You confirm that you are 18 years of age or over, earn at least $20,000 p.a., have a good credit history, have not been bankrupt nor defaulted on any payments.
Credit card approval is subject to a good credit rating. Please complete all fields below in CAPITAL LETTERS and ensure you sign this form.
Please fax both sides of this form to: (02) 8987 5923
Issued by HSBC Bank Australia Limited ABN 48 006 434 162. GPO Box 4263 Sydney NSW 2001, ph: 132 152, www.hsbc.com.au
By providing your email address, you consent to HSBC or its related entities sending you promotional
electronic messages. If you do not wish to receive such messages, please leave this space blank.
Your contact details
Home no. ( )
Your previous address – if less than 3 years at your current residential address.
YOUR PERSONAL DETAILS
Specify the number of dependants under 18 years
Driver’s licence number
Date of birth (dd/mm/yyyy)
Nationality (if not Australian, please specify)
Time with main bank
The bank which your salary is paid into.
If “Yes”, please advise HSBC customer number
Are you a permanent Australian resident?
Are you an HSBC customer?
Give details of current landlord/agent (if renting/boarding)
Landlord/Agent’s phone no. ( )
Name of landlord/agent
Live with parents
Your current residential address (not a PO Box)
FOR YOUR SECURITY
Please give details of a relative or friend who lives in Australia but DOES NOT live with you.
Relationship to you
Evening phone no. ( )
Day phone no. ( )
Mother’s maiden name (i.e. surname before
HSBC may contact