Apply for a Scotiabank MasterCard® card today.
Apply for a Scotiabank MasterCard® card today. Select your choice of credit card. MasterCard®
Gold MasterCard
MAGNA MasterCard
Aero* MasterCard
PriceSmart MasterCard
Are you a MAGNA Program Member? If yes # is Government ID’s: 2 of either Passport, National ID, Driver’s Licence payslips issued
Proof of physical and mailing address (if not on ID), such as utility bill
Latest 2 consecutive
Original employment letter, must include salary, length of employment, company contact details, occupation and type of contract (permanent,
contract, seasonal)
Bank statement (must be statement from the last month),
References †: 2 required (must not be living in same household) and
Mortgage statement or rent receipts (if applicable).
Tax registration number (TRN),
Any other liability statement issued in the last month.
Please tell us more about yourself: Are you a Scotiabank customer? Mr.
Mrs.
Ms.
Yes
Miss
No
If yes, Account #:
ScotiaCard #:
First Name:
Initial:
Passport/National ID #:
Last Name:
Please print last name in full
Other ID :
# of Dependents:
Date of Birth: | D | D | M | M | Y | Y |
Country of Birth:
Mother’s Maiden Name:
Email Address Country of Citizenship:
City:
Address:
Country:
Postal Code (if applicable):
Cell Phone #:
Marital Status:
Monthly mortgage/rent payment? $
Single
Married
Time at current residence:
Divorced
Years
Home Phone #:
Widow(er) Months
Residential Status:
Own
Rent
If less than 2 years, time at previous residence:
Previous Landlord Name:
Living with Parents
Other
Years
Months
Phone #:
Previous address if less than 2 years:
Your financial information: Depending on source and consistency of income, additional information may be required, i.e. self-employed, contract income, variable income earner, commissions sales. Existing Mortgage on Home (if applicable): $
Lender Name:
Current Employer: Full-time
Employer Address:
Part-time
Self-employed
Occupation:
Position Title:
Business Phone #:
Time with Employer:
Previous Employer:
Phone #:
Bankrupt in the last 7 years?
Yes
No
Monthly Pymt: $ Other assets:
Other assets:
Other Lender
Yes
Other Credit Cards? Other assets:
No
Yes
Property
If less than 2 years, time at your previous Employer:
No
Have you ever had a judgement filed against you?
Value: $
Yes
Do you have any loans with Scotiabank?
Lender Name (if any):
Months
Source: Yes
No
Amount: $
Monthly Pymt: $ Monthly Pymt: $
Lender Name:
Monthly Pymt: $
Lender Name:
Savings / Deposit Account
Years
Other Monthly Income: $ No
Lender Name (if any):
No Amount: $ Yes
Months
Current Monthly Employment Income: $
Lawsuits or claims?
Car Value: $
Years
Credit Limit: $ Balance: $
Monthly Pymt: $
Investments/Stocks Value: $
Additional card: First Name:
Last Name:
Address:
Phone#:
Occupation:
Relationship to the Primary Cardholder:
Country of Birth:
Country of Citizenship:
Do you have any immediate relative(s) employed at any Scotiabank branch?
Yes
Date of Birth: | D | D | M | M | Y | Y |
No If yes, please list name(s) of immediate relatives and the branch.
Name(s)
Branch
Do you have any unsecured loan(s) outstanding at any Scotiabank branch?
Yes
No If yes, please list amount(s) and the branch.
$
Branch
†Please provide the contact information for two personal references. References should not live in your household.
Reference 1: First Name:
Last name:
Address:
Phone #:
Reference 2: First Name:
Last name:
Address:
Yes,
Phone #:
I would like to insure my Scotiabank credit card account balance for Single Life & Critical Illness coverage.
Coverage is subject to specific limitations and exclusions including age restrictions and maximum coverage limits as described on the reverse and in the Certificate of Scotiabank Credit Insurance. Please read the important information on the reverse. “We”, “our”, “us”, “Scotiabank” and the “Bank” mean The Bank of Nova Scotia. I hereby certify the above information to be true and complete. If this application is accepted by The Bank of Nova Scotia (the“Bank”) I request the Scotiabank credit cards be issued to me as designated above. I hereby authorise and consent to the Bank obtaining further information about me and checking the information I have given here and exchanging information about me with other parties. I agree to read and be bound by the Credit Cardholder Agreement. I authorise the Bank to debit my credit card account with the amount of the annual fees in effect for the card. I understand that I (the Primary Cardholder) am solely liable for all charges incurred on the account by an Additional Cardholder. | D | D | M |M| Y | Y | Applicant’s (Primary Cardholder’s) Signature
Date
| D | D | M |M| Y | Y | Additional Cardholder’s Signature
* Trademark of The Bank of Nova Scotia, used under licence. ®MasterCard is a registered trademark of MasterCard International Incorporated.
