Application for Supplementary CC V2 copy - ADCB...IOQGƒdG äGOÉaE’G ™«ªL ¿CG Gò¡H ôbCG...
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IOQGƒdG äGOÉaE’G ™«ªL ¿CG Gò¡H ôbCG ,…QÉéàdG »ÑXƒHCG ∂æH øe á«aÉ°VEG á«fɪàFG äÉbÉ£H/ábÉ£H ≈∏Y ∫ƒ°üë∏d Ωó≤ŸG »Ñ∏W ≈dEG IQÉ°TEG ÉgGôj »àdG á«fɪàF’G äÉjôëàdG ™«ªéH ΩÉ«≤dG …QÉéàdG »ÑXƒHCG ∂æH ¢VƒaCG ɪc ,…OÉ≤àYEGh »ª∏Y Ö°ùM á«≤«≤Mh áë«ë°U Ö∏£dG Gòg ‘ ∂æÑdG ¿CGh .…QÉéàdG »ÑXƒHCG ∂æH äÓé°S øe k GAõL íÑ°üJ ¬d áªYóŸG ≥FÉKƒdGh äGóæà°ùŸGh Ö∏£dG ¿CG ∑QOCG ɪc ,á∏°U äGPh áÑ°SÉæe /QƒcòŸG ¢üî°ûdG ≈dEG ≈HÉ°ùM ≈∏Y É¡eGóîà°SE’ á«aÉ°VEG äÉbÉ£H/ábÉ£H OGó°UEG …QÉéàdG »ÑXƒHCG ∂æH ¢VƒaCGh .‹ É¡JOÉYEÉH Ωõà∏e ÒZ A’Dƒg/¢üî°ûdG Gòg ójhõJ ∂æÑ∏d Rƒéj ¬fCG ≈∏Y ≥aGhCGh .ô°ûY áæeÉãdG ø°S ¥ƒa º¡fCG ó¡©JCG øjòdGh ,√ÓYCG øjQƒcòŸG ¢UÉî°TC’G ÖÑ°ùH ÉgóÑμàj ób ∞«dÉμJ hCG äÉeGõàdG hCG QGô°VCG hCG ôFÉ°ùN …CG øY ∂æÑdG ¢†jƒ©J ≈∏Y Gò¡H ≥aGhCGh .ÜÉ°ù◊G øY äÉeƒ∏©Ã ¢UÉî°TC’G á«bÉØJEG •hô°Th ΩÉμMCG øe …CG hCG ôcòdG ∞fB’G •ô°û∏d á«aÉ°VE’G äÉbÉ£ÑdG »∏eÉM/ábÉ£ÑdG πeÉM ÖfÉL øe hCG »ÑfÉL øe áØdÉfl …CG »JÉaGƒe ºà«°S ¬fCG ∑QOCG ÊCGh .á«aÉ°VE’G ábÉ£ÑdG »∏eÉM/πeÉ◊ á«fƒfÉb á«∏gCG ΩóY hCG õéY …CG ÖÑ°ùH hCG ∂æÑdÉH á°UÉÿG ¿ÉªàF’G ábÉ£H ócDƒj äÉbÉ£Ñ∏d »eÓà°SG ¿EGh äÉbÉ£ÑdG/ábÉ£ÑdG ™e äÉeóÿGh QÉ©°SC’G π«dOh …QÉéàdG »ÑXƒHCG ∂æH øe ¿ÉªàF’G ábÉ£H á«bÉØJEÉH á«bÉØJG •hô°Th ΩÉμMCÉH ΩGõàd’G ≈∏Y ≥aGhCG ɪc .π«dódGh á«bÉØJE’G ‘ IQƒcòŸG •hô°ûdGh ΩÉμMC’G ≈∏Y »à≤aGƒeh »YÓWEGh »eÓà°SG øe É¡dÉNOEÉH …QÉéàdG »ÑXƒHCG ∂æH Ωƒ≤j ób äÓjó©J …CG ∂dP ‘ Éà äÉeóÿGh QÉ©°SC’G π«dOh …QÉéàdG »ÑXƒHCG ∂æÑd ¿ÉªàF’G ábÉ£H hCG ¬dƒÑb hCG ¬∏jó©J hCG ¬Ñë°S Rƒéjh ,…QÉéàdG »ÑXƒHCG ∂æÑd ≥∏£ŸG ôjó≤àdG Ö°ùM ó«°UôdG πjƒ– ¢VôY ¿CG ≈∏Y ≥aGhCG ɪc .ôNB’ âbh .ÜÉÑ°SCG …CG AGóHEG ¿hO hCG ≥Ñ°ùe QÉ©°TEG ¿hO ¬°†aQ Ver.02/November2018 FRM-CCB-000-0.2 V.2.0 Dec-2018 Application for Supplementary Credit Card Supplementary card applicant must be over 18 years. á``«aÉ°VG ¿É``ªàFG á``bÉ£H IQÉ``ªà°SG .áæ°S 18 `dG ¥ƒa á«aÉ°V’G ábÉ£ÑdG ÖdÉW ¿ƒμj ¿CG Öéj Please fill in the details in CAPITAL LETTERS. Complete ALL SECTIONS and indicate areas Not Applicable by marking it NA. Countersign all modifications or corrections you make to ensure clarity of information. ∫ƒ≤ë∏d áÑ°ùædÉH ≥Ñ£æe ÒZ áeÓY ™°Vhh äGô≤ØdG áaÉc ∫ɪcG ≈Lôj .IÒÑc ±hôëH π«°UÉØàdG ∫ɪcG ≈Lôj .