Diners Club Singapore International ACE Credit Card Application Form

MY PERSONAL DETAILS

FULL NAME AS IN NRIC
Surname: Name:

Date of Birth:

NRIC No: (SxxxxxxxA)

Nationality:

Marital Status:

Gender:

No of Dependents:

Academic Qualifications:

Race:

LOCAL HOME ADDRESS (should not be a P.O. Box address)
Address: Singapore ( )

Home Phone:

Handphone:

Years There:

Residence:

Email Address:

Please embossed my name as follows(max 23 spaces & include initials of full name)^*
*The proposed embossed name may be altered to comply with Diners Club's card embossing specifications.

NAME OF CLOSEST RELATIVE/FRIEND NOT LIVING WITH ME
Name: Tel:

All fields are mandatory.

MY SPOUSE DETAILS (Married applicant to complete)
Name:		Tel:
Date of Birth:	NRIC No: (SxxxxxxxA)	Nationality:
Company Name: I am self-employed
Position Held: if Others:
Gross Annual Income: S$

MY EMPLOYMENT (Non-student applicant to complete)

Company Name: I am self-employed

Company Address: Singapore ()

Position Held:

if Others:

Date Joined:

Gross Annual Income: S$

Tel:

MY EDUCATION (Student applicant to complete)
Educational Institute:	if Others:
Length of Course: years	Currently Studying in: year

Applicant's Declaration
By signing below, I hereby request Diners Club (Singapore) Pte. Ltd. (DCS) to open a Card Account (Card Account) for me and to issue DCS Credit Card (the Card) (including renewal Card(s)) until the Card Account is terminated. hereby authorise DCS and/or its representatives to contact my bankers or any other source to obtain and verify any information about me as DCS may be required to do so by law, and consent to DCS’s use, disclosure, and/or processing of information relating to me and my use of the Card(s) for any of these purposes: (a) account opening, and operations relating to my account including closing my account; (b) providing services and facilities to me from time to time; (c) administration and/or managing the relationship between DCS and/or my account; (d) carrying out my instructions or responding to any enquiries by me; (e) the process of approving my application, the conduct of credit and/or identity checks, verification of ongoing credit worthiness; (f) developing new services and/or products; (g) to provide me with marketing, advertising and promotional information, materials and/or documents relating to banking, investment, credit and/or financial products and/or services that DCS with business partners (such as co-branders) may be selling, marketing, offering or promoting, whether such products or services exist now or are created in the future. I understand that I have the right to opt out of receiving such marketing information and can do so by writing to DCS, telephoning DCS or sending an email to DCS at DCS’ address or number on the Website. (h) to comply with the disclosure requirements of any regulatory authority or applicable law; (i) investigating fraud, misconduct, any unlawful action or omission, whether relating to my application or any other matter relating to my Account, and whether or not there is any suspicion of the aforementioned; (j) carry out due diligence or other screening activities in accordance with DCS’s legal or regulatory obligations or risk management procedures designed to combat financial crime, including “know-your customer”, anti-money laundering, counter-terrorist financing or anti-bribery and corruption customer and counterparty due diligence and screening; (k) to update me on DCS’s products and services from time to time; (l) if consented by me in the application form, account opening document and/or other methods of consent notification, provide for the dispatch of marketing information relating to services or products offered by DCS whether by DCS, DCS’s affiliates, business partners or related companies) which DCS thinks is of benefit or interest to me via my consented method(s) of communication; (m) processing any applications or requests for new services and/or products made by me; (n) enforcing my legal and/or contractual rights against me; (o) maintaining the safety and security of DCS’ premises with the use of security cameras; (p) seeking professional advice (including but not limited to obtaining legal advice and facilitating dispute resolution); (q) conducting checks with the Do Not Call Registry; (r) administrating loyalty and rewards programs (including but not limited to the processing of redemption vouchers, benefits or entitlements); (s) managing DCS’ business operations and complying with DCS’ internal policies and procedures; and (t) processing my application for Card Account, services and products by DCS (collectively, the “Permitted Purposes”). I consent to DCS collecting myr personal data from DCS’ business partners and for such business partners to disclose my personal data to DCS for the purpose of managing and administrating any benefits I may enjoy as DCS’ cardholder. DCS shall not use, disclose and/or process my personal data for purposes which are not stated above. Should DCS wish to use, disclose and/or process my personal data for a new purpose, DCS will notify me and seek my prior written consent. Notwithstanding the foregoing, I may withdraw my consent for DCS, and any of its officers, employees, agents, contractors or service providers to process, collect, use and/or disclose my information for one or more of the Permitted Purposes at any time by writing to DCS, telephoning DCS or sending an email to DCS at DCS’ address or number on the Website. Where necessary, DCS may disclose my personal data to DCS’ franchisees worldwide; any credit bureau of which DCS is a member or subscriber and/or to any other members, subscriber and/or compliance committee of such credit bureau and to any other person to whom disclosure is permitted or required by any statutory provision or law; or DCS’ third party service providers and agents (including its lawyers/law firms), (whether located in or outside Singapore) for any of the Permitted Purposes only. DCS shall not disclose my personal data for purposes for which I have not obtained consent. (a) am aware that if DCS approve the application made herein, the Card will be issued by DCS subject to DCS’s terms and conditions indicated herein and to its other terms and conditions for issuance of Credit Cards; (b) am aware that the terms and conditions of issuance of Credit Cards can be inspected at DCS’s office and a copy will be despatched to me with the Card and I agree to be bound by them upon receipt or acceptance of or signing on or use of the Card unless the Card, cut into half, is returned to DCS. am aware and agree that the Card will have a credit limit of S$500 only and known as Diners Club Ace Credit Card for administrative purpose and cannot have a supplementary card annexed to it. agree that the Card may be sent to me at my risk by ordinary mail to my billing address. agree that the I shall be responsible for all charges/liabilities (including Annual Fees or any other fees/charges) which may arise out or be incurred in respect of the Card. confirm that at the time of this application, I am not under the Debt Repayment Scheme or undischarged bankrupt and no statutory Demand nor any legal action process has been served on me. authorise DCS, if this application is or is purported to be given or sent by me to DCS by electronic transmission, to rely on and process this application in accordance with the submitted copy of the form, though DCS is not obliged to do so, without waiting for the original signed form. I will submit to DCS the original signed form even though the Credit Card had been issued in accordance with the submitted copy if DCS requests for the original form. agree to comply with our co-brand partner(s)’ in-house terms and conditions, if applicable. hereby warrant that the information given herein and all documents (if any) submitted are true and correct. agree that DCS may decline this application at its sole discretion without assigning any reason. For applicants below 21 years old: At the time of application, I agree that upon reaching 21 years of age, if the Card Account opened for me is not cancelled, my continued maintenance of my Card Account and/or continued use of the Card shall be construed and interpreted as my firm ratification of this application under the terms indicated herein and subject to DCS’s terms and conditions of issuance of the Card without any requirement on my part to re-apply for the Card Account and/or the Card and/or to do any whatsoever act to re-accept the terms and conditions of this Agreement.

