Credit Card Application Form
Credit Card Application Form
(Please complete the application form in BLOCK LETTERS. Insufficient information may cause delays in processing. All information is subject to verification before a card is issued)
I would like to request a VISA MasterCard
PERSONAL DETAILS
Name In Full (as per NIC):
Title: Mr/Mrs/Miss/Rev/Dr/Other
Last Name
First Name
Other Names
No Of Dependents
Name to appear on card (maximum 20 characters including title and spaces)
Date Of Birth:
E-mail Address
Nationality
Permanent Address
(Billing Proof required if different from NIC)
Correspondence Address
(Please provide if different from
permanent address given above)
Billing Proof:
National Identity Card Income Tax Receipt Utility Bill (Please specify)
Passport Assessment Notice Driving License
Letter from a Public Authority Tenancy Agreement Employment Contract Others (Specify)
Residence Tel No
Mobile No
Other
Please tick the relevant boxes provided (you may tick more than one)
Ongoing Sources of Earnings:
from Present Employment Personal Savings from Business Interest Family Remittances Return from Investment/Investment Matured
Below Rs.50,000/- Between Rs.50,000/- & Rs.100,000/- Between Rs.100,000/- & Rs.500,000/-
REFERRAL DETAILS
Name of a Relative not living with you
Address
Relationship
SPOUSE DETAILS
Spouse Name
Employer Name
CLASSIFICATION
Do you have an immediate family member who is a Director or an employee at HNB?
Do you or an immediate member of the family hold any senior public office?
EMPLOYMENT DETAILS
Salaried Self-Employed Other
Professional Other(specify)
Designation
Nature of Business:
Advertising Garments Telecommunication
NGO/NPO/Charity
INCOME DETAILS
Basic Salary : Rs
Fixed Allowances : Rs
Other Allowances : Rs
Other Income : Rs
Sources of Other Income: Earnings from Employment Earnings from Business Interests
Investment Income Deposit Interest Income
Other (please specify)
Assets
Land/Buildings
Vehicles
Shares/Deposits
Vehicle Number
Please settle % per month (Minimum due amount to Maximum 100%, subject to minimum payment) by debiting my HNB Account Number
Branch
BALANCE TRANSFER
Do you wish to transfer your other bank credit card balances to your
Account Name
(Name on Card)
Expiry Date
(Please attach a copy of the latest credit card statement)
All Supplementary Cardholders are bound by the same Credit Card Agreement entered into by the Principal Applicant as detailed overleaf.
(Please tick the relationship to Principal Applicant)
Title: Mr/Mrs/Miss/Rev/Dr/Other
Last Name
First Name
Other Names
Date Of Birth
No:
*(Copy of NIC is mandatory for Sri Lankans)
Nationality
Residence Tel No
Mobile No
Correspondence Address
E-mail Address
Occupation
Employer Name
PIN NUMBERS
For security reasons, the Personal Identification Number/s (PIN/s) will be dispatched via mail to the billing address only.
OUR AGREEMENT
By signing below I/we request that Hatton National Bank PLC - VISA/MasterCard Account be opened for me/us, and Card/s issued as I/we request, and that you renew and replace them until I/we
surrender the right to use the Card/s by cutting the Card/s in half and returning both halves to you. I/We authorize my/our Banks or any other sources to release any information to your representatives,
as you may require from time to time without reference to me/us. I/We acknowledge and agree to be bound by the conditions and terms of use of the Credit Card Agreement detailed above. I/We agree
jointly and severally to be responsible for all charges to the Principal and Supplementary Card/s issued on my/our request. In addition, I/we agree that the Supplementary Card Member will be bound by
the terms and conditions of use of the said Credit Card Agreement and will be liable for all charges to that Card. I/We hereby warrant that all information provided by me/us in this Application is true and
correct.
I/We acknowledge that Hatton National Bank PLC is not responsible for any liability arising out of incorrect/untrue information provided in this application.
Having read, clarified and understood the above terms and conditions of use detailed in this agreement, I/we herewith place my/our signature/s below to confirm receipt of a copy of the application form
and also to signify our acceptance of terms and conditions contained herein.
...............................................................................