É¡H Ωƒ≤J »àdG äÉë«ë°üàdG hCG äÓjó©àdG áaÉc ≈∏Y ™«bƒàdG ≈Lôj .á≤Ñ£ŸG ÒZ For Bank Use Only á«°ù«FôdG ábÉ£ÑdG πeÉM ¿ÉªàFG ábÉ£H ºbQ á«°ù«FôdG ábÉ£ÑdG πeÉM º°SG ∫hC’G º°S’G ÜC’G º°SG á∏FÉ©dG º°SG CIF no. Betaqti Card Image Reference Number (IRN) CID Promotion code Source code Branch code I) Supplementary Applicant(s) card details Leave one space between names. Maximum 19 characters. If more supplementary cards are required, please complete additional forms and attach. In consideration of my application for the Abu Dhabi Commercial Bank (referred to as ADCB in this form) Credit Card(s), I hereby declare that all statements made by me in this application are true and correct to the best of my knowledge and authorise ADCB to make any and all credit investigations that are deemed appropriate. I understand that ADCB can decline this application without assigning any reason whatsoever and that the application and its supporting documents will become a part of ADCB’s records and will not be returned to me. I authorise ADCB to issue Supplementary Card(s) for use on my account to the person(s) named, who I undertake, is/are over 18 years of age and agree that the Bank may provide information to him/her about the account. I hereby agree to indemnify the Bank against any loss, damage, liability or costs incurred by the Bank on account of any breach by me or the Supplementary Cardholder(s) of the aforesaid condition or any Terms and Conditions contained in the Bank’s Credit Card Agreement or by any reason of any legal disability or incapacity of the Supplementary Cardholder(s). The ADCB Credit Cardholder Agreement and the Service and Price Guide will be made available to me along with the Credit Card(s), my acknowledgement of the card(s) confirms that I have received read and agree to the conditions mentioned therein. I further agree that the contents of the ADCB Credit Cardholder Agreement and the Service and Price Guide including amendments, which ADCB may make from time to time, will be binding