CREDIT CARD APPLICATION

Insufficient information may cause delays in processing. All information is subject to verification before a card is issued.

I would like to request a : *
Preferred statement date : *

(Payment due date would be 25 days from your statement date)

By submitting this form, I/we ask that a Hatton National Bank 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 authorise 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 card membership agreement. I/we agree jointly and severally for all charges to the basic and supplementary card member will be bound by the conditions of use 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.

Your PIN

For security reasons the Personal Identification Number/s (PIN/s) will be dispatched via mail to the billing address only.

I have read and understood the declaration and terms & conditions