Eurocard Corporate Private liability - page 1 Arrangement ID Product no.
Completed by the commpany
Company name
Address
Postal code Town/City Country code
(not DK) Telephone
+
Contact person (required field)
Desired payment method
Payment of consumption on corporate cards desired via
Private account – regarding private account, please provide payment information on page 2.
Company account – please provide desired payment method below.
Reg. no. (sort code) Account no.
Betalingsservice
Bank Giro form - invoice to be sent to company address. If another address is to be used, please provide it here
Attn. name
Invoice address
Postal code Town/City Country code
(not DK)
Electronic payment via EAN no.:
Authorised signatory
We hereby confirm the company information provided above, and that the card applicant is an employee of the company. We approve the issue of a Eurocard Corporate Card to the stated emplo- yee/card applicant. We accept that the card must be returned to Eurocard if the employee leaves the company. 201119
Date Company seal and signature – authorised signatory
Company reg. no.
Name in print Social security number*
–
Name in print Social security number*
–
* If a signatory lacks a Nordic social security number, a copy of the signatory’s passport must be attached (certified by another person with name, contact information and signature) together with the address details in the country of residence.
Information card applicant 1505
Eurocard is issued by SEB Kort Bank Danmark branch of SEB Kort Bank AB (Sweden) CVR-nr.: 25804759 Business ID. 556574-6624. eurocard.com
* Eurocard Corporate Private liability - page 2
Completed by the card applicant – Please enclose copy of latest pay check and picture ID, copy of passport or driving license.
Social security (CPR) no. Employee no./SAP ID
–
First name Surname
C/o name (if applicable) Address since (mth/yr)
–
Address
Postal code Town/City Country code
Telephone (daytime) Telephone (mobile) (not DK) + +
Electronic marketing Yes, I would like to receive updates by e-mail, SMS or push notification via the card issuer’s app and our partners, which can be subject to change. An overview of our partners can be viewed on our website. The marketing contains information, news, competitions and offers concerning new or improved cards- or insurance products, credit products, special customer offers, events as well as discounts. I reserve the right to withdraw my consent at any given time by contacting the card issuer, by means of the app or by choosing the “withdraw” function at the bottom of the card issuer’s e-mail or SMS. Marital status Residential status Married Single Divorced/ Cohabiting Other Owner Tenant Parents Cooperative Other Separated Employment status Member of unemployment fund Employed Self-employed Student Pensioner Unemployed Housewife Other Yes No
Monthly income: Gross DKK Net DKK Capital DKK Estimated annual turnover on Eurocard
Monthly expenses. State your share of the total cost of the household. Number of adults Number of children Number in the household living at home of cars Housing costs Other expenses Borrowing costs Transport costs
Occupation Bank sort code
Employed by/self-employed (name) Employed since (month/year) –
Trade Professional Managerial Clerical Health services Education Civil servant Skill. man. Sales Other
Financial institute & payment options
Client since (month/year) Settle account via Sort code Account number
– Giro payment Direct debit
I hold the following credit cards Eurocard Petrol card American Express Mastercard Dankort Department store VISA Other
Signature card applicant
Eurocard is issued by SEB Kort Bank Danmark branch of SEB Kort Bank AB (Sweden) CVR-nr.: 25804759 Business ID. 556574-6624. eurocard.com Eurocard Corporate Private liability - page 3
KreditStatus
I agree that SEB Kort may retrieve data concerning my loans/credits with other businesses connected to KreditStatus (see the businesses at www.kreditstatus.dk). The retrievable data are: Identification data, balance, loan type, principal amount/credit limit and creation date. The data may only be used for credit assessment in connection with my application for credit. It is up to me to decide if I want to give consent to the creditor collecting and processing data concerning my credit commitments. If I do not want to give my consent, it may mean that the credit- worthiness cannot be assessed until I obtain the necessary documentation for the Creditor.