Signature of the
Principal Card Applicant
................................................................................
Signature of the Supplementary
Card Applicant
I/ We
(Principal 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 terms and conditions applicable for the use of Electronic Fund Transfer Cards (EFTCs) as detailed in the Directions No.03 of 2021 dated 18 March
2021 issued under the provinsions of Foreign Exchange Act, No. 12 of 2017 (the FEA) 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
(bank) may require for the purpose of the FEA.
I/We am/are aware that the bank is required to suspend availability of foreign exchange on EFTC if reasonable grounds exist to suspect that foreign exchange transactions which are not permitted in
terms of the Directions issued under the provisions of the FEA 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 EFTCs to the bank, If I/We migrate or leave Sri Lanka for Permanent residence or employment abord as applicable. Further I/We also agreed to notify
my/our change in residential status to the bank if any accordingly.
...............................................................................
Signature of the
Principal Card Applicant
................................................................................
Signature of the
Supplementary Cardholder
Signature
Standing order instructions (if any) have also been duly checked and verified.
Extracted Information
Annual Income Other Income (Annual)
Accounts at HNB Age
Employment/Business
Verification of Information
CRIB Information
Verified by (Name/Signature)
For Bank Use Only
I, as the Authorized officer of the bank have carefully examined the information together with relevant documents given by the applicant/s and satisfied with the bona-fide of these information and
documents. Further, I as the Authorized Officer of the Bank undertake at all times, 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 foreign exchange transactions which are not permitted in terms of Directions No 03 of 2021 dated 18
March 2021 issued under the provisions of the Foreign Exchange Act, No 12 of 2017 are being carried out of the EFTC, in violation of the undertaking given by the card holder and to bring the matter to
the attention of the Director-Department of Foreign Exchange.
Supplementary
Issuing Officer
1. DEFINITIONS
In these conditions where the contract so requires or admits, ‘this Agreement’ means the Agreement between the Bank and the Cardholder, the terms of which are these conditions as varied from time
to time. ‘Card’ means all Credit Cards issued by Hatton National Bank PLC to the Principal and Supplementary Cardholders. ‘Principal Cardholder’ means the Cardholder in whose name a Card Account is
maintained, and his/her heirs, Assigns Executors or Administrators. ‘Supplementary Cardholder’ means a Cardholder who is a nominee of the Principal Cardholder who is permitted to effect card
transactions and includes his/her heirs, Assigns Executors or Administrators. ‘The Bank’ means Hatton National Bank PLC, its assignee and successors. ‘Card Account’ means an account maintained by the
Bank in relation to card transactions and maintained at the Card Centre. ‘Card Centre’ means the Main Office of the Credit Card Department of Hatton National Bank PLC which has its Registered Office at
479, T. B. Jayah Mawatha, Colombo 10 or any other place as notified and published in the website. ‘Cardholder’ means any person who uses a Card issued by the Bank in terms of this Agreement and
includes the Principal Cardholder and Supplementary Cardholders and his/her heirs, Assigns Executors or Administrators. ‘Card Transactions’ means any payment to any merchant for the supply of goods
or services or cash advances obtained by the use of the Card Number or in any manner authorized by the Cardholder, for debit to the Card Account. ‘Immediate Family Member’ means the spouse of the
Cardholder, dependent children who are over 18 years or a parent of the Cardholder. ‘Merchant’ means a person or organization who is acknowledged by the Bank to sell goods or services on the
acceptance of the Card. ‘Card Limit’ means the maximum aggregate debit amount permitted on the Card Account as determined and notified to the Principal Cardholder by the Bank from time to time.
‘PIN’ means the Personal Identification Number which is a secret number, confidentially issued to the Cardholder. ‘Payment Due Date’ means the date by which the Cardholder must make payment to the
Bank for all or minimum amounts due from him/her for using the Card and shall be a specified date of each month selected by the Bank at its discretion and notified to the Principal Cardholder and
published in the Website. ‘HNB ATM’ means HNB Automated Teller Machine. ‘Website’ means www.hnb.net (or such other website maintained by the bank from time to time and notified to the Cardhold-
er) which shall be the official website wherein all general notifications pertaining to the Card shall be published.
