Smiths City

Smiths Card Application

it's the easy way to buy

instant credit
Your Smiths Card also gives instant identification as a Special Smiths City customer for Hire Purchase, Easy-Pay and Charge Accounts.

easy payments
You choose the way you pay. Pay the full account balance monthly and no charges apply or you can pay only 3% of the balance each month with the remaining balanced being charged our competitive interest rate.

special offers
You will be invited to our special Smiths City Customer evenings and be included in promotions to win or qualify for free gifts.

purchase by mail or phone
You can use your Smiths Card to buy from our catalogues, adverts or through our 0800 764 847 phone number.

Smiths Card Application
First Names :
Last Name :
Street
Suburb
City
Status :	Rent Own Home Flatting
Phone Number :
Mobile Number:
Date of Birth	eg: 01/01/2004
Email address
How long have you lived at the above address	years
If you have lived at the above address less than 3 years, please complete the following
Street
Suburb
City
Identification Details
ID Type :	Drivers Licence Passport
	Amex Diners Visa
	Bankcard Mastercard
ID Number :
Occupation :
Employer :
Employed for :	years
Business Phone:
Partners Details
Partners Name :
Partners Occupation :
Partners Employer :
Employed for:	years
Business Phone :
Next of kin or friend
Name :
Street
Suburb
City
Phone Number :
Credit Limit Request
up to $500
$500 - $1000
$1000 - $2000
over $2000
Privacy Act 1993 I understand that Smiths City is collecting the information in this application for the purposes of credit approval and administering the account. This may require information to be provided to external collections and credit reporting agencies, and other agencies required from time to time to be involved in the administration or enforcement of this account. I authorise any person or company to provide Smiths City with such information as Smiths City may require to administer and enforce this agreement. Conditions and Consent to use and disclose information When we send your Smiths Card to you we will also send a copy of the terms and conditions which relate to its use. Your acceptance will occur when you sign and use the card. You are also certifying that the information is true and correct, that you are not an undischarged bankrupt, acknowledge that joint account holders are severally liable for payment and that Smiths City may decline to issue a Smiths Card at its discretion. In addition you acknowledge that on issue of the Smiths Card, Smiths City holds information that can be used for purposes relating to the provision of credit and the administration and management of our account, the marketing of goods and services and providing information on request to credit agencies. To apply for the Smiths Card, you must be at least 18 years or over. Yes I am over 18 years old
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