upon me. Declaration by principal card applicant Primary Cardholder’s Credit Card number Mr. Relationship Husband Wife Primary Cardholder’s name First name Middle name Last name Mother’s maiden name (This is a security feature for your protection) First name Last name First name Middle name Last name Name as you would like it on your ADCB Supplementary Credit Card Nationality Date of birth Passport number Credit Limit AED (In multiples of 5%) Mother Marital status Married Single Others Daughter Father Son Mrs. Ms. II) Supplementary Applicant(s) card details Leave one space between names. Maximum 19 characters. Mr. Relationship Husband Wife Mother’s maiden name (This is a security feature for your protection) First name Last name Signature First name Middle name Last name Name as you would like it on your ADCB Supplementary Credit Card Nationality Date of birth Passport number Credit Limit AED (In multiples of 5%) Date Mother Marital status Married Single Others Daughter Father Son Mrs. Ms. á«aÉ°VE’G ábÉ£ÑdG äÉfÉ«H (1 .±ôM ١٩ ≈°übC’G ó◊G .Aɪ°SC’G ÚH óMGh ÆGôa ∑ôJ ≈Lôj ábÓ©dG ó«°ùdG Ió«°ùdG á°ùfB’G áLhR êhR ΩCG ÜCG áæHCG øHCG ∫hC’G º°S’G á∏FÉ©dG º°SG ∫hC’G º°S’G ÜC’G º°SG á∏FÉ©dG º°SG …QÉéàdG »ÑXƒHCG ∂æH øe á«aÉ°VE’G ¿ÉªàF’G ábÉ£H ≈∏Y ¬àYÉÑW ‘ ÖZôJ …òdG º°S’G á«°ùæ÷G OÓ«ŸG ïjQÉJ ôØ°ùdG RGƒL ºbQ á«YɪàL’G ádÉ◊G ÜõYCG êhõàe iôNCG (%5 äÉØYÉ°†e) äGQÉeE’G ºgQóH ¿ÉªàF’G óM (∂àjɪ◊ »æeCG AGôLG Gòg) ∫hC’G ΩC’G º°SG á«aÉ°VE’G ábÉ£ÑdG äÉfÉ«H (2 ábÉ£ÑdG ≈∏Y ∫ƒ°üë∏d »°SÉ°SC’G Ωó≤àŸG QGôbG §≤a ∂æÑdG ΩGóîà°SE’ .±ôM ١٩ ≈°übC’G ó◊G .Aɪ°SC’G ÚH óMGh ÆGôa ∑ôJ ≈Lôj ábÓ©dG ó«°ùdG Ió«°ùdG á°ùfB’G áLhR êhR ΩCG ÜCG áæHCG øHCG ∫hC’G º°S’G .É¡bÉaQEGh á«aÉ°VE’G äÉÑ∏£dG áÄÑ©J ≈Lôj ,á«aÉ°VEG ábÉ£H øe ÌcC’ áLÉëH âæc GPEG ™«bƒàdG ïjQÉàdG á∏FÉ©dG º°SG ∫hC’G º°S’G ÜC’G º°SG á∏FÉ©dG º°SG …QÉéàdG »ÑXƒHCG ∂æH øe á«aÉ°VE’G ¿ÉªàF’G ábÉ£H ≈∏Y ¬àYÉÑW ‘ ÖZôJ …òdG º°S’G á«°ùæ÷G OÓ«ŸG ïjQÉJ ôØ°ùdG RGƒL ºbQ á«YɪàL’G ádÉ◊G ÜõYCG êhõàe iôNCG (%5 äÉØYÉ°†e) äGQÉeE’G ºgQóH ¿ÉªàF’G óM (∂àjɪ◊ »æeCG AGôLG Gòg) ∫hC’G ΩC’G º°SG
Transcript of Application for Supplementary CC V2 copy - ADCB...IOQGƒdG äGOÉaE’G ™«ªL ¿CG Gò¡H ôbCG...