'Personal Use' means for the use of the holder of the Card, his/her spouse, children and parents and does not include the usage of the card for any commercial purposes.
2. USE OF THE CARD
2.1 The Card must be signed by the Cardholder immediately upon receipt and may only be used;
i. By the Cardholder for personal use.
ii. Subject to the terms of this Agreement current at the time of use.
iii. Within the Card Limit (any excess over the Card Limit being immediately repayable to the Bank. When calculating whether the credit limit has been exceeded, the Bank shall take into account the
amount of any Card Transaction not yet debited from the Card Account and any authorization given by the Bank to a third party in respect of a prospective Card Transaction).
iv. During the validity period embossed on the Card.
v. In the event of the Card being used in an Electronic Fund Transfer (EFT) involving foreign currency, the same will be subject to the Regulations of the Exchange Control Department and will be for the
purposes authorized by the Exchange Control Department only.
vi. The Cardholder shall not use the Credit Card for the purchase of any land or property, the payment of monthly instalments or any capital account transactions as specified in the Exchange Control
Regulations Act, Directions or Guidance.
vii. The Cardholder shall handover the card to an HNB Branch/Card Centre upon the request by the Bank in the event of a replacement/dispute/investigation, subject to it being confirmed as blocked
by the Bank.
viii. The Cardholder shall inform the Bank of the use of the card overseas for transaction verifying purposes.
3. THE CARD ACCOUNT
3.1 The Bank may debit the Card Account with the amounts of all Card Transactions and other liabilities accumulated by the Cardholder, inclusive of legal fees, other administrative costs, losses,
etc. incurred by the Bank arising from the use of the Card.
3.2 The Cardholder will be liable to pay to the Bank all amounts so debited, whether or not a sale or cash advance voucher is signed by the Cardholder.
3.3 The Cardholder should not use the Card for any illegal or unlawful purposes and should not violate CBSL regulations and Exchange Control regulations of Sri Lanka.
3.4 The Bank will email a monthly Statement of Accounts to the Principal Cardholder, to the email address given in the Application, or to any other email address duly notified in writing to the Card
Centre at least fourteen (14) days before the payment due date.
3.5 The Cardholder shall pay at least the Minimum Payment on or before the Payment Due Date. The Minimum Payment would be the amount shown in the Cardholder’s monthly statement or the
stipulated minimum amount as per the statement. Where, the total outstanding, as at the statement date, exceeds the Credit Limit, the minimum payment would be the sum of the excess
amount over the Credit Limit plus the minimum due amount of the outstanding balance.
3.6 All amounts due under this Agreement will be immediately payable in full upon the commission of an act of bankruptcy by, or upon the death of, the Principal Cardholder or at the Bank’s
discretion, if there is any breach of this Agreement by the Cardholder.
3.7 Any payment made to the Bank will only take effect when received and credited to the Card Account.
4. FEES AND CHARGES
4.1 The Cardholder agrees to pay the Bank’s Joining and Annual Fee for the Card(s). Such Fees will be debited to the Card Account when due and will not be refunded, unless the Cardholder has given
one month prior written notice before the expiry date given on the Credit Card.
4.2 Interest will be charged on Card Transactions for the period commencing from the date of the transaction on the Card Account, up to the date of payment in full, calculated on the average daily
balance over the said period, at an annualized rate to be determined by the Bank at its discretion and which will be notified to the Principal Cardholder by publication in the Website. (The said
method of calculation of interest, and the rate of interest, shall be applicable to both purchases made and cash advances obtained by using the Card. The interest so charged shall be debited to the
Card Account on the Statement Date. For the convenience of the Cardholder, the Website shall contain illustrations of the method of charging interest on outstanding sums set out herein.)
4.3 If the Cardholder fails to pay the Bank the total outstanding by the Payment Due Date, the outstanding balance on the Statement Date will be charged and interest calculated on the average daily
balance over the billing period at an annualized rate to be determined by the Bank at its discretion at any given time and which will be notified to the Principal Cardholder and published in the
Website. (The said method of calculation of interest and the rate of interest shall be applicable to both purchases made and cash advances obtained by, using the Card. The interest so charged shall
be debited to the Card Account on the Statement Date. For the convenience of the Cardholder, the Website shall contain illustrations of the method of charging interest on outstanding sums set out
herein.)
