REQUIREMENTS ABOUT MY WORK/ FINANCES

1 Employment PRIVATE SECTOR SELF-EMPLOYED GOVERNMENT RETIRED

• Must be 18 to 60 years old with a minimum gross annual income of Php 360,000 Current Employer/ Business Name 3 Nature of Business
2
• Must have a residence/business landline phone
• Must be employed or practicing a profession or own a business that has been
existing for at least one year 4 Current Position 5 Total Years in Work/ Business

6 Complete Business Address

Duly accomplished and signed application form _________________________________________________________________________________________________
Photocopy of an acceptable identification document with photo and signature _________________________________________________________________________________________________
Supporting documents: 7
Zip Code Office Phone No. Local Extension

8 Applicant’s Gross Annual Income 9 Applicant’s Other Annual Income

a. For Regular Applications
10 Spouse’s Gross Annual Income 11 Spouse’s Other Annual Income
PROOF OF INCOME:
If employed/ fixed salary earner: If self-employed:
BIR form 2316 (W-2) Income Tax Return BIR form 1701 or 1702 with BIR or bank stamp
12 Do you own other credit cards? YES NO If yes, how many credit cards do you have? __________
Please list down the card/s and fill up the required information.
OPTIONAL DOCUMENTATION REQUIREMENTS: CREDIT CARD CARD NUMBER ISSUANCE DATE CREDIT LIMIT
_______________ _______________ _______________ _______________
Certificate of Employment and compensation (original copy) for employed/ fixed salary earner
_______________ _______________ _______________ _______________
Audited financial statement with BIR or bank stamp for self-employed _______________ _______________ _______________ _______________
Other proof of income like contracts, bank certification of deposits/ placements
13 Are you a depositor of UnionBank?
(should indicate date account was opened)
YES Please indicate your account number ___________________________________
If existing cardholder of other credit card company: NO Would you be interested in becoming a UnionBank depositor? YES NO
Latest credit card statement (should be of current status). Must have been a cardholder for
at least 12 months. Banking relationship with other banks? DEPOSIT ________________SPECIFY CURRENT/ SAVINGS
Photocopy of existing credit card (front and back) 14 DATE OPENED BANK/ ACCOUNT NO. LOAN
______________ ______________________ DEPOSIT ________________SPECIFY CURRENT/ SAVINGS
*PROOF OF BILLING ADDRESS IF OUTSIDE METRO MANILA (Latest Statement for any of the ff.) LOAN
______________ ______________________
PHONE (LANDLINE) CELLULAR PHONE MERALCO OTHER CREDIT CARDS
CABLE TV WATER -------------------------------------------------------------------------------------------------
Deliver my card to my: Deliver my Statement of Account to my:
RESIDENCE OFFICE RESIDENCE OFFICE E-MAIL
-------------------------------------------------------------------------------------------------
CyberStatement
b. For Secured Credit Card Applications (all of the following)
*SIGNED DEED OF ASSIGNMENT OF DEPOSIT WITH UNIONBANK *PHOTOCOPY OF RESIDENCE CERTIFICATE Please also send my Statement of Account via email to: ________________________________________________________

YES, SEND ME A SUPPLEMENTARY CARD!

JOINING FEE ANNUAL FEE
P300 1 Name: First Middle Last
WAIVED
HARIBON VISA PRINCIPAL P1,500
HARIBON VISA SUPPLEMENTARY P300 P750
CASH ADVANCE 2 Name to appear on card ( Up to 21 characters only)
*SERVICE FEE 6% of the transaction amount or P300, whichever is higher Cardholder
*OVER-THE-COUNTER TRANSACTION FEE P500 per transaction Name
FINANCE CHARGE 3.5% per month *(computed based on average daily balance)
MINIMUM AMOUNT DUE 5% of outstanding balance or P500, whichever is higher Sex
3 Birthdate mm dd yyyy 4 Mother’s Full Maiden Name 5
LATE PAYMENT CHARGE 6% (computed based on minimum amount due) or P500 whichever is higher
MALE
*42% per annum (computed based on average daily balance)
FEMALE
The above fees are accurate as of the month the application form was updated. The fees are subject to change after the said date without prior
notice. For information regarding any changes in the fees, please call our Customer Service Hotline: Metro Manila 841-8600; Fax 636-6256.
For Domestic Toll Free 1-800-1888-2277; Universal Toll Free (IAC) +800-8277-2273 (USA, Netherlands, Spain, Switzerland, Malaysia, 6 Relationship with Principal Cardholder
Australia, Singapore, Japan, Korea-Koreatel, Koreal-Onse, Israel); Email: customer.service@unionbankph.com
Please do not enclose payment. Membership fees will be reflected on your Statement of Account upon approval of your application. 7 Sub-limit requested for Supplementary Cardholder P___________________________