I can withdraw my consent by contacting card issuer. However, it will not affect any processing and disclosure of my data occurring before the consent is withdrawn.
Read more about the processing of your data on eurocard.com
Signature card applicant
I have read and accepted the card terms and conditions for Eurocard Corporate Card, including the price sheet and clause 3.8 on fee changes. I confirm the correctness of the information in the application form and approve that Eurocard may search other sources of information about my application, according to clause 4 of the card terms and conditions. I accept that the Eurocard Corporate Card may only be used for company expenses, and that my private expenses must be paid in another manner, such as using a Euro- card Double Card. As the Card, irrespective of type of liability, is a Company Card, I accept that the company may limit the use of the Card in terms of amount as well as in terms of geography and industry. I am not registered with RKI Credit Information or the Debtor Register.
Eurocard processes the customer information submitted by me in order to fulfill the agreement with me. I give my consent according to clause 5 of the card terms and conditions to all informa- tion relating to the customer relationship, including CPR no. (social security number), may be disclosed to and received from other companies in the SEB group, including SEB and SEB Invest, and to credit information agencies approved by the Danish Data Protection Agency.
General customer information such as name, address, date of birth, telephone number and card number may be used to market Eurocard’s own products and products from Eurocard’s part- ners, as listed in the card terms and conditions. New partners may be added at a later date. If I have checked “yes” above in relation to electronic marketing, I consent to receiving electronic marketing material. I may notify Eurocard that I no longer wish to receive electronic marketing material at any time. I can withdraw my consent by contacting Eurocard. However, it will not affect any processing and disclosure of my data that has occurred before the consent is withdrawn.
Read more about our processing of your data on eurocard.com.
Date Signature card applicant
Please return the application to Eurocard, P.O.Box 351, DK-0900 Copenhagen C
Eurocard is issued by SEB Kort Bank Danmark branch of SEB Kort Bank AB (Sweden) CVR-nr.: 25804759 Business ID. 556574-6624. eurocard.com Politically exposed person
Pursuant to the Act on Measures Against Money Laundering and Terrorist Financing, we are required to ask whether you are a politically exposed person. A politically exposed person is a person who holds, or has held during the past 18 months, a prominent public function in a state or international organisa- tion such as the European Union or NATO. We are also required to ask if you are a family member, or a close associate of, a politically exposed person. Below is a list of positions/functions defined as politically exposed persons as well as a list of which relatives that are defined as family members.
1. Are you a politically exposed person, or are you a family member or a close associate of a politically exposed person? Yes – please answer questions 2 and 3 No – please proceed to section 4 and sign this form
2. Below is a list of positions/functions held by politically exposed persons. (Check at least one box and enter the person’s title and the country or organisation where he/she holds the position/function.) Head of state or head of government Ambassador
Minister Head of diplomatic mission Deputy or assistant minister Senior officer in the armed forces (e.g. general, lieutenant general, major general, admiral, vice admiral, rear admiral) Member of Parliament Member of an administrative, management or supervisory body of a state-owned enterprise (e.g. CEO, board member, deputy CEO or deputy board member) Supreme court judge Director, deputy director or board member of an international organisation Judges in other courts or judicial bodies that constitute (e.g. EU or NATO) a final court of appeal Member of the governing body of a political party elected Senior officer of an auditing authority in country- or EU Parliament Board member of a central bank
Title and country/Organisation:
3. Specify whether you are the politically exposed person, or if not, what your relationship is to the politically exposed person.
I declare that I am a politically exposed person Child Spouse 091019 Child’s spouse, cohabiting partner or registered partner
Registered partner Parent Cohabiting partner Close associate
If you are related to or close associate of a person in a politically exposed position, state the person’s name
4. I declare that I have read and understood what is written above and answered all the questions truthfully: Personal identity number (10 digits)
Place and date Signature
Name in block capitals 9600 DK ENG
Please remember to return this form together with your application. In order to fulfill the application for a new card the information above is requested.