Omnibus AF

NO. OF DEPENDENTS:

MY PERSONAL DATA

MY JOB

NAME

GENDER

NATIONALITY/CITIZENSHIP

Unemployed

Retired (Pension, etc.)

ADDRESS

MY SUPPLEMENTARY

MY DELIVE

RY/PAYMENT INSTRUCTIONS

I will pay in cash or check at a Metrobank branch/PSBank branch

OFFICE

Please debit my Peso current/savings account no.:

Automatic Debit Arrangement (ADA):

Preferred payment mode:

DELIVER CARD & STATEMENT TO:

HOME

at Metrobank__________________________________________Branch

Minimum amount due

Full amount due

Supplementary card applicants not related to the principal cardholder are required to submit a photocopy of a valid

government-issued ID and complete the fields marked (*).

For inquiries, call our 24-hour Customer Service Hotline

at 8-700-700 or 1-800-1-888-5775 (Domestic Toll-Free)

or fax this form to

I/We hold myself/ourselves liable for all obligations and liabilities incurred with the use of the

Metrobank Credit Card/s issued to me/us. I/We warrant that I/we shall be jointly and severally liable for

the same obligations and that I/we hereby commit ourselves to the following declarations: 1) I/We

certify that the foregoing facts are true and correct; (2) I/We authorize METROBANK CARD

CORPORATION (A FINANCE COMPANY) [MCC] to receive and exchange any and all information

concerning myself/ourselves with other financial institutions, entities tasked to provide consumer credit

reporting or reference schemes, the appropriate government agencies and third parties with whom

MCC may reasonably share such information; (3) I/We authorize MCC to acquire any information from

Metropolitan Bank & Trust Company (Metrobank) and Philippine Savings Bank (PSBank) to facilitate

the approval of my credit card application as well as all credit card transactions, e.g., cash advance,

increase in credit limit, etc.. initiated upon my/our own initiative and in the event of default arising from

non-payment of credit card obligations with MCC; (4)I/We authorize MCC, its authorized

representative/s and/or agent/s to verify and investigate these facts from whatever source it deems

appropriate; (5)I/We understand that should my/our application be denied, MCC has no obligation on

its part to furnish the reason for such rejection; (6) I/We agree that by calling MCC or any of its service

providers, MCC or its service providers may, at its sole option and discretion, tape or record all my/our

telephone communications. I/We likewise agree that such taped or recorded communications or

transactions may be used by MCC or its service provider against me/us or any third party, or replayed

or communicated to any third party, for any purpose, including as evidence in any proceeding; and

(7)I/We agree to the TERMS AND CONDITIONS governing the issuance of a Metrobank Credit Card.

This further serves as a waiver of confidentiality of all personal information that I/we have provided and

authorizes MCC to conduct random verification with the BIR in order to establish the authenticity of my

ITR and the accompanying financial statements I submitted.

DECLARATION

SIGNATURE OF PRINCIPAL CARDHOLDER

SIGNATURE OF SUPPLEMENTARY

At least 4 months, ADB of > Php30,000 or $500

At least 6 months,

ADB of > Php10,000

At least 3 months, netpayroll credit of > Php8,600/month

(Php ___________________)

DATE

THE CONTRACTS IN THIS APPLICATION FORM ARE BETWEEN THE

CARDHOLDER/CARD

APPLICANT AND METROBANK CARD CORPORATION

(A FINANCE COMPANY), A SUBSIDIARY OF METROBANK. ALL

TRANSACTIONS

ARISING OUT OF OR RELATED TO THESE CONTRACTS

SHAL

L BE BINDING ONLY BETWEEN THESE TWO (2) CONTRACTING

PARTIES. IT IS UNDERSTOOD THAT THE TRANSACTION IS NEITHER INSURED

BY THE PHILIPPINE DEPOSIT INSURANCE CORPORATION NOR

GUARANTEED B

Y METROBANK.

MY SPOUSE

Must be a principal credit cardholder for least one (1) year. Credit card must be issued in the Philippines with

Credit Limit of at least Php 10,000.

Date of Birth

Employment

Self-employment/Business

PERSONAL REFERENCE

RELATIONSHIP

TEL. NO.

COMPANY NAME

NATURE OF WORK/BUSINESS

Investments (Property, Deposits, etc.)

Others, please specify________

SOURCE OF FUNDS

HOME OWNERSHIP:

Owned

rtgaged

Rented

Living with pa

rents/relatives

ALL FIELDS ARE MANDATORY AND MUST BE FILLED UP.

OCCUPATION/POSITION

Card Company

Card No. Credit Limit

Member Since

NAME TO APPEAR ON CARD

BIRTHD

ATE

Place of bi

rth

MOBILE PHONE NO.

MOTHER’S FULL MAIDEN NAME

HOME PHONE NO.

Referror’s Name:

Referro

r’s Card Number:

Branch and Branch Code:

Applicant Details

NAME: Family Given Middle

FOR METROBANK BRANCH USE ONLY

MY OTHER CREDIT CARD(S)

NAME TO APPEAR ON CARD

BIRTHDATE

PLACE OF BIRTH

CON

TACT NO.

RELATION TO PRINCIPAL APPLICANT

ASSIGNED MONTHLY SPENDING LIMIT

100% of Principal’s Credit Limit

Others:Php_____________

The monthly spending limit given to the Supplementary Cardholder is part of the Principal’s credit limit. If the monthly spending

limit indicated is g

reater than the approved credit limit, the monthly spending limit to be given to the Supplementary Cardholder

will be the same as the app

roved credit limit.

Note: Supplementary Ca

rdholder must be 14 - 80 years old.

HOME ADDRESS

(For foreigners, attach ACR & ICR)

NATIONALITY/CITIZENSHIP

PERMANENT ADDRESS (If different from Home Address)

GENDER

BRANCH OFFICER’S SIGNATURE OVER PRINTED NAME

If we cannot process your application for a Gold card,

would you accept a Metrobank Classic Card?

YES

GROSS MONTHLY INCOME

MY FINANCIAL STANDING

Note: Existing MCC Credit Card must be over 12 months to qualify for another card.

MY OTHER METROBANK CREDIT CARD(S)

Credit Limit

Member Since

Classic Visa/MasterCard

Gold Visa/MasterCard Platinum Peso MasterCard

Femme Visa

Gold Dollar MasterCard Platinum Dollar MasterCard

MY CHOICE OF A METROBANK CREDIT CARD

Metrobank/PSBank Client:

Depositor Since:

YES

(Php ___________________)

DATE