Sagicor Bank/PriceSmart Credit Card Application Form

Sagicor Bank/PriceSmart Credit Card Application Form

General Information
Dear Valued Client,

To facilitate a seamless application process, please have the following supporting documents digitally scanned (where applicable) and ready to upload on this application. You will be unable to submit your application unless these documents and information required are attached:

·         Proof of Address

·         Two (2) References (full name, phone number and email address)

·         ID (Driver’s License, Passport, National ID / Voter’s ID)

·         TRN (only required if ID given is not a Driver’s License)

·         Last Three (3) Months Payslips (Not required for Pre-approved Clients & Team Members)

Please ensure that you have your supporting documents ready to be uploaded before continuing.

Sagicor Bank/PriceSmart Credit Card Application Form

General Information
Approval Status
Are you a PriceSmart Member?*

YesNo
Please enter your Membership Number*
Are you a Sagicor Team Member?*

YesNo
Sagicor Entity Employed
Length of Employment
Employment Status
Employment Grade Level
Are you a Pre-approved Sagicor Bank Client?*

YesNo
Please enter your Sagicor Bank Pre-approval Offer Code
You will need a PriceSmart Membership to complete your application. Click here to sign up online for a PriceSmart Membership or visit any in store PriceSmart location before continuing this application.

Contact Information
Title (Mr, Mrs, Ms, etc.)*
First Name*
Middle Name
Last Name*
Mother's Maiden Name*
Offer Code
Campaign Code
Date of Birth*

DayMonthYear
Date
Marital Status*
Number of Dependents*
TRN Number*
Country of Birth*
Country of Citizenship*
Country of Residence*
ID Type*
ID Number*
Are you a Politically Exposed Person (PEP) or related to a PEP?*

YesNo

Contact Information
E-mail Address*
example@example.com
Mobile Number*
Please enter a valid phone number.
Home Number
Please enter a valid phone number.
Work Number
Please enter a valid phone number.
Is your home address the same as your mailing address*

YesNo
Home Address*

Address Line 1

Address Line 2

Address Line 3State / Province

Postal / Zip Code
Mailing Address*

Address Line 1

Address Line 2

Address Line 3State / Province

Postal / Zip Code
Preferred Delivery Location for Collection of Card

PriceSmart KingstonPriceSmart PortmoreSagicor Bank Branch
Preferred Sagicor Branch for Collection of Card*
You will be contacted when the card is ready for pickup.

References
Reference #1 - Full Name*
Reference #1 - Phone Number*
Please enter a valid phone number.
Reference #1 - Email
example@example.com
Reference #2 - Full Name*
Reference #2 - Phone Number*
Please enter a valid phone number.
Reference #2 - Email
example@example.com

Document Uploads
Upload your ID here (Front)*

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Upload your ID here ( Back)*

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Upload your TRN here*

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Upload your Proof of Address here*

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Upload your Last Three (3) Month's Payslips here (You can multi-select files to upload)*

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Credit Card Application Declaration
I/We, the undersigned, authorise Sagicor Bank Jamaica Limited (‘the Bank’), to obtain any information as it may require concerning this application including my/our personal and financial information. I/We warrant and confirm that:

(i) the information given herein is true, correct and complete;

(ii) I/we understand that the information is being used to determine my/our credit worthiness and the Bank will be relying on the information in evaluating my/our application;

(iii) no information, which might affect the Bank’s decision to make a credit facility available, has been withheld;

(iv) this application is and shall remain the property of the Bank whether or not the application is granted;

(v) I/we are responsible for the use of the card;

(vi) I/we shall pay all interest on the balance outstanding on the card account, charges and fees at the rate set out in the Bank’s schedule of fees as the same may be amended by the Bank from time to time in its absolute discretion;

(vii) I/we agree to be bound by the terms and conditions set out in the Cardholder Agreement as the same may be amended from time to time; and

(viii) I/we are 18 years or older and not subject to any disability with respect to this application or maintaining a credit card.

