VISA Gold and Classic Card Application - GBTI

VISA Gold and Classic Card Application

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Please fill out the following form and print before your visit or click here to download the form

    All Fields marked with * are Mandatory

    CREDIT CARD REQUIRED: GBTI VISA GOLD - US$10,000 (Maximum) | GBTI VISA CLASSIC - US$5,000 (Maximum)

    Print in the boxes below how you would like your name to appear on Card. Spell last name completely. Full name must not exceed 20 spaces.

    Full name must not exceed 20 spaces*

    PRINCIPAL APPLICANT

    Branch*
    Reason for applying for GBTI VISA Credit Card*
    Personal Details
    First Name*
    Middle Name
    Surname*
    No of Dependants*
    Salutation *MrMsMrs
    Marital Status *DivorcedMarriedSingleWidowed
    Date of Birth (dd/mm/yy): *
    Place of Birth Country*
    Nationality*
    National Identification No
    Date of issue
    Passport No*
    Country*
    Date of issue*
    Expiry Date*
    Drivers Licence No
    Country
    Date of issue
    Expiry Date
    Tax Payers Identification No
    Contact Details
    Home Address*
    Mailing Address (if different from home address)
    No of years there
    Type of Residence* FamilyOwnerParentsTenant
    Other please state
    Email address *
    Confirm Email address *
    Country Code *
    Home No *
    Country Code
    Work No
    Country Code
    Cell No
    Country Code
    Fax No


    Telephone details when overseas:

    Country Code
    Number
    Name a contact person who we may contact in the event you are overseas:
    Full Name
    Full Address
    Country Code
    Home No
    Country Code
    Work No
    Country Code
    Cell No
    Email address
    Confirm Email address
    Relationship
    Employment Details
    Status*
    EmployedSelf EmployedStudent
    Other: Please state
    Occupation*
    Employers Name
    Employers Address
    City
    No of years there
    Monthly Salary/Income
    Banking Information
    Account No*
    Account Class*
    Safe Deposit Box
    Other VISA cards held
    Security/Collateral*

    My Financial Summary

    Assets

    Description

    Value/Balance $

    Property(ies)

    Vehicle(s)

    Equipment

    Cash/Bank/Shares

    Trader Debtors/ Receivables

    Other

    Total Assets $

    Liabilities

    Description/Name

    Monthly Payments

    Balance

    GBTI

    Other Banks

    Hire Purchase/Trade Creditors

    Bank Credit Card

    Rent

    Utilities

    Insurance

    Other

    Total Monthly Payments/Total Liabilities

    Gross Monthly Income

    From my Employer $

    From My Co-Applicant $

    Other Income $

    Sources:

    Total Monthly Income $

    CO-APPLICANT

    Branch
    Reason for applying for GBTI VISA Credit Card
    Personal Details

    First Name
    Middle Name
    Surname
    Salutation
    MrMrsMs
    Marital Status
    DivorcedMarriedSingleWidowed
    No of Dependants
    Date of Birth (dd/mm/yy):
    Place of Birth Country
    Nationality
    National Identification No
    Date of issue
    Passport No
    Country
    Date of issue
    Expiry Date
    Drivers Licence No
    Country
    Date of issue
    Expiry Date
    Tax Payers Identification No
    Contact Details

    Home Address
    Mailing Address (if different from home address)
    No of years there
    Type of Residence FamilyOwnerParentsTenant
    Other please state
    Country Code
    Home No
    Country Code
    Work No
    Country Code
    Cell No
    Country Code
    Fax No
    Email address
    Confirm Email address

    Telephone details when overseas:

    Country Code
    Number

    Name a contact person who we may contact in the event you are overseas:

    Full Name
    Full Address
    Country Code
    Home No
    Country Code
    Work No
    Country Code
    Cell No
    Email address
    Confirm Email address
    Relationship
    Employment Details
    Status
    EmployedSelfEmployedStudent
    Other: Please state
    Occupation
    Employers Name
    Employers Address
    No of years there
    Monthly Salary/Income
    Banking Information
    Account No
    Account Class
    Safe Deposit Box
    Other VISA cards held