THE WING ON DEPARTMENT STORES (HONG KONG) LIMITED CHARGE CARD DEPT Charge Card Application Form

Please complete this application in English and in block letters Version 2015 1. YOUR PERSONAL PARTICULARS 4. YOUR PREFERENCE Name should be the same as the one on your I.D. Card (Applicant must be a Hong Please send statement to Kong resident aged 18 or above) And annual income of HK$100,000 or above is  Home Address  Office Address required. (P.O. Box and Overseas address are not acceptable)  Mr.  Miss.  Mrs.  Ms.  I accept The Wing On Department Stores (Hong Kong) Limited to use my personal data in direct marketing via Electronic Channels / SMS / Mail / Call. Family Name Given Name Personal Settlement of account by Date of Birth D M Y  Debit bank account thru Auto-pay system (Please fill in autopay authorization form) HKID No. ( ) Nationality  Payment by check/cash Marital Status ▲ Married  Single  Other I wish to pick up my card(s) from Education  Secondary  Tertiary  University or above  Main Store  Wing On Plus ()  Store  Wing On Plus ( East) Home Address 5. SUPPLEMENTARY CARD APPLICATION Flat/Room Floor Block Applicant must be aged 18 or above  Mr.  Miss.  Mrs.  Ms. Building Family Name Given Name Road / Street Date of Birth D M Y District / Area  HK 口 KLN 口 NT HKID No. ( ) Relationship Pager/Mobile Home Tel No Phone No Contact Tel No

E-mail Address 6. NOTICE In order to speed up your application, please attached copies of the following  Mortgage ▲  Company Quarters ▲ documents:

 Own Property ▲  Relative’s Property ▲ 1. Your and supplementary card applicants’ HKID card ; AND 2. Current residential proof (e.g. electricity bill / bank statement); AND  Rent ▲ Years there ▲ 3. Latest 2 months’ salary record; (e.g. income tax return, payroll slip); AND 4. Latest 2 months’ savings record; (e.g. fixed deposit / investments / bank record)

2. YOUR JOB  If you are not employed, please provide any financial / asset proof; (e.g. Fixed deposit note or the latest 3 months’ savings record) Company Name Note: Documents supplied (including this application form) are not returnable. Department 7. YOUR SIGNATURE Office Address I/we warrant that the above information and documents enclosed with this application are true and correct. I/We authorize The Wing On Department Stores Flat/Room Floor Block (Hong Kong) Limited. to exchange and obtain information from any source including credit reporting agencies in order to process this application and operate Building my/our account. Conditions of use will accompany the Wing On Charge Card(s) when issued. I/we agree that all terms and conditions of the Wing On Charge Road / Street Card Agreement and this application will constitute my/our agreement with you for the use of such card(s). I/we understand that (i) failure to answer all District / Area 口 HK  KLN  NT questions listed in this application may prevent you from processing my/our application; and (ii) you may refuse to accept this application in the light of my/our Office Tel No Years there individual circumstances.

 Self Employed Position

Nature of Business Signature of Main Card Applicant (Please do not alter) Date 3. YOUR FINANCIAL DATA Applicant Monthly Income (HK$) Other Income (HK$) Total Annual Income (HK$)* Signature of Supplementary Card Applicant (Please do not alter) X months Date

* Please refer to Item 6 for documents required. OFFICE USE ONLY Other Credit Card Account(s) ( if any) ▲ Handled by Bank Account No Credit Limited (HK$) APF No. Card No.

APP/REJ/CAN Date Issued

App Credit Limit Approved by ▲ Optional

Mailing address: Charge Card Department, 2/F Wing On Godown Building, 1 Wang Kee Street, Kowloon Bay, Kowloon. Tel: 2318-2462