First Global Bank Credit Card Application Form

Thank you for your interest in the First Global Bank Platinum Plus Credit Card. Please note the following supporting documents required below.

Eligibility Criteria:
- 18 years or older.
Employed Persons:
- Gross Monthly Income J$500,000 or the USD equivalent.
- Must be employed for a minimum of 6 months. If current role does meet this employment tenure, proof of previous employment is required to support the application.
Self-Employed Persons:
- Minimum of one (1) year in business.
Identification:
- Copy of government-issued identification.
- Copy of Tax registration number.
Proof of address. Submit any ONE of the following:

The proof of address document should be no older than 90 days.
- Utility bill
- Letter from a Justice of the Peace
- Bank statement
- Lease agreement
Proof of Income:

Employed
- 3 months most recent salary slips or Job Letter
Self-Employed
- 12 Months’ bank statement & Letter from a chartered accountant.
Commission-based Paid
- 3 months salary slips plus December salary slip from prior year OR Job Letter

FINANCIAL INFORMATION
Please state your Gross Monthly Income *
(Minimum Gross Monthly Income J$500,000 or the USD equivalent to qualify)
Please state your monthly utilities expenses.*
Please state your monthly transportation expenses.*
Please state your monthly food expenses.*
EMPLOYMENT
EmployedEmployed - CommissionedSelf-Employed
Current Employer*
Employer's Number*
Number of Years Employed*
Previous Employment

(Complete this section if you have not been with your current employer for 6 months or more)
Previous Employer
Number of Years Employed

Reference Information

Your reference must be a family member not living at your address.
Please provide the name of a reference*
What is the relationship to your reference?
Phone Number of Reference*
Format: (000) 000-0000.
Email of Reference*
example@example.com
Address of Reference*

Street Address

Street Address Line 2

CityTown

Parish

Additional Cardholder

Government-issued Identification required for additional cardholder.
YesNo
Additional Cardholder's Name

First NameMiddle NameLast Name
Email of additional cardholder.
example@example.com

BANK ACCOUNT
YESNO
Card Delivery

Tell us how you want to receive your credit card.
Nearest FGB BranchDelivery by courier
I would like to collect my card at the following branch.
I would like my card delivered by courier to the following address:

NOTICE and CONSENT PURSUANT TO THE CREDIT REPORTING ACT

To: The Customer of First Global Bank Limited(as identified below)
In this Notice and Consent, the following expressions have the following meanings: “Act” means the Credit Reporting Act, as amended and/ or re-enacted from time to time; “Bank” means First Global Bank Limited; “Credit Bureau” means a credit bureau licensed under the Credit Reporting Act. “Customer” or “You” means (collectively, as applicable) the customer(s) of the Bank and/ or any guarantor(s)who has/have received this notice and counter-signed the same for acceptance of the content(s) as provided below. NOTICE TO CUSTOMER The Bank hereby gives the Customer notice as to the below-mentioned matters and by countersigning for the acceptance of this document the Customer accepts such notice: 1. The Bank will treat information relating to the Customer as confidential and in providing you with banking services the Bank may disclosure any information in its possession relating to You (including but not limited to “credit information” as defined under the Act) (hereinafter called “Customer Information”) to (i) the branches, subsidiaries, representative offices, affiliates and agents of the Bank and third parties selected by any of them wherever situated, for confidential use (including in connection with the provision of any service by the Bank to the Customer and for data processing, statistical and risk analysis purposes); and (ii) Credit Bureaus. 2. The Bank may, from time to time, give any Customer Information to: (a) credit bureau or reporting agency; (b) person with whom the Customer may have or propose to have financial dealings; (c) person(s) in connection with any dealings the Customer has or proposes to have with the Bank. The Customer agrees that the Bank may use all such information to establish and maintain the Customer’s relationship with the Bank, and to offer the Customer any products or services from time to time. The Bank will not be liable to the Customer by reason of any act, delay or omission of any third party (including any Credit Bureau)in the performance of services required of it. 3. The Bank shall be entitled to charge non-refundable fees to the Customer where the Bank seeks to obtain any Customer Information from any third party including Credit Bureaus. CUSTOMER ACKNOWLEDGEMENT AND CONSENT The undersigned hereby confirms and agrees that by counter-signing/ executing this Notice and Consent as hereinafter appearing(1) ,the undersigned consents to the Bank sharing the Customer Information described above to and among such subsidiaries, affiliates and agents of the Bank and third parties (including Credit Bureaus) in connection with any business/transactions as between the Bank and the Customer and for all the purposes of the Act. (2) the undersigned (1) consents to the Bank (as a credit information provider),disclosing the Customer’s credit information to person(s) authorized to receive the same pursuant to and for the purposes provided for by the Act; and (2) intends that any Credit Bureau(s) receiving a copy of this Notice and Consent, duly executed by the Customer, shall rely on such copy Notice and Consent as providing the consent required pursuant to the Act for the disclosure by such Credit Bureau(s) of credit information concerning the Customer to persons authorized to receive the same. (3) the undersigned provides to the Bank and to any and every and such Credit Bureau as may be designated by the Bank consent for the sharing of the Customer’s credit information among the Bank and such credit bureau(s) for all the purposes and to the extent provided for by the Act and in respect of both initial and subsequent requests for credit information which the bank may have during the currency of the consent herein contained; and (4) the consent(s) herein provided for shall remain valid and binding unless/until the same shall be revoked by the undersigned in writing, PROVIDEDTHAT no such revocation shall be effective for so long as any credit facility or accommodation as between the Bank and the undersigned shall remain in force. (5) the Notice and Consent contained herein have been received, read by or read to and understood by the undersigned;*

Yes
Please ensure your signature is affixed and matches the one on your valid ID. Any discrepancies may cause delays in processing.
Cardholder Signature*

Clear
Address Map Locator
Should be Empty:

CUSTOMER INFORMATION

FINANCIAL INFORMATION

EMPLOYMENT

Previous Employment

Reference Information

Additional Cardholder

BANK ACCOUNT

Card Delivery

NOTICE and CONSENT PURSUANT TO THE CREDIT REPORTING ACT