I/We consent to DCS sending me/us regular updates on Diners Club promotions/services including, but not limited to, discounted offers and incentive programs by way of email and postal mail; and to the telephone numbers provided on this application form, notwithstanding the fact that such numbers may be registered on the Do-Not-Call registry, by way of : VOICE CALLS [ Please note that if you do not tick this box, you nevertheless consent to DCS sending such updates by way of voice calls if the telephone number you provided is not registered on the Do-Not-Call registry, or sending you updates by way of text or fax messages by relying on the Singapore Personal Data Protection Act 2012. If you wish to withdraw your consent to be contacted by DCS on the above updates, you may do so at www.dinersclub.com.sg. ]

I agree to the above Declaration
Applicant Signature:	Date:

Parent's/Guardian's Details & Agreement

COMPULSORY if applicant is below 21 years old at time of application
The address on both applicant's & parent's/guardian's NRIC must match.

Name of Parent/Guardian:		Relationship:
NRIC No: (SxxxxxxxA)	Home Phone:	Handphone:

By signing here, I, the Applicant’s parent / guardian, hereby

consent and agree to Diners Club (Singapore) Pte. Ltd. (DCS) opening the Card Account (Card Account) and issuing a DCS Credit Card (the Card) to the Applicant thereunder until the Card Account is terminated subject to the terms of application herein and to DCS’s Credit Card terms and conditions;
give DCS my unconditional, irrevocable and continued guarantee for the due and punctual payment and/or performance by the Applicant of all sums and/or other liabilities or obligations due and owing by or from the Applicant to DCS arising from and/or in relation to the Card Account in consideration of DCS opening the Card Account for and issuing the Card to the Applicant;
unconditionally and irrevocably undertake and agree and guarantee to pay DCS and/or perform all such sums and/or other liabilities and obligations and/or indemnify DCS against all losses arising from and in relation to the Card Account if for any whatsoever reasons the Applicant fails to pay any/all sums or perform any/all the liabilities and obligations arising from and/or in relation to the Card Account.

Parent/Guardian Signature:

Date: