AYALA GROUP INFORMATION SHEET

Express Credit FREE ANNUAL MEMBERSHIP FOR LIFE

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HOW TO APPLY SELECT CARD
1. Completely fill out and sign this form. Choose the BPI Express Credit Card that’s right for you:
2. Scan and send the application form to your company HR or email to groupretailcards@[Link].
NOTES: BPI Blue MasterCard BPI Edge MasterCard BPI Amore Visa
• Applicants who have credit cards for which they have been a principal cardholder for at least one year with the
corresponding credit limits below are no longer required to submit income documents if they are able to provide their
card number, credit limit and expiry date.
• P30,000 for all card variants except BPI Gold and Platinum
• P75,000 for BPI Gold BPI Gold MasterCard Petron-BPI MasterCard BPI Amore Platinum
• P150,000 for BPI Platinum
• This is a personal application and is not company guaranteed. Your application will undergo regular credit evaluation
and subject to the declaration below.
• For Platinum card applications, the cardholder will be given the card he is qualified for, depending on the evaluation of BPI SkyMiles MasterCard
his application.
• Bank of the Philippine Islands (BPI) is regulated by the Bangko Sentral ng Pilipinas. For Inquiries or complaints, you may
contact BPI at Tel No. 89-100 (Metro Manila) / 1-800-188-89100 (Outside Metro Manila) or BSP Financial Consumer BPI eCredit: The Internet Shopping Card will be automatically issued as a companion card upon approval of BPI Express Credit MasterCard
Protection Department at Tel No. 708-7087 and shall be subject to the BPI Credit Card Terms and Conditions.

ABOUT MY FINANCES
CREDIT CARDS
MY OTHER CREDIT CARDS (IF ANY)
CREDIT CARD CARD NUMBER CREDIT LIMIT EXPIRY DATE

DEPOSIT ACCOUNTS
MY BPI/BPI FAMILY BANK ACCOUNTS (IF ANY)
BPI ACCOUNT/LOAN NUMBER DEPOSIT/LOAN TYPE BRANCH LOCATION

MY OTHER BANK ACCOUNTS (IF ANY)

BANK DATE OPENED AVERAGE DAILY BALANCE

LOANS
MY OTHER CREDITORS (IF ANY)
CREDITOR DATE GRANTED TERM AMOUNT GRANTED MONTHLY AMORTIZATION

CARDHOLDER INFORMATION
NAME

Last First Middle

Name to appear on card (Must not exceed 23 characters, including spaces; aliases/nicknames are not acceptable) SSS / GSIS No.:

TIN No.:

Gender: Male Female Civil Status: Single Separated Married Widow/er Citizenship: Filipino Non-Filipino (pls specify) ______________________________

Mother’s Full Maiden Name: _____________________________________________________________ Birthdate (mm/dd/yy): __________________________________ Place of Birth: ____________________________________
Home Address
House/Unit No. Street Village/Brgy./Municipality City/Province Zip code

Home Ownership Years of stay:_____________ Car Ownership No. of cars owned: _______
Owned Living with parents Living with relatives Rented Php______________ /month Mortgaged Php______________ /month Owned Mortgaged Php______________ /month

Permanent Address (Please fill out if not the same as Home Address) Education
Grade School High School College Post Graduate
House/Unit No. Street Village/Brgy./Municipality City/Province Zip code

Best time to call: Best time to call:

Note: Within office hours AM Note: Within office hours AM
8:30am-7:00pm 8:30am-7:00pm
Home Phone Number/s: ___________________ Mondays thru Fridays PM Mobile Number/s: ___________________ Mondays thru Fridays PM Personal Email Address: __________________________

Company Name: Subsidiary name (If applicable):

Best time to call:

Note: Within office hours AM
8:30am-7:00pm
Rank ______________________ Position ______________________ Office e-mail address ____________________________ Office Phone Number/s: ______________________ Mondays thru Fridays PM

Office Address:
Floor No. Building Building No. Street Village/Brgy./Municipality City/Province Zip code

Previous Employer: Years with Previous Employer/Business:

Are you a Director, Officer, or Stockholder (DOS) of BPI Family Savings Bank (BFSB), BPI, or any BPI subsidiary and/or affiliate?
Yes No If yes, please indicate name, company and position. (Note: Please disclose all relationships; a separate sheet may be attached if necessary)
Name: Company & Position: Affiliation/Position:
Are you related to a DOS of BFSB, BPI, or any BPI subsidiary and/or affiliate (e.g. BPI Leasing, BPI Capital, BPI/MS, etc.) or the Ayala Group of Companies (e.g. Ayala Corp., Ayala Land Inc., etc)?
Yes No If yes, please indicate name, company and position. (Note: Please disclose all relationships; a separate sheet may be attached if necessary) Name:
Company & Position: Affiliation/Position: Relationship:

SPOUSE DETAILS
Name: Birthdate (mm/dd/yy): Best time to call:
Note: Within office hours AM
Mobile Number/s: 8:30am-7:00pm
Last First Middle Mondays thru Fridays PM

MY PERSONAL REFERENCE
Name:

Last First Middle

Home Phone Number Best time to call:
(if provincial include Area Code) Note: Within office hours AM
8:30am-7:00pm
Mobile Number/s: Mondays thru Fridays PM

SUPPLEMENTARY CARD
NOTE: (Supplementary applicant must submit a photocopy or scanned copy of 1 valid ID with picture)
NAME Last First Middle

Name to appear on card (Must not exceed 23 characters, including spaces; aliases/nicknames are not acceptable)

Relationship to Principal Cardholder: Birthdate (mm/dd/yy): Gender: Male Female

DELIVERY
Deliver Card to: Deliver Statement to:
Office Home Office Home I want to receive my Statement of Account via Email

DECLARATION
By signing below, I (We) confirm that:
1. All the statements, information and supporting documents provided by me (us) are true, correct and accurate;
2. Where the information or data provided was collected by me (us) from third party sources, the relevant consent has been secured by me (us) from the relevant parties to whom such information relates.
3. Any material misrepresentations or falsity or omission herein will be construed as an act to defraud BPI and may be a ground for the denial of my (our) [application] or, if already granted, the cancellation or termination thereof, without prejudice to such
civil and/or criminal liability that BPI may pursue against me (us).
4. It is the sole prerogative of BPI to grant or deny my (our) [application] and should the same be denied, BPI has no obligation to provide me (us) the reason for such decision.
5. All information and documents obtained by BPI in connection with my (our) [application] shall remain the property of BPI.
6. BPI may impose such terms, conditions and requirements as it may deem necessary or proper relative to my (our) availment of any of BPI products, services, facilities and channels.
7. In the event my (our) application is approved, the waiver of the annual fee shall only be effective for as long as I continue to be employed with the same "Employer" indicated on this application.
8. I (we) shall notify BPI of any material change affecting the information and documents provided by me (us).
9. I (we) may receive updates, notices and announcements on my (our) [application] and/or any of BPI’s products, services facilities and channels via SMS/text, email or fax transmission or such other means of communication deemed appropriate by BPI.
10. Where applicable, BPI may enroll my (our) approved [application] with any credit protection provider, or guarantee program of any institution, whether public or private, at BPI’s sole option.
11. I (we) have read and understood [BPI’s Terms and Conditions governing Products, Services, Facilities and Channels found at [bpiexpressonline] and expressly agree, where applicable, to the term and conditions thereof.
12. The foregoing shall apply to all products, services, facilities and channels of BPI that I (we) may avail of.

SIGN
HERE

Signature of Principal Cardholder Date

Signature of Supplementary Cardholder Date

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