4.4 Without prejudice to the payment of the interest charge referred to, if the Cardholder fails to pay the Minimum Amount due by the payment due date, a Late Payment Fee will be charged on the
total outstanding balance on the Statement Date at a rate to be determined by the Bank, from time to time and notified to the Principal Cardholder and published in the Website.
4.5 The Bank shall charge the Cardholder and debit from the Card Account a handling fee, at a rate to be determined by the Bank and notified to the Principal Cardholder and published in the Website,
if any cheque or other payment order issued or presented by the Cardholder or any other party, to the Bank is not honoured for payment for any reason whatsoever. This charge will be in addition
to any postage charges that may be charged by the Bank.
4.6 A Cash Advance Fee will be charged on all cash advances debited from the Card Account at a rate to be determined by the Bank and notified to the Principal Cardholder and published in the Website.
All payments made by the Card for Traveller’s Cheques, Drafts and Telegraphic Transfers shall also be treated as Cash Advances and are subject to the above charges.
4.7 An Over Limit Fee shall be charged, if the assigned Card Limit is exceeded at any point in the billing period. The Over Limit Fee shall be determined by the Bank from time to time, at its discretion,
and shall be notified to the Principal Cardholder and published in the Website. For this purpose the amount of any bank charges will also be considered, when applying the Over Limit Fee.
4.8 All purchases of Petrol, Diesel, Gas and other supplies available from Filling Stations in Sri Lanka, are subject to a handling fee at a rate to be determined by the Bank and notified to the Principal
Cardholder and published in the Website.
4.9 All Card Transactions which are executed without physically presenting the Card for payment are subject to a handling fee at a rate to be determined by the Bank and notified to the Principal
Cardholder and published in the Website.
4.10 A fee for the retrieval of a photocopy of a sales draft will be debited to the Card Account at a rate to be determined by the Bank and notified to the Principal Cardholder and published in the Website.
4.11 Stamp Duty as currently applicable or any other Statutory Charge or Levy will be charged to the Card Account for each and every transaction made with the Card, including Cards issued to
Supplementary Cardholders or through any other method, as stipulated by such Statutes, Regulations or Rules.
4.12 A replacement Credit Card fee will be debited to the Card Account at a rate to be determined by the Bank and notified to the Principal Cardholder and published in the Website, in the event of such
a replacement becoming necessary for any reason whatsoever.
5. SUPPLEMENTARY CARD
5.1 The Bank may at the request of the Principal Cardholder issue a Supplementary Card to the Principal Cardholder’s immediate family members provided that the Supplementary Cardholder and the
use of the Supplementary Card shall be bound and governed by the same terms and conditions contained in this Agreement where applicable. Card Transactions and Cash Withdrawals made by the
Supplementary Cardholder will be debited to the Card Account and shown in the Monthly Statement of Accounts sent to the Principal Cardholder and no separate Statement of Accounts will be
given to the Supplementary Cardholder.
5.2 The Principal Cardholder and the Supplementary Cardholder shall be jointly and/or severally liable to the Bank for any charges incurred by the use of the Supplementary Card. The Principal Cardhold-
er shall be liable for the full outstanding sum shown in the Card Account as the Principal Debtor, even though the full sum or part thereof may have been incurred by the Supplementary Cardholder
and the liability of the Principal Cardholder shall continue as long as the sum payable to the Bank remains outstanding, notwithstanding cessation of the relationship between the Principal Cardhold-
er and the Supplementary Cardholder.
5.3 Once the Supplementary Card is issued, it will be in force until the same is cancelled by written notice to the Card Centre, by the Principal Cardholder or the Supplementary Cardholder.
5.4 Upon the termination of this Agreement and the use of the Principal Card, the use of all Supplementary Card/s shall also be terminated and the Supplementary Card/s shall be returned immediately
to the Bank.
6. BILLING AND PAYMENT
6.1 The Bank will send a Statement of Accounts monthly, at the end of the billing period, to the Principal Cardholder (on a specified date of each month as selected by the Bank at its discretion) for the