Apply today.
Apply today. Are you a Scotiabank customer? Mr.
Mrs.
Ms.
Yes
No If yes, Account #:
ScotiaCard #:
Miss First Name:
Initial:
Passport/National ID #: Your Date of Birth: | D | D | M | M | Y | Y |
Country of Birth: City:
Mother’s Maiden Name:
Address: #
Country: Marital Status:
Single
Married
Time at current residence:
Previous Address, if less than 2 years
Street:
Postal Code (if applicable):
Monthly mortgage/rent payment? $ Address: #
Divorced
Years
Widow(er) Months
Home Phone #: Residential Status:
Own
Rent
Living with Parents
If less than 2 years, time at previous residence:
Other
Years
Months
Years
Months
Street:
City:
Country:
Postal Code (if applicable):
Your financial information: Existing Mortgage on Home (if applicable): $ Full-time
Part-time
Lender Name:
Self-employed Occupation:
Position Title:
Current Employer: ■ AAdvantage MasterCard
®
Employer Address:
Business Phone #:
Time with Employer:
Previous Employer:
Phone #:
Bankrupt in the last 7 years?
Yes
Other assets: Other Lender
Other assets: Car Value: $ Yes
Other Credit Cards? Other assets:
Yes
Property
No Have you ever had a judgement filed against you? Value: $
If less than 2 years, time at your previous Employer:
Yes
Other Monthly Income: $ No Do you have any loans with Scotiabank?
Lender Name (if any):
Source: Yes
No Amount: $
Monthly Pymt: $ Monthly Pymt: $
Lender Name:
Monthly Pymt: $
No Lender Name:
Savings / Deposit Account
Months
Lender Name (if any):
No Amount: $ Yes
Years
Current Monthly Employment Income: $
No Lawsuits or claims?
Monthly Pymt: $ ■ MAGNA MasterCard
Please print last name in full
Email Address (Optional):
Country of Citizenship:
Cell Phone #:
■ Gold MasterCard
Last Name:
Other ID :
# of Dependents:
■ MasterCard®
Are you a MAGNA Program Member? If yes # is
Are you an AAdvantage® Program Member? If yes # is
Please tell us more about yourself:
ONAC4304
Select your choice of credit card.
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:
Will this credit card be used to conduct transactions for anyone other than the authorised Cardholder(s)?
Yes,
Date of Birth: | D | D | M | M | Y | Y |
Yes
No If yes, please complete a Third Party Determination Form available at your local Scotiabank branch.
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 next page. “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
Date
* Trademarks of The Bank of Nova Scotia. ®MasterCard is a registered trademark of MasterCard International Incorporated. American Airlines reserves the right to change AAdvantage® program rules, regulations, travel awards and special offers at any time without notice, and to end the AAdvantage® program with six months notice. Any such changes may affect your ability to use the awards or mileage credits that you have accumulated. Unless specified, AAdvantage® miles earned through this promotion/offer do not count toward elite-status qualification or Million MilerSM status. American Airlines is not responsible for products or services offered by other participating companies. For complete details about the AAdvantage® program, visit www.aa.com/aadvantage. Scotiabank issues the Scotiabank / AAdvantage® card. ®AmericanAirlines, AAdvantage and Million Miler are trademarks of American Airlines, Inc.
SV-08/12
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 EC$35,000 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 licensed insurance companies.
Mrs.
Ms.
Yes
No If yes, Account #:
ScotiaCard #:
Miss First Name:
Initial:
Passport/National ID #: Your Date of Birth: | D | D | M | M | Y | Y |
Country of Birth: City:
Mother’s Maiden Name:
Address: #
Country: Marital Status:
Single
Married
Time at current residence:
Previous Address, if less than 2 years
Street:
Postal Code (if applicable):
Monthly mortgage/rent payment? $ Address: #
Divorced
Years
Widow(er) Months
Home Phone #: Residential Status:
Own
Rent
Living with Parents
If less than 2 years, time at previous residence:
Other
Years
Months
Years
Months
Street:
City:
Country:
Postal Code (if applicable):
Your financial information: Existing Mortgage on Home (if applicable): $ Full-time
Part-time
Lender Name:
Self-employed Occupation:
Position Title:
Current Employer: ■ AAdvantage MasterCard
®
Employer Address:
Business Phone #:
Time with Employer:
Previous Employer:
Phone #:
Bankrupt in the last 7 years?
Yes
Other assets: Other Lender
Other assets: Car Value: $ Yes
Other Credit Cards? Other assets:
Yes
Property
No Have you ever had a judgement filed against you? Value: $
If less than 2 years, time at your previous Employer:
Yes
Other Monthly Income: $ No Do you have any loans with Scotiabank?
Lender Name (if any):
Source: Yes
No Amount: $
Monthly Pymt: $ Monthly Pymt: $
Lender Name:
Monthly Pymt: $
No Lender Name:
Savings / Deposit Account
Months
Lender Name (if any):
No Amount: $ Yes
Years
Current Monthly Employment Income: $
No Lawsuits or claims?
Monthly Pymt: $ ■ MAGNA MasterCard
Please print last name in full
Email Address (Optional):
Country of Citizenship:
Cell Phone #:
■ Gold MasterCard
Last Name:
Other ID :
# of Dependents:
■ MasterCard®
Are you a MAGNA Program Member? If yes # is
Are you an AAdvantage® Program Member? If yes # is
Please tell us more about yourself:
ONAC4304
Select your choice of credit card.
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:
Will this credit card be used to conduct transactions for anyone other than the authorised Cardholder(s)?
Yes,
Date of Birth: | D | D | M | M | Y | Y |
Yes
No If yes, please complete a Third Party Determination Form available at your local Scotiabank branch.
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 next page. “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
Date
* Trademarks of The Bank of Nova Scotia. ