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Credit Card Application

Enhance Your Lifestyle


Open a world of opportunity
A range of unique experiences awaits you as the holder of a credit card from
People’s Bank. Be it Classic, Gold or Premium, you will benefit from amazing deals,
great discounts, low interest rates and a host of other advantages. You will be able
to do transactions with utmost convenience at numerous places across the country
and the world. The cards come with exciting features to enhance your lifestyle!

Convenience
Accepted worldwide at over 30 million establishments, with easy access to
more than 3.5 million ATMs – Make purchases anywhere, anytime.

Value
Smart deals all year round with overseas travel insurance and no collateral or
guarantors on your credit. Utmost flexibility with minimum requirements, low
interest rates and competitive charges.

Flexibility
Extended settlement plans up to 3 years combined with flexible transfer
facilities and easy instalment based repayment options with a choice of VISA,
Mastercard or both for the same account.

Connectivity
Free SMS alerts on your transactions and free electronic statements via e-mail

Link your card to your phone and to People’s E-banking free of charge while
checking transactions and balances through the Internet

Settle dues online with no branch visits and enjoy 24-hour call centre support
services
The ability to settle card payments at over 700 branches and service centres
islandwide

Safety
Fraud prevention with 3D Secure and dual authentication complying with EMV
standards

Documents Required
If monthly salaried:
Duly completed application form
Copy of National ID
Copy of Service Identity Card
Last 2 months’ pay slips certified by employer and service certificate issued
by employer
Billing proof when required (utility bill copy such as electricity, water, etc.)

Business / Self-employed:
Duly completed application form
Copy of National ID
Copy of business registration
Income proof documents
Business account maintained in People’s Bank (no need of income proof
documents)
Billing proof when required (utility bill copy such as electricity, water, etc.)

People’s Bank Card Centre


2nd floor, No.1161, Maradana Road, Colombo 8.
Call Center : 1961 Fax : 0112 169 029 / 0112 169 023
E-mail : [email protected] Web : www.peoplesbank.lk
*Terms and Conditions Apply
Emp. No. Branch Agent
code code

CARD TYPE

Mastercard VISA

Classic Gold Platinum Signature World

Please Fill in Block Letters

Date : Ref. No.

MY PERSONAL DETAILS

Mr. Mrs. Miss Dr. Others, Please specify

FIRST NAME

OTHER NAMES

LAST NAME

Name as it should appear on the card (Max. 19 letters)

As per NIC / Passport

Male Female Date of Birth


Day Month Year

Nationality

NIC No.

Passport No./DL No.


(Please attach photocopies of NIC, Passport or DL)

Marital Status : Single Married Divorced Widowed

No. of dependents

Professional Qualifications if any

Residential Status

Own Rent Company Provided

Mortgaged With Parents

Home Address

City District

Duration at above address Years Months


Phone No. Home

Mobile No.
By selecting “Yes” you will receive transaction
SMS Alert Service Yes No
details, one time password and information
related to your card.
E-mail Address

Authorized e-mail address to communicate Yes No


E-statement
card-related information

Mother’s Maiden Name

If Married
Spouse’s Name

NIC No.

Spouse’s Occupation

Office Address

Spouse’s Income : Monthly Annual

Phone No. (Home)

Mobile No.

Phone No. (Office)

Fax

Details of relatives not living with you


1. Name

Home Address

Office Address

Phone No. (Home)

Mobile No.

Phone No. (Office)

Fax

Relationship
2. Name

Home Address

Office Address

Phone No. (Home)

Mobile No.

Phone No. (Office)

Fax

Relationship

MY OCCUPATION
Employer/Name of business

Office Address (include department)

Tel No. Ext

Fax

E-mail

Length of service at current employment:

Years Months

No. of employees

Up to 10 11-50

51-100 More than 100


Job title

Permanent Contract Other


Industry
Armed Services Telecom

Banking/Finance Medical

Garments Construction

Government Public Utility

Hotel Advertising

Insurance Airline

Import/Export Professional Service

Manufacturing Conglomerate

Travel Plantations

Trading Freight FWD / Shipping

Information Tech. * Others

* If other, please specify

Employment status : Salaried Self-employed Retired

TO BE COMPLETED BY SELF-EMPLOYED PERSONS ONLY

Capital invested Annual turnover

MY ANNUAL INCOME

Basic annual salary Rs.

Fixed allowances Rs.

Variable allowances Rs.

Other income Rs.

Source(s) of other income

If you have been in your current job for less than one year, please specify
your previous employment details and telephone number.
Previous employer

Tel No.

Nature of business

Length of service at previous employment:

Years Months

Job title
MY INVESTMENTS

Bank Branch A/C No. A/C Type A/C Since

MY ASSETS
(Market value)
Properties

Fixed / Call deposits

Shares

Other (specify)

MY OBLIGATIONS

Monthly
Type Bank Balance Outstanding
Instalment

Housing Loan

Car Loan

Other Loan(s)

Monthly Living Expenses

MY OTHER CREDIT CARDS

Monthly
Card Type Bank Balance Outstanding
Instalment
MY SUPPLEMENTARY CARD
I, the primary card holder hereby authorize and request you to issue in accordance
with the Terms and Conditions of the People’s Bank Credit Cardholder Agreement, a
supplementary People’s Bank Credit Card to the person named below who is not
less than 18 years of age for use on my People’s Bank Credit Card Account /
between 16-18 Years of age and I confirm that the People’s Bank Credit Card will be
used strictly for payments regarding educational purposes and he/she is a direct
dependent of mine. I also hereby take full responsibility to settle the expenditure
incurred by the supplementary card holder.
I, the primary card holder hereby authorize that both the primary cardholder and the
supplementary cardholder will be jointly and severally liable for the use of the card
as well as the supplementary card.

Surname Mr./Mrs./Miss

Other Names

Name as it should appear on the card (Max 19 letters)

As per NIC / Passport

Relationship to the primary applicant

NIC No.

Passport No.
( Please attach photocopies of NIC and Passport)

Date of Birth
Year Month Day
Mother’s maiden name

Phone No.

Credit limit to be allocated to supplementary card

Rs.

DECLARATION
I/We state that the above details are true and correct and are given in support of
my/our application to People’s Bank, Sri Lanka for a Credit Card Account, subject to
the respective Credit Cardholder Agreement which outlines the Terms & Conditions
of Use, and which will be sent to me/us upon approval of my/our application.

I/We authorize People’s Bank to debit my/our Card Account with the charges, fees
due and transactions done assisting the card in respect of this card account and will
be liable jointly and severally for all charges, fees and transactions done assisting
the card to the primary and supplementary cards issued on my/our request. If
People’s Bank considers it relevant for purpose of assessing this application, I/We
would authorize People’s Bank to obtain a report about my/our commercial
activities or commercial creditworthiness from Businesses/Institutes which provide
this information. I/We understand this information may be used to assist me/us to
avoid default and to notify other credit providers of my/our defaults.
I/We also authorize People’s Bank to make inquiries about the information included
on my/our application from any other source, that People’s Bank may deem fit. I/We
also acknowledge the right of the Bank to deduct the due from my/our account
under personal or business name and appoint an agent to collect all sums due to
the Bank from me/us. By signing below I/We request that a card account to be
opened for me/us and to renew and replace it (subject to Terms & Conditions) until
I/We surrender my/our rights to use the card by cutting the card and returning it to
People’s Bank with written notification.
I/We authorize People’s Bank to charge all pending payments and other fees and
charges at its prevailing rates from surviving cardholder on the death of primary
cardholder or supplementary cardholder.
I/We also confirm that the brochure/leaflet and the description/nature of the
product/service to be received by me/us were explained to me/us by the bank
making this application and that I/we fully understand the details and the nature of
the product/service offered herein. I/We further authorize the Bank to use my/our
personal information for marketing and operational matters. I/We further authorize
the Bank to report any default by me/us to the Credit Information Bureau or similar
organization in Sri Lanka or abroad. I/We accept that the Credit Card will be issued
at the sole discretion of the Bank.
I/We hereby authorize the Bank to accept and execute the instructions received by
fax or e-mail from me/us bearing or purporting to bear my/our signature/s. I/We
hereby undertake to keep the Bank fully indemnified and free from all claims,
damages, charges and expenses which the Bank may incur, directly or indirectly, by
reason of complying with this request/instruction or any incorrect or improperly
authorized instruction from me/us received by the Bank via fax or e-mail, unless the
Bank acts fraudulently or with gross negligence. Notwithstanding the foregoing, the
Bank may at any time at its absolute discretion decline to execute any request or
instruction given via fax or e-mail pursuant to this request/instruction. This
request/instruction shall remain in force until I/we shall give the Bank written notice
to the contrary. I/We assume all risk in relation to any such communication via fax /
telephone and/or e-mail.

Declaration by the Applicant/s for Electronic Fund Transfer Cards

To: Director - Department of Foreign Exchange

I/We
(Basic Cardholder), (Supplementary Cardholder)
declare that all details given above by me/us on this form are true and correct. I/We
hereby confirm that I/we am/are aware of the conditions imposed under the
provision of the Foreign Exchange Act, No. 12 of 2017 (the Act) on Electronic Fund
Transfer Cards (EFTCs) subject to which the card may be used for transactions in
foreign exchange and I/we hereby undertake to abide by the said conditions. I/We
further agree to provide any information on transactions carried out by me/us in
foreign exchange on the card issued to me/us as People’s Bank may require for the
purpose of the Act. I/We am/are aware that the Authorized Dealer (Bank) is required
to suspend availability of foreign exchange on EFTC if reasonable grounds exist to
suspect that unauthorized foreign exchange transactions are being carried out on
the EFTC issued to me/us and to report the matter to the Director - Department of
Foreign Exchange. I/We also affirm that I/we undertake to surrender the Credit
Card/s to People’s Bank, if I/we migrate or leave Sri Lanka for employment abroad,
as applicable.
I have read & understood the above declaration & Credit Cardholder Terms & Conditions.

DD.MM.YY Signature of the Primary Basic Cardholder

DD.MM.YY Signature of the Supplementary Cardholder


I (name of the Officer) have carefully examined
the information together with relevant documents submitted by
(name of the Cardholder) and satisfied myself that the said information and
documents are in conformity with Exchange Control requirements and the internal
policies of the Bank. The Bank undertakes to exercise due diligence on the
transactions carried out by the Cardholder on his/her EFTC in foreign exchange and
to suspend the availability of foreign exchange on the EFTC if reasonable grounds
exist to suspect that unauthorized foreign exchange transactions are being carried
out on the EFTC in violation of the undertaking given by the Cardholder and to bring
the matter to the notice of the Controller of Exchange.

Date Signature of the Authorized Officer on behalf of the Bank

I/We the undersigned hereby certify that the above information is true and if the
application is accepted, request a People’s Credit Card/Cards be issued to me/us.
I/We have read and understood and agreed to abide by the Terms and Conditions,
applicable in present and future, which form an integral part of this application.
I have read and understood the above declaration.

Primary Applicant’s Signature Supplementary Applicant’s Signature

Date Date

Preference to collect my card:

People’s Card Centre

People’s Bank Branch

FOR CARD CENTRE USE ONLY


Securities (if any)

P S

Credit Limits Rs.

Cash Limits Rs.

Statement Cycle

Recommended by: Approved by:

Date Date

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