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  Application for American Express Card

[ * Mandatory Fields ]

[ PERSONAL INFORMATION ]

Title:
Surname: *
Fore Names: (in full) *
Father's Name:
Date of Birth: (eg. 31/12/1973) *
Identity Card Number: *
Passport No: (for Non Cypriots only)
Country of Issue: (for Non Cypriots only)
Nationality: (for Non Cypriots only)
Sex: *
Marital Status: *
Number of dependant children:


[ BANKING DETAILS ]

Bank: *
Branch:
Account: (If Other - Specify AC)   -  
Number of accounts at the Bank of Cyprus:
Years of cooperation with the Bank:
Persons who can give reference for you:
(name/address/tel/occupation)


[ FINANCIAL STATUS - MONTHLY INCOME ]

Net Salary: EUR 
Spouse's net salary: EUR 
Other Income: EUR 


[ MONTHLY EXPENSES ]

Rent: EUR 
Loan/Finance payments: EUR 
Other Expenses: EUR 
Residence:
Loans/Obligation's: (Amount) EUR 


[ EMPLOYMENT INFORMATION ]

Occupation: *
Employer's Name:
Employers Address:
Postal Code:
Nature of Business:
Position:
Years of Employment:
Spouse's Employer:
Spouse's Employer's Address:


[ MAIL ADDRESS ]

Residence Address: *
Residence Postal Code: *
E-mail Address: *
Tick here if you do not wish to receive e-mails from Bank of Cyprus
Please send my mail at:


[ APPLY FOR1bank]

Apply for 1bank



Signature: ......................................



Date: .......................................
(For the Print Option ONLY)

  

Fill-in, print the application, sign it and send it to:
Bank of Cyprus
Card Center
97, Kyrenias Avenue,
Platy, Aglantzia
P.O Box 21472
1599 Nicosia, Cyprus

Or hand it into any Bank of Cyprus Branch