Date
JA-08/12
T16C5306
Simply complete the application form and return it to your nearest branch, along with the required documents for both Yourself and the Additional Cardholder (if applicable).
Life and Critical Illness Protection Terms and Conditions MasterCard Credit Protection protects your family and estate from the obligation to repay the insured balance outstanding under your Scotiabank MasterCard® credit card account up to JA$1,000,000 or US$15,000 in the event of your death or diagnosis of a covered critical illness (heart attack, cancer or stroke). To be eligible for Life and Critical Illness coverage, you must be the Primary Cardholder over age 18 years of age and under age 60 years of age at the time of enrollment and that coverage will be bound by the Terms and Conditions stated in the Certificate of Scotiabank MasterCard Credit Insurance. The premium for Single Life and Critical Illness is only 53 cents/$100 of your outstanding balance. No premium is charged if your last statement balance was zero. You authorise the Bank to provide the insurer with your Scotiabank MasterCard® credit card account number, monthly statement balance and any other necessary information, and you authorise the insurer to charge monthly premiums to your Scotiabank MasterCard®
credit card account. Your insurance Enrollment, the Certificate of Scotiabank MasterCard Credit Insurance and the Group Policy (the “Policy”) comprise the entire arrangement governing your coverage. The Bank will on behalf of the Insurance Company issue a Certificate of Scotiabank MasterCard Credit Insurance to you. Coverage is subject to specific Limitations and Exclusions including age restrictions, as described in this insurance enrollment, the Certificate of Scotiabank MasterCard Credit Insurance and the Policy. Please refer to the Certificate of Scotiabank MasterCard Credit Insurance for more details. If after examining the Certificate, you are not satisfied for any reason, you may notify your Bank branch in writing within 30 days of the Insurance Effective Date that you do not want the insurance. Any premium you have paid will be credited to your Scotiabank MasterCard account. Scotiabank MasterCard Credit Protection is underwritten by Scotia Jamaica Life Insurance Company.
Gold MasterCard
MAGNA MasterCard
Aero* MasterCard
PriceSmart MasterCard
Are you a MAGNA Program Member? If yes # is Government ID’s: 2 of either Passport, National ID, Driver’s Licence payslips issued
Proof of physical and mailing address (if not on ID), such as utility bill
Latest 2 consecutive
Original employment letter, must include salary, length of employment, company contact details, occupation and type of contract (permanent,
contract, seasonal)
Bank statement (must be statement from the last month),
References †: 2 required (must not be living in same household) and
Mortgage statement or rent receipts (if applicable).
Tax registration number (TRN),
Any other liability statement issued in the last month.
Please tell us more about yourself: Are you a Scotiabank customer? Mr.
Mrs.
Ms.
Yes
Miss
No
If yes, Account #:
ScotiaCard #:
First Name:
Initial:
Passport/National ID #:
Last Name:
Please print last name in full
Other ID :
# of Dependents:
Date of Birth: | D | D | M | M | Y | Y |
Country of Birth:
Mother’s Maiden Name:
Email Address Country of Citizenship:
City:
Address:
Country:
Postal Code (if applicable):
Cell Phone #:
Marital Status:
Monthly mortgage/rent payment? $
Single
Married
Time at current residence:
Divorced
Years
Home Phone #:
Widow(er) Months
Residential Status:
Own
Rent
If less than 2 years, time at previous residence:
Previous Landlord Name:
Living with Parents
Other
Years
Months
Phone #:
Previous address if less than 2 years:
Your financial information: Depending on source and consistency of income, additional information may be required, i.e. self-employed, contract income, variable income earner, commissions sales. Existing Mortgage on Home (if applicable): $
Lender Name:
Current Employer: Full-time
Employer Address:
Part-time
Self-employed
Occupation:
Position Title:
Business Phone #:
Time with Employer:
Previous Employer:
Phone #:
Bankrupt in the last 7 years?
Yes
No
Monthly Pymt: $ Other assets:
Other assets:
Other Lender
Yes
Other Credit Cards? Other assets:
No
Yes
Property
If less than 2 years, time at your previous Employer:
No
Have you ever had a judgement filed against you?
Value: $
Yes
Do you have any loans with Scotiabank?
Lender Name (if any):
Months
Source: Yes
No
Amount: $
Monthly Pymt: $ Monthly Pymt: $
Lender Name:
Monthly Pymt: $
Lender Name:
Savings / Deposit Account
Years
Other Monthly Income: $ No
Lender Name (if any):
No Amount: $ Yes
Months
Current Monthly Employment Income: $
Lawsuits or claims?
Car Value: $
Years
Credit Limit: $ Balance: $
Monthly Pymt: $
Investments/Stocks Value: $
Additional card: First Name:
Last Name:
Address:
Phone#:
Occupation:
Relationship to the Primary Cardholder:
Country of Birth:
Country of Citizenship:
Do you have any immediate relative(s) employed at any Scotiabank branch?
Yes
Date of Birth: | D | D | M | M | Y | Y |
No If yes, please list name(s) of immediate relatives and the branch.
Name(s)
Branch
Do you have any unsecured loan(s) outstanding at any Scotiabank branch?
Yes
No If yes, please list amount(s) and the branch.
$
Branch
†Please provide the contact information for two personal references. References should not live in your household.
Reference 1: First Name:
Last name:
Address:
Phone #:
Reference 2: First Name:
Last name:
Address:
Yes,
Phone #:
I would like to insure my Scotiabank credit card account balance for Single Life & Critical Illness coverage.
Coverage is subject to specific limitations and exclusions including age restrictions and maximum coverage limits as described on the reverse and in the Certificate of Scotiabank Credit Insurance. Please read the important information on the reverse. “We”, “our”, “us”, “Scotiabank” and the “Bank” mean The Bank of Nova Scotia. I hereby certify the above information to be true and complete. If this application is accepted by The Bank of Nova Scotia (the“Bank”) I request the Scotiabank credit cards be issued to me as designated above. I hereby authorise and consent to the Bank obtaining further information about me and checking the information I have given here and exchanging information about me with other parties. I agree to read and be bound by the Credit Cardholder Agreement. I authorise the Bank to debit my credit card account with the amount of the annual fees in effect for the card. I understand that I (the Primary Cardholder) am solely liable for all charges incurred on the account by an Additional Cardholder. | D | D | M |M| Y | Y | Applicant’s (Primary Cardholder’s) Signature
Date
| D | D | M |M| Y | Y | Additional Cardholder’s Signature
* Trademark of The Bank of Nova Scotia, used under licence. ®MasterCard is a registered trademark of MasterCard International Incorporated.
Date
JA-08/12
T16C5306
Simply complete the application form and return it to your nearest branch, along with the required documents for both Yourself and the Additional Cardholder (if applicable).
Life and Critical Illness Protection Terms and Conditions MasterCard Credit Protection protects your family and estate from the obligation to repay the insured balance outstanding under your Scotiabank MasterCard® credit card account up to JA$1,000,000 or US$15,000 in the event of your death or diagnosis of a covered critical illness (heart attack, cancer or stroke). To be eligible for Life and Critical Illness coverage, you must be the Primary Cardholder over age 18 years of age and under age 60 years of age at the time of enrollment and that coverage will be bound by the Terms and Conditions stated in the Certificate of Scotiabank MasterCard Credit Insurance. The premium for Single Life and Critical Illness is only 53 cents/$100 of your outstanding balance. No premium is charged if your last statement balance was zero. You authorise the Bank to provide the insurer with your Scotiabank MasterCard® credit card account number, monthly statement balance and any other necessary information, and you authorise the insurer to charge monthly premiums to your Scotiabank MasterCard®
credit card account. Your insurance Enrollment, the Certificate of Scotiabank MasterCard Credit Insurance and the Group Policy (the “Policy”) comprise the entire arrangement governing your coverage. The Bank will on behalf of the Insurance Company issue a Certificate of Scotiabank MasterCard Credit Insurance to you. Coverage is subject to specific Limitations and Exclusions including age restrictions, as described in this insurance enrollment, the Certificate of Scotiabank MasterCard Credit Insurance and the Policy. Please refer to the Certificate of Scotiabank MasterCard Credit Insurance for more details. If after examining the Certificate, you are not satisfied for any reason, you may notify your Bank branch in writing within 30 days of the Insurance Effective Date that you do not want the insurance. Any premium you have paid will be credited to your Scotiabank MasterCard account. Scotiabank MasterCard Credit Protection is underwritten by Scotia Jamaica Life Insurance Company.
