To: UnionBank Customer Service

Fax No: 636-6256

Application Form
I AM QUALIFIED TO GET A UNIONBANK CREDIT CARD ABOUT MY SPOUSE
1. I am 18 to 60 years old with a minimum gross annual income of: 1 Name: First Middle Last
SINGLE MARRIED (combined)
CLASSIC / BAI / TITANIUM / OMNIPASS P150,000 P180,000
GOLD P480,000 P600,000 2 Employment PRIVATE SECTOR SELF-EMPLOYED GOVERNMENT RETIRED
2. I have a residence/business landline phone.
3. I have been employed or practicing my profession or own a business that has been existing for at least one year.
3 Birthdate mm dd yyyy 4 Current Employer/Business Name

I AM APPLYING FOR A UNIONBANK CREDIT CARD 5 Nature of Business 6 Current Position 7 Total Years in
Work/Business
CLASSIC GOLD TITANIUM BAI OMNIPASS SECURED CREDIT CARD
8 Complete Business Address
I WILL SUBMIT THE FOLLOWING REQUIREMENTS
Duly accomplished and signed application form
Photocopy of an acceptable identification document with photo and signature
Supporting documents: Zip Code 9 Office Phone No. Local Extension
a. For Regular Applications
ABOUT MY WORK/FINANCES
PROOF OF INCOME:
1 Employment PRIVATE SECTOR SELF-EMPLOYED GOVERNMENT RETIRED
If employed/fixed salary earner: If self-employed:
2 Current Employer/Business Name 3 Nature of Business
BIR form 2316 (W-2) Income Tax Return BIR Form 1701 or 1702 with BIR or Bank Stamp
OPTIONAL DOCUMENTATION REQUIREMENTS: 4 Current Position 5 Total Years in Work/Business
Certificate of Employment and compensation (original copy) for employed / fixed salary earner
Audited financial statement with BIR or bank stamp for self-employed 6 Complete Business Address
Other proof of income like those contracts, bank certification of deposits / placements (should indicate date
account was opened)
If existing cardholder of other credit card company:
Zip Code 7 Office Phone No. Local Extension
Latest credit card statement (should be of current status). Must have been a cardholder for at least 12 months.
Photocopy of existing credit card (front and back) 8 Applicant’s Gross Annual Income 9 Applicant’s Other Annual Income

*PROOF OF BILLING ADDRESS IF OUTSIDE METRO MANILA (Latest statement for any of the ff.) Spouse’s Gross Annual Income Spouse’s Other Annual Income
PHONE (LANDLINE) MERALCO PAGER OTHER
10 11
CELLULAR PHONE WATER CABLE TV CREDIT CARDS
12 Do you own other credit cards? YES NO If yes, how many credit cards do you have?
b. For Secured Credit Applications (all of the following) Please list down the card/s and fill up the required information.
* SIGNED DEED OF ASSIGNMENT OF DEPOSIT WITH UBP * PHOTOCOPY OF RESIDENCE CERTIFICATE
CREDIT CARD CARD NUMBER ISSUANCE DATE CREDIT LIMIT
PRINCIPAL JOINING FEE ANNUAL FEE PROGRAM FEE
GOLD P300 P2,500
TITANIUM P300 P3,000
CLASSIC/BAI P300 P1,500
OMNIPASS P300 P1,500 P500
13 Are you a depositor of UnionBank?
YES Please indicate your account number
SUPPLEMENTARY JOINING FEE ANNUAL FEE PROGRAM FEE
NO Would you be interested in becoming a UnionBank depositor? YES NO
GOLD P300 P1,250
TITANIUM P300 P1,500 Banking relationship with other banks?
CLASSIC/BAI P300 P750 DATE OPENED BANK / ACCOUNT NO.
OMNIPASS P300 P750 DEPOSIT SPECIFY
LOAN CURRENT/
CASH ADVANCE SAVINGS
DEPOSIT SPECIFY
*SERVICE FEE 6% of the transaction amount or P300, whichever is higher CURRENT/
LOAN
*OVER-THE-COUNTER TRANSACTION FEE P500 per transaction SAVINGS

FINANCE CHARGE 3.5% per month *(computed based on average daily balance) Deliver my card to my: Deliver my Statement of Account to my:
MINIMUM AMOUNT DUE 5% of outstanding balance or P500, whichever is higher RESIDENCE OFFICE RESIDENCE OFFICE EMAIL
LATE PAYMENT CHARGE 6% (computed based on minimum amount due) or P500 whichever is higher
*42% per annum (computed based on average daily balance) Cyberstatement Please also send my Statement of Account via email to:

YES, SEND ME A SUPPLEMENTARY CARD!

