 3.50%" CCHCath Advance Monthy EMectve terest Rate! |, 364% a ‘Other Fees and Charges for All Card Types Php5OO 3% ot cx can novos ara | sicher igh. Adina fe at PhPSOD a aneny 31 20% PHPSOO 6% «i ous near, unchver ahr ttecve Ferny, 2018 PHPBSO or te ures Minimum amon! De, whhve slower Late sherge dma pt singlet sera Monthly US Charge Your Wninum Anat Do “PhpS00. 4.thesmotte tenstow er PAPSOO wc shiner Sty ast ou Amount 2h eon ue forthe ments aCe on 2: roin nares ren to 4 mute ie reared pent pcan ot 19%, Minimums Amoant Bue at carces mace in cance wit stata fe Siveice Ph snipe ramnsten [Poe Prana Esra Foe Maanuatrcr. a te ot Inpoed onthe converte amount which reareentt eersascn tes and anesomanh Yes Cursed Sicahnatrewe citi cattforcash | PAPO wit be charged tor the covery of the Manta Cheek | yaragers ches arated ute th i eat fr Cah ohey ches | avae Php30O sppiabie oct PayLte ane cit Pits Phe caveninion | ———__________ Fresrasnatee [4% ot tne urbled pina consonet of the FEeRemecement | PAPAOO serena ister sown cx Php5OO nou Reston saree thensarce terse al you Ch Crh esl ot test ronsncler tony rcets our Relators {ine ee, on were your Crs ov Acomt Creat Line yer acstouates ects yor acct Cet int ne il py these sy yo vent — [Caro with the transaction that fev reece on your cr oenth over, yer Inthe suceedna nents. PHSOO overt Fee fais caret pre Sree Sone pty tC Spy PHp1,500 wie shred fr over heck hat ‘atteration, erasure o deficiency, o foray oer reesen. PhP25O ior exch charge so rotrieved upon your charge peur or shove een Te sone nour eee [charges to you for each caarge sip retrieved by t Sranatrenan vt dance, bieburcamant Fee |PhP25O freer aporoved chi calor ath ne ‘Attorney Faoe [Sion totate nd tceatchrges be cet ofceecton Sagi ude | ejr ate er nd Wigston ard cles | agree to the following terms and conditions: FEES AND CHARGES. | agree to pay an Annual Membership Fee to be determined by the Bank for the issuance and use of the Card, as wall as fee/s for other {eclties and services that | avall of and/or for the maintenance and administration of any balance or transaction on the Card (See the Citi (Card Fees and Charges for the prevailing rates). The said fee/s shall be deducted trom tne avaliable Relationship Limit ("RL") or Account Credit Limit. | agree that the Bank may change or increase the Interest charces, {e0t, and other charges, and their rates and ealeulatien from time to ‘time. The Bank wil notity me of any changes on interest charges, tees, ‘and other charges before these tate effect. ‘CARD PAYMENT my appileation is approved, | am liable to pay any andallcutstanding balances on my Card account.| must pay atleast the Minimum Amount Due (as described in the Citi Card Agreement) plus the Overlimit “Amount if any, for @ particular month. This payment mast be received by the Bank on or before the payment due date ("Payment Due Date") indicated on my Statement of Account ("SOA"). 2/5My Overimit ammount, If any, [s the portion ofthe Retatlenship Balance Gineluding unbilled principal on intallment transactions, it any) which exceeds my RL or Account Credit Limit. This will be Indicated separately from the Minimum Amount Due on my SOA. Once my Card account becomes over limit, all my Citi Cards will be immediately Dlocked and may not be able to use any of them. may only continue touse them after | settle the Overlimit Amount ot my total payments have reduced my balance to.an amount lower than my RLor Account Crecit Limit. I ipay tess than the Total Amount Due by the Payment Due Date, my Card account will be charged Interest as described in the Interest Charge section. INTEREST CHARGE ‘The applicable monthly interest rates for Retall Transactions and for Cash Advance transactions Interest") are stated in my SOA. The applicable monthly effective interest rates ("EIR") for Retail Transactions and Citi Cash Advance transactions are stated in the Gili Card Fees and Charges. interest cater aro quoted based on 3 30-day period. For months with more (or less) than 30 days, the applicable Interest rate shall increase (or decrease) accordingly. Interest is compounded menthiy. In accordance with the Philippine Accounting Standards (PAS) definton, effective interest rate (EIR) isthe rate that oxactly aiscounts estimated future cash flows through the life of the joan to the net amcunt of loan proceeds (BSP Circular No. 730, 52010. Allard Transactions and any amounts chargedto my Card shall incur Interest. The Bark computes interest each month based on dally balances (including new transactions}. How the dally balance is computed: ‘The daily balance fs computed Separately for each type of balance (Citi Cash Advance balance and Retail balance), in the following manné ‘Step Start with the ending belance from the previous day. ‘Step 2 Add any new purchases, the principal portion ofthe Monthly Installments Due, and charges transacted en that day. ‘Step 3 suotract any credits, payments, and/or otner aqustments mado on that day. How interest is computed: ‘Step Multiply each daby balanco by the dally Interest rato (which 's the monthly Interest rate clvided by 30) to determine the daily Interest. The Bank does not comoute Interest on any creéit balance. ‘Step 2 Repeat Step for each day n the biling period. 3 Add up all the dally Intorest to determine the total Interest for the biting period. For Retall Interest only: I pay the Total Amount Due of my current SOA In full by its Payment Due Date, the Retall Interest on my new Card transactions will be deferred to my nest SOA ("Deferred interest". If | continue to pay my Total Amount Due on the next SOA in full by the next 50's Payment Due Date, the Deferred interest will not be charged, bit! pay the Total Amount Due of my current SOA In full By its Payment Due Date, but | have an unpaid balance from the previous 0A, the unpeld portion of the Previous Balance wil incur Interest; the computed interest onthe unpaid amount o the Previous Balance willbe charged on my next SOA ("Residual Interost”). 6. If Go not pay the Total Amount Due of my current SOA In tull by Payment Ove Dato, the total Retall Interest assested equa |. Total interest forthe bling period (es computed In Step 3); plus i. Any Deterred interest from the previous billing period. Interest Is compounded monthiy; on the Statement Date, Interest charged on Retall Transactions wil be added tothe outstancing Retall balance and Interest charged on Citi Cash Advances will be added to ‘the Citi Cash Advance outstanding balance, if any. Although the monthiyinterestrates are as statedin my SOA, the total Interest | pay on an annual basis may be higher depending on the amounts I pey and when | pay. can save on Interest when Ipay more than the Minimum Amount Due ana/er pay earler. RELATIONSHIP LIMIT acknowledge that ally Citi Cards. including any existing Cards, wil be subject to the Relationship Limit. The Relationship Limit is the ‘maximum amount that Ican spend on any of my Cards, provided that the sum of the outstanding balances (including unbiled principal on Installment transactions) on all my Cards does not exceed the Relationship Limit MONTHLY INSTALLMENT DUE ‘Applicable to installment dues incurred forthe avaliment of Ctl PayLite, Citi PayLite Atter Purcnase, Citi Call for Cash, citi Balance Transter ‘and Cit} Balance Conversion. The monthiy installment due for my installment Transaction ("Monthly Inetallment Du the Minimum Amount Dve on my SOA nti the installment Transaction Amount and the applicable Interest ‘are paid in full. | may compute the Monthy Installment Due by using the folowing formula: Installment Transaction Amount x {1+(Converted Monthly Fecior m)) ‘The Monthly Installment Due comprises the Interest and principal ‘components and is computed on a diminishing balance basis, The Interest and principal components of the Monthly instalment Due ‘vary each menth and are computed as follows: * Interest componer Prior month's eutstancing principal balance x monthly Effective Interest Rate (EIR), where monthly EIR = (1+ Anat EIR)" ~ + Principal pertion: Monthly Installment Due Interest component for the month. ‘The Interest charge on the first Monthiy installment Due is computed based on the number of days between the approval date of the Installment Transaction and Statement Date, whichis the date when my SOA Is generatec atter eacn billing periog. The Interest on succeeding Nonthly instalments Due is computed based on a fixed ‘30-day period. This wil result in the first Monthiy Installment Due being different from subsequent ones. IT pay tess than the Total Amount Cue indicated on the SOA, the unpaid portion of the Monthiy installment Due is subject to the prevailing monthly retail interest charge. interest Is compounded rmonthiy. Usual Late Charges also appiy, In addition, ify Card account Is past due for 60 days or more, the Installment Transaction will be ‘cancelleg. Any remaining unpaid belence will be billed to my Card ‘account in full and will be subject to the prevailing monthly retail Interest charge. APPLICANT'S INFORMATION, {declare that the above information In this application form and the information in the submitted documents are trus,cerrect andundated: ‘and the said documents are genuine and culy executed. | authorize the Bank to verity and obtain copies of ll information and ‘submitted documents from the Bureau of Internal Revenue (BIR) and other appropriate sources including my employer/s and/or my ‘accountant/s("income Sources”). | also authorize each ofthe Income Sources to disclose any information relevant to the said verification ‘and give copies of my Income Documents to the Bank. | waive any rights on the configeatialty of my income information as tequired by BSP Circular 622, as amended by BSP Circular 855. understand that ‘any falsification relates to my application Is sufficient grouné forlegal action and rejection of my application. | understand that it my applications denied, he Bank has ne obigation to furnishthe reason {for such rejection. | agree that if my application is denied, the Bank may re-precess and re-evaluate my application witnin three (3) months from the date of {denial andit may, inits diseretion, issue me a Card at that time. ‘CONSENT FOR PROCESSING, PROFILING AND SHARING OF DATA AND INFORMATION Please read these provisions (the "Consent”) on Citi Processing, Profiling and Sharing of Data and Information thorouahly. Capitalized ‘terms used herein shall have the meanings set forth in Citi's Dato Privacy Statement (version 1, 3/31/2017), the terms of which ‘are incorporated herein by reference. Citi's Data Privacy Statement (Data Statement”) canbe viewed online at ‘won cititank.com.ph/DataPrivacyStatement. “The words “I", "Me" and “My” refer to you as a barking, brokerage, credit, debit or prepaid card or loan prospect/applicant or client or Relevant individual of@Data Subject of Ctibank, NA. Philippine Branch (Citibank) or Citicorp Financial Services and Insurance Brokerage 3/5