I/we hereby authorise and consent to:

(a) the Bank setting-off sums due on the card account against funds standing to my/our credit with the Bank;

(b) the Bank receiving and/or sharing any credit, financial or other information about me/us from or with any of its affiliates, parent company or subsidiaries whether in or outside the jurisdiction, agents, third party assignees, other financial institutions, third party service providers, credit bureaus or credit reporting agencies, regulators in and outside of the jurisdictions in which the Bank does business as may be required by law or from or with any other person or corporation with whom I/we may have or propose to have financial or other business dealings from time to time.

In particular, I hereby authorize Sagicor Life Jamaica Limited and Sagicor Investments Jamaica Limited to disclose information about me to the Bank. The Bank may use the information in this application in respect of any of its present or future services permitted by law.

I/We hereby indemnify the Bank against any loss, claims, damages, liabilities, actions and proceedings and legal and/or other expenses incurred by the Bank as a consequence of the disclosure of my/our credit, financial and/or other information.

E-BANKING DECLARATION

I/We hereby authorise the Bank to use the information provided herein in creation of an E-Banking Account with the Bank’s E-Banking Service, “SAGICOR e-BANK” or such other application and I/we agree to be bound by the terms and conditions published by Sagicor and which are applicable to its on-line banking products and services.
I/We, the undersigned, authorise Sagicor Bank Jamaica Limited (‘the Bank’), to obtain any information as it may require concerning this application including my/our personal and financial information. I/We warrant and confirm that:(i) the information given herein is true, correct and complete;(ii) I/we understand that the information is being used to determine my/our credit worthiness and the Bank will be relying on the information in evaluating my/our application;(iii) no information, which might affect the Bank’s decision to make a credit facility available, has been withheld;(iv) this application is and shall remain the property of the Bank whether or not the application is granted;(v) I/we are responsible for the use of the card;(vi) I/we shall pay all interest on the balance outstanding on the card account, charges and fees at the rate set out in the Bank’s schedule of fees as the same may be amended by the Bank from time to time in its absolute discretion;(vii) I/we agree to be bound by the terms and conditions set out in the Cardholder Agreement as the same may be amended from time to time; and(viii) I/we are 18 years or older and not subject to any disability with respect to this application or maintaining a credit card.I/we hereby authorise and consent to:(a) the Bank setting-off sums due on the card account against funds standing to my/our credit with the Bank;(b) the Bank receiving and/or sharing any credit, financial or other information about me/us from or with any of its affiliates, parent company or subsidiaries whether in or outside the jurisdiction, agents, third party assignees, other financial institutions, third party service providers, credit bureaus or credit reporting agencies, regulators in and outside of the jurisdictions in which the Bank does business as may be required by law or from or with any other person or corporation with whom I/we may have or propose to have financial or other business dealings from time to time.In particular, I hereby authorize Sagicor Life Jamaica Limited and Sagicor Investments Jamaica Limited to disclose information about me to the Bank. The Bank may use the information in this application in respect of any of its present or future services permitted by law.I/We hereby indemnify the Bank against any loss, claims, damages, liabilities, actions and proceedings and legal and/or other expenses incurred by the Bank as a consequence of the disclosure of my/our credit, financial and/or other information.E-BANKING DECLARATIONI/We hereby authorise the Bank to use the information provided herein in creation of an E-Banking Account with the Bank’s E-Banking Service, “SAGICOR e-BANK” or such other application and I/we agree to be bound by the terms and conditions published by Sagicor and which are applicable to its on-line banking products and services.

I Agree
Signature*

Clear
Date Signed*

DayMonthYear
Please verify that you are human*
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Sagicor Bank/PriceSmart Credit Card Application Form

Sagicor Bank/PriceSmart Credit Card Application Form

Contact Information

Contact Information

References

Document Uploads

Credit Card Application Declaration