ABOUT MYSELF _____________________________________________ _____________________________

SUPPLEMENTARY APPLICANT’S SIGNATURE DATE
1 Name: First Middle Last
To comply with the BSP requirements and BIR Regulations, I/we hereby authorize UnionBank of the Phi-
MR. MS. MRS.
lippines or any of its authorized representatives to conduct random verification with the BIR to establish
2 Name to appear on card ( Up to 21 characters only) authencity of the Income Tax Return and accompanying financial statements submitted by me/us.
Cardholder By signing below, I/we certify that the information given by me/us is true and correct. I/we authorize
Name UnionBank of the Philippines to verify and investigate the information provided by me/us from whatever
sources it may consider appropriate. I/we understand that falsifying any of the information on the enclosed
3 Birthdate mm dd yyyy 4 Mother’s Full Maiden Name 5 Sex documents is sufficient ground for legal action and the rejection of my/our application. By signing at the back
MALE of the card when delivered to me/us, I/we signify my/our agreement to the UnionBank Credit Card Terms and
FEMALE Conditions accompanying said card. I/we understand that should my/our application be denied, UnionBank
6 Civil Status SINGLE MARRIED WIDOWED SEPARATED has no obligation to provide me/us with the reason for such rejection.
7 Education HIGH SCHOOL COLLEGE SOME COLLEGE POSTGRADUATE
*In choosing Residential Address for my card delivery, I hereby authorize You or Your official courier to
8 Citizenship FILIPINO OTHERS ___________________________ 9 No. of dependents release, in my absence, my approved card to any member of the household upon presentation of an identifica-
TIN tion card with picture. In choosing Office Adress for my card delivery, I hereby authorize You or Your official
10 11 SSS courier to release, in my absence, my approved card to my co-workers, secretaries or to our desk receptionist
Home Address upon presentation of an identification card with picture or any other form of identification such as Driver’s
12
__________________________________________________________________________________________________________________ License, Passport and SSS ID. Furthermore, I shall be liable for any card availment/s or usages thereafter as a
__________________________________________________________________________________________________________________ result of such delivery and hereby hold You free and harmless from any liability whatsoever for delivering my
__________________________________________________________________________________________________________________ card as authorized herein.
Zip Code
13 Years of stay 14 Home Phone 15 CellPhone No.

16 Home Ownership OWNED/ MORTGAGED RENTED

OWNED/ NOT MORTGAGED LIVING WITH RELATIVES/ PARENTS ______________________________________________________
Car Ownership OWNED/ MORTGAGE PRINCIPAL APPLICANT’S SIGNATURE
17 Do you own a car? YES
NO OWNED/ NOT MORTGAGED
COMPANY PROVIDED _____________________
DATE
18 Email Address:
19 Reference NAME: _____________________________________________________________________ NOTE: Applications that are not duly accomplished and signed and/or not accompanied by the required
documents will not be processed.
ADDRESS: _____________________________________________________________________

PHONE No.: _____________________________________________________________________ FOR BANK USE ONLY

For Secured Credit Card Applications
ABOUT MY SPOUSE UnionBank Branch __________________________________
Account Number _______________________________
1 Name: First Middle Last
UnionBank Customer since (mm/yy) _____________________
2 Employment PRIVATE SECTOR SELF-EMPLOYED GOVERNMENT RETIRED Deposit Amount ________________________________
Date Opened __________________________________
3 Birthdate mm dd yyyy 4 Current Employer/ Business Name Branch Officer’s Signature ________________________

5 Nature of Business 6 Current Position 7 Total Years in

SOURCE CODE
Work/ Business Received by/ Date: __________________________________________________________________________________________________
8 Complete Business Address Processed by/ Date: _________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________ 4404 5
9 Zip Code 10 Office Phone No. Local Extension 4404 5
As of August 6, 2010