1 Name: First Middle Last

2 Name to appear on card (Up to 21 characters only)

Please do not enclose payment. Membership fees will be reflected on your Statement of Account upon approval of your application.

ABOUT MYSELF 3 Birthdate mm dd yyyy

4 Mother’s Full Maiden Name 5 Sex
M
1 Name: First Middle Last F
MR.
MS. 6 Relationship with Principal Cardholder
MRS.
7 Sub-limit requested for Supplementary Cardholder
2 Name to appear on card (Up to 21 characters only)
Cardholder
Name SUPPLEMENTARY APPLICANT’S SIGNATURE DATE
Company
Name* I WILL AVAIL OF THE BALANCE TRANSFER OPTION
* For Corporate Accounts only If your application is approved, do you want to avail of the Balance Transfer Option? YES NO
If yes, please fill up portion below and attach your latest Statement of Account with the stated bank/credit card company.
3 Birthdate mm dd yyyy 4 Mother’s Full Maiden Name 5 Sex
M
F
Credit Card Issuer’s Name:
Account Name:
6 Civil Status SINGLE MARRIED WIDOWED SEPARATED Credit Card Account No.:
Outstanding Balance to Date:
7 Education HIGH SCHOOL COLLEGE SOME COLLEGE POST GRADUATE
Upon approval of my UnionBank Credit Card application, please transfer my credit card outstanding balance from the above-stated bank/credit card company to my
UnionBank account. I understand that this option is subject to UnionBank’s approval based on my credit standing with the stated bank/credit card company.
8 Citizenship FILIPINO OTHERS 9 No. of dependents
To comply with the requirements of BSP Circular No. 472, Series of 2005, and BIR Regulations No. 4-2005, I/we hereby authorize UnionBank of the
Philippines or any of its authorized representatives to conduct random verification with the BIR to establish authenticity of the Income Tax Return and
10 TIN 11 SSS accompanying financial statements submitted by me/us.
By signing below, I/we certify that the information given by me/us is true and correct. I/we authorize UnionBank of the Philippines to verify and
12 HOME ADDRESS investigate the information provided by me/us from whatever sources it may consider appropriate. I/we understand that falsifying any of the
information on the enclosed documents is sufficient ground for legal action and the rejection of my/our application. By signing at the back of the card
when delivered to me/us, I/we signify my/our agreement to the UnionBank Credit Card Terms and Conditions accompanying said card. I/we understand
that should my/our application be denied, UnionBank has no obligation to provide me/us with the reason for such rejection.
*In choosing Residential Address for my card delivery, I hereby authorize You or Your official courier to release, in my absence, my approved card to any
memnber of the household upon presentation of an identification card with picturr. In choosing Office Address for my card delivery, I hereby authorize
You or Your official courier to release in my absence, my approved card to my co-workers, secretaries or to our desk resceptionist upon presentation of an
identification card with picture or any other form of identification such as Driver’s License, Passport and SSS ID. Furthermore, I shall be liable for any card
availment/s or usages thereafter as a result of such delivery and hereby hold You free and harmless from any liability whatsoever for delivering my card
13 Years of stay 14 Home Phone 15 CellPhone No. as authorized herein.
Zip Code
PRINCIPAL APPLICANT’S SIGNATURE DATE
16 Home Ownership OWNED/MORTGAGED RENTED
OWNED/NOT MORTGAGED LIVING WITH RELATIVES/PARENTS NOTE: Applications that are not duly accomplished and signed and/ore not accompanied by the required documents will not be processed.

17 Do you own a car? YES Car Ownership OWNED/MORTGAGED FOR BANK USE ONLY
NO OWNED/NOT MORTGAGED
COMPANY PROVIDED For Secured Credit Applications
UBP Branch Deposit Amount
18 Email Address: Account Number Date Opened
UBP Customer since (mm/yy) Branch Officer’s Signature
19 Reference
NAME:
SOURCE CODE
ADDRESS:
Received by/Date: 4 4 0 4 5
PHONE No.:
Processed by/Date: 4 4 0 4 5