PDF《For Internal Use》

PrimeCredit WeWa Visa Card Application Form 安信WeWa Visa卡申请表格 Please select credit card type 请选择信用卡类别: 1.

Applicant must be a Hong Kong Resident aged

18 or above. 信用卡申请人须为年满18岁之香港居民. 2. Full-time University / Tertiary Student applicant must be a full-time student of the University / Tertiary Institution designated by PrimeCredit, please refer to www.wewacard.com for related Institutions. 全日制大学 / 大专学生之申请人须就读於安信指定之香港全日制大学/大专院校, 有关指定之院校请浏览www.wewacard.com. 3. Any application not meeting the Platinum Card requirement will be considered as Classic Card application. The approval of Credit Card is subject to the final decision of PrimeCredit. 若信用卡申请人之白金卡申请未能符合白金卡之要求 , 则自动当作普通卡申请处理.信用卡之批核须视乎安信之最终决定 . 4. No Welcome Offer for WeWa Visa Card application from

1 March

2019 to

31 December 2019. WeWa Visa卡申请於2019年3月1日至2019年12月31日期间不予提供迎新优惠 . Card Type 信用卡类别 WeWa Visa Platinum Card WeWa Visa白金卡 (Annual income required: HK$150,000 年薪须达 HK$150,000) WeWa Visa Classic Card WeWa Visa普通卡 (Annual income required: HK$60,000 or for Full-time University / Tertiary Student 年薪须达HK$60,000或为全日制大学 / 大专学生) Personal Data 个人资料 Please put a P in the appropriate boxes below and fill in with BLOCK LETTERS 请於适当方格内加「P」号并以英文正楷填写下列各项 Notes 注U For Internal Use DS Code: PO EM AT ST Venue Code: FD IM CA P. Time: Any Mr Ms 先生 女士 Family Name 姓Given Name 名Chinese Name Date of Birth 中文姓名: 出生日期: Hong Kong Place of Birth Identity Card No. 出生地点: 香港身份证号码 : Nationality Chinese (Hong Kong) Others 国籍: 中国香港 其他 Marital Status Single Married Divorced Others No. of Dependents 婚姻状况: 未婚 已婚 离婚 其他 供养人数: (Optional 可选填) Education Level Primary School Secondary Vocational/ Tertiary/University Others 教育程度: 小学 中学 Technical Institute 大专/大学 其他 职业训练/工业学院 Residential Address 住宅地址(P.O. Box is not accepted 恕不接纳邮政信箱): Flat/Room 室Floor 层Block 座Building/Estate 大厦/屋 No. and Name of Street 街道号数及名称 District 地区 HK KLN NT Years There YR(S) MTH(S) 香港 九龙 新界 已居住年数: 年月Home Tel. No. Mobile Phone / Pager No. 住宅电话号码: 手提电话/传呼机号码: Self-owned Mortgaged Rented Company Quarters Property Owned Public Housing Others 自置物业 按揭物业 租赁 公司宿舍 by Relatives 公屋 其他 亲属物业 Monthly Mortgage Instalment / Rental Payment (HK$) 元Applicant'

s Personal Burdens Amount % 每月按揭供款/租金(港币): 个人负担百分比: Billing Address 账单寄发地址: Residential 住宅 Office 公司 D 日DM月MY年YEmail Address 电子邮件地址: Occupation 职业 Chinese 中文 English 英文 Preferred Language 通讯语言 Email 电邮 Mobile Message 流动讯息 Mail 邮寄 Phone 电话 Please tick the relevant box(es) below if you do not consent PrimeCredit to use your data for direct marketing as set out in the PrimeCredit'

s Notice to customers and other individuals relating to the Personal Data (Privacy) Ordinance and the Code of Practice on Consumer Credit Data , through any of the following channel(s): 如申请人不同意安信透过以下任何途径将阁下之资料用於安信「关於《个人资料(私隐)条例》及《个人信贷资料实务守则》致客户及其他个别人士 的通知」中载列之直接促销,请於下列相关方格内填上「 」号: Relationship with PrimeCredit 与安信关系 Opt-out from use of personal data in direct marketing 拒绝个人资料用於直接促销 If you are related to or a spouse # of PrimeCredit'