Credit Card Service Request Form
Please state as fully and accurately as possible the information asked for hereunder:
Primary Customer’s Name: Application No.
Service requested for (please fill accordingly)
Mastercard X X X X X X
Visa Card X X X X X X
Supplementary (1) X X X X X X
Supplementary (2) X X X X X X
Supplementary (3) X X X X X X
Supplementary (4) X X X X X X
Type of request (please specify the type of request)
Reinstate for: Application Credit Card
Renewal If card expired Early Renewal (before expiry by 60 days)
Credit limit increase Primary Supplementary 10% 25% 50% 75% 100%
Credit limit decrease Primary Supplementary 10% 25% 50% 75%
Upgrade from to
Downgrade from to
Please Note:
• In case of Upgrade/Downgrade the Annual Membership Fee will be adjusted accordingly (Gold: AED 400 & Cashback: AED 400)
• You may be requested to submit original documents for processing your service request (attach this form to the documents)
• Documents presented to First Abu Dhabi Bank (FAB) will remain the property of FAB
• The request is subject to Dubai First Credit Card Terms and Conditions
• I hereby authorize FAB to request a Credit Information Report from Al Etihad Credit Bureau or any authorized credit reference agency at any time and
disclose any information to; (a) any member of FAB (b) any professional advisor of FAB who is under a duty of confidentiality to FAB (c) any authorized
credit reference agency or credit bureau (d) any actual or potential transferee or assignee of our rights under Dubai First Credit Card Terms and Conditions
or (e) as required by law, government or regulatory authority or by Court order.
Customer’s Signature Date:
DD MM YY
Email this application to contactus@[Link] Terms and conditions apply.
For official Use Only
Date:
DD MM YY
FORM/CCSER/E/28062020
Documents received/required from customer:
Name and Signature of Customer Services Officer:
Dubai First is a trademark owned by First Abu Dhabi Bank PJSC
10. REQUEST FOR SUPPLEMENTARY CARD
Mr Mrs Ms
Relationship
Wife Husband Mother Father Daughter Son Brother Sister
Full name (as in passport)
Supplementary cardholder's name in English as you want it to appear on the card,
[Link]
using CUSTOMER
more than 21 CONSENT FORM FOR RELEASE OF STATEMENT OF ACCOUNT
letters and spaces.
Consent (permission upon signing this consent form)
By signing this form, you consent (give permission) to First Abu Dhabi Bank PJSC to request your statement of account from your bank (as can be
identified by the account number and IBAN) through the Central Bank of the United Arab Emirates, and also to your bank to provide this information
Nationality
through
Date of birth the
D DCentral
M M Y Bank
Y Y of the United
Y Passport no. Arab Emirates without obtaining additionalCredit
consent.
limit (in AED)
Mobile no. Email ID
Passport no. Emirates ID no.
Name as per document
FOR BANK USE ONLY
Account no.
Statement
Source codeperiod Campaign code Sub promo
By signing the below, I consent to the (one-time) release of my account statement exclusively for the purpose stipulated in the consent form:
FATCA US Indicia Yes No Submission date Signature Review date
Signature
FOR BANK USE ONLY
WHY
SourceCONSENT
code IS NEEDED AND HOW THECampaign
INFORMATION
code WILL BE USED Sub promo
Your consent (permission) is required for us to obtain and share your account information, including the transaction details for the identified
period,
FATCA USforIndicia
the purposes listed
Yes and explained
No below. The information
Submission date provided will be shared andReview
retained
datein accordance with applicable laws
concerning data security and privacy protection. The information you authorise us to obtain and share will be used to determine your eligibility
for the product. You understand that some services may not be available to you unless you consent to share/release information as stated
in this authorisation.
11. CUSTOMER CONSENT FORM FOR RELEASE OF STATEMENT OF ACCOUNT
Consent (permission upon signing this consent form)
By signing this form, you consent (give permission) to First Abu Dhabi Bank PJSC to request your statement of account from your bank (as can be
identified by the account number and IBAN) through the Central Bank of the United Arab Emirates, and also to your bank to provide this information
through the Central Bank of the United Arab Emirates without obtaining additional consent.
Passport no. Emirates ID no.
Name as per document
Account no.
Statement period
By signing the below, I consent to the (one-time) release of my account statement exclusively for the purpose stipulated in the consent form:
Signature Signature
This credit card application form was printed in Sep. 2019.
For updated schedule of charges visit [Link]
WHY CONSENT IS NEEDED AND HOW THE INFORMATION WILL BE USED
Your consent (permission) is required for us to obtain and share your account information, including the transaction details for the identified
period, for the purposes listed and explained below. The information provided will be shared and retained in accordance with applicable laws
concerning data security and privacy protection. The information you authorise us to obtain and share will be used to determine your eligibility
for the product. You understand that some services may not be available to you unless you consent to share/release information as stated
in this authorisation.