IOQGƒdG äGOÉaE’G ™«ªL ¿CG Gò¡H ôbCG ,…QÉéàdG »ÑXƒHCG ∂æH øe á«aÉ°VEG á«fɪàFG äÉbÉ£H/ábÉ£H ≈∏Y ∫ƒ°üë∏d Ωó≤ŸG »Ñ∏W ≈dEG IQÉ°TEG ÉgGôj »àdG á«fɪàF’G äÉjôëàdG ™«ªéH ΩÉ«≤dG …QÉéàdG »ÑXƒHCG ∂æH ¢VƒaCG ɪc ,…OÉ≤àYEGh »ª∏Y Ö°ùM á«≤«≤Mh áë«ë°U Ö∏£dG Gòg ‘ ∂æÑdG ¿CGh .…QÉéàdG »ÑXƒHCG ∂æH äÓé°S øe kGAõL íÑ°üJ ¬d áªYóŸG ≥FÉKƒdGh äGóæà°ùŸGh Ö∏£dG ¿CG ∑QOCG ɪc ,á∏°U äGPh áÑ°SÉæe /QƒcòŸG ¢üî°ûdG ≈dEG ≈HÉ°ùM ≈∏Y É¡eGóîà°SE’ á«aÉ°VEG äÉbÉ£H/ábÉ£H OGó°UEG …QÉéàdG »ÑXƒHCG ∂æH ¢VƒaCGh .‹ É¡JOÉYEÉH Ωõà∏e ÒZ A’Dƒg/¢üî°ûdG Gòg ójhõJ ∂æÑ∏d Rƒéj ¬fCG ≈∏Y ≥aGhCGh .ô°ûY áæeÉãdG ø°S ¥ƒa º¡fCG ó¡©JCG øjòdGh ,√ÓYCG øjQƒcòŸG ¢UÉî°TC’G ÖÑ°ùH Égóѵàj ób ∞«dɵJ hCG äÉeGõàdG hCG QGô°VCG hCG ôFÉ°ùN …CG øY ∂æÑdG ¢†jƒ©J ≈∏Y Gò¡H ≥aGhCGh .ÜÉ°ù◊G øY äÉeƒ∏©Ã ¢UÉî°TC’G á«bÉØJEG •hô°Th ΩɵMCG øe …CG hCG ôcòdG ∞fB’G •ô°û∏d á«aÉ°VE’G äÉbÉ£ÑdG »∏eÉM/ábÉ£ÑdG πeÉM ÖfÉL øe hCG »ÑfÉL øe áØdÉfl …CG »JÉaGƒe ºà«°S ¬fCG ∑QOCG ÊCGh .á«aÉ°VE’G ábÉ£ÑdG »∏eÉM/πeÉ◊ á«fƒfÉb á«∏gCG ΩóY hCG õéY …CG ÖÑ°ùH hCG ∂æÑdÉH á°UÉÿG ¿ÉªàF’G ábÉ£H ócDƒj äÉbÉ£Ñ∏d »eÓà°SG ¿EGh äÉbÉ£ÑdG/ábÉ£ÑdG ™e äÉeóÿGh QÉ©°SC’G π«dOh …QÉéàdG »ÑXƒHCG ∂æH øe ¿ÉªàF’G ábÉ£H á«bÉØJEÉH á«bÉØJG •hô°Th ΩɵMCÉH ΩGõàd’G ≈∏Y ≥aGhCG ɪc .π«dódGh á«bÉØJE’G ‘ IQƒcòŸG •hô°ûdGh ΩɵMC’G ≈∏Y »à≤aGƒeh »YÓWEGh »eÓà°SG øe É¡dÉNOEÉH …QÉéàdG »ÑXƒHCG ∂æH Ωƒ≤j ób äÓjó©J …CG ∂dP ‘ Éà äÉeóÿGh QÉ©°SC’G π«dOh …QÉéàdG »ÑXƒHCG ∂æÑd ¿ÉªàF’G ábÉ£H hCG ¬dƒÑb hCG ¬∏jó©J hCG ¬Ñë°S Rƒéjh ,…QÉéàdG »ÑXƒHCG ∂æÑd ≥∏£ŸG ôjó≤àdG Ö°ùM ó«°UôdG πjƒ– ¢VôY ¿CG ≈∏Y ≥aGhCG ɪc .ôNB’ âbh
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Application for Supplementary Credit Card
Supplementary card applicant must be over 18 years.
á``«aÉ°VG ¿É``ªàFG á``bÉ£H IQÉ``ªà°SG
.áæ°S 18 `dG ¥ƒa á«aÉ°V’G ábÉ£ÑdG ÖdÉW ¿ƒµj ¿CG Öéj
Please fill in the details in CAPITAL LETTERS. Complete ALL SECTIONS and indicate areas Not Applicable by marking it NA. Countersign all modifications or corrections you make to ensure clarity of information.
∫ƒ≤ë∏d áÑ°ùædÉH ≥Ñ£æe ÒZ áeÓY ™°Vhh äGô≤ØdG áaÉc ∫ɪcG ≈Lôj .IÒÑc ±hôëH π«°UÉØàdG ∫ɪcG ≈Lôj.É¡H Ωƒ≤J »àdG äÉë«ë°üàdG hCG äÓjó©àdG áaÉc ≈∏Y ™«bƒàdG ≈Lôj .á≤Ñ£ŸG ÒZ
For Bank Use Only
á«°ù«FôdG ábÉ£ÑdG πeÉM ¿ÉªàFG ábÉ£H ºbQ
á«°ù«FôdG ábÉ£ÑdG πeÉM º°SG∫hC’G º°S’GÜC’G º°SGá∏FÉ©dG º°SG
CIF no.
Betaqti Card Image Reference Number (IRN)
CID Promotion code Source code Branch code
I) Supplementary Applicant(s) card details
Leave one space between names. Maximum 19 characters.
If more supplementary cards are required, please complete additional forms and attach.
In consideration of my application for the Abu Dhabi Commercial Bank (referred to as ADCB in this form) Credit Card(s), I hereby declare that all statements made by me in this application are true and correct to the best of my knowledge and authorise ADCB to make any and all credit investigations that are deemed appropriate. I understand that ADCB can decline this application without assigning any reason whatsoever and that the application and its supporting documents will become a part of ADCB’s records and will not be returned to me. I authorise ADCB to issue Supplementary Card(s) for use on my account to the person(s) named, who I undertake, is/are over 18 years of age and agree that the Bank may provide information to him/her about the account. I hereby agree to indemnify the Bank against any loss, damage, liability or costs incurred by the Bank on account of any breach by me or the Supplementary Cardholder(s) of the aforesaid condition or any Terms and Conditions contained in the Bank’s Credit Card Agreement or by any reason of any legal disability or incapacity of the Supplementary Cardholder(s). The ADCB Credit Cardholder Agreement and the Service and Price Guide will be made available to me along with the Credit Card(s), my acknowledgement of the card(s) confirms that I have received read and agree to the conditions mentioned therein. I further agree that the contents of the ADCB Credit Cardholder Agreement and the Service and Price Guide including amendments, which ADCB may make from time to time, will be binding upon me.
Declaration by principal card applicant
Primary Cardholder’s Credit Card number
Mr.
Relationship HusbandWife
Primary Cardholder’s nameFirst name Middle name Last name
Mother’s maiden name (This is a security feature for your protection)
First name Last name
First name Middle name Last name
Name as you would like it on your ADCB Supplementary Credit Card
Nationality Date of birth
Passport number Credit Limit AED (In multiples of 5%)
Mother
Marital status MarriedSingle Others
DaughterFather Son
Mrs. Ms.
II) Supplementary Applicant(s) card details
Leave one space between names. Maximum 19 characters.
Mr.
Relationship HusbandWife
Mother’s maiden name (This is a security feature for your protection)
First name Last name
Signature
First name Middle name Last name
Name as you would like it on your ADCB Supplementary Credit Card
Nationality Date of birth
Passport number Credit Limit AED (In multiples of 5%)
Date
Mother
Marital status MarriedSingle Others
DaughterFather Son
Mrs. Ms.
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∫hC’G º°S’Gá∏FÉ©dG º°SG
∫hC’G º°S’GÜC’G º°SGá∏FÉ©dG º°SG
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á«°ùæ÷GOÓ«ŸG ïjQÉJ
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(%5 äÉØYÉ°†e) äGQÉeE’G ºgQóH ¿ÉªàF’G óM
(∂àjɪ◊ »æeCG AGôLG Gòg) ∫hC’G ΩC’G º°SG
á«aÉ°VE’G ábÉ£ÑdG äÉfÉ«H (2
ábÉ£ÑdG ≈∏Y ∫ƒ°üë∏d »°SÉ°SC’G Ωó≤àŸG QGôbG
§≤a ∂æÑdG ΩGóîà°SE’
.±ôM ١٩ ≈°übC’G ó◊G .Aɪ°SC’G ÚH óMGh ÆGôa ∑ôJ ≈Lôj
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.É¡bÉaQEGh á«aÉ°VE’G äÉÑ∏£dG áÄÑ©J ≈Lôj ,á«aÉ°VEG ábÉ£H øe ÌcC’ áLÉëH âæc GPEG
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á∏FÉ©dG º°SG
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á«°ùæ÷GOÓ«ŸG ïjQÉJ
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á«YɪàL’G ádÉ◊GÜõYCGêhõàeiôNCG
(%5 äÉØYÉ°†e) äGQÉeE’G ºgQóH ¿ÉªàF’G óM
(∂àjɪ◊ »æeCG AGôLG Gòg) ∫hC’G ΩC’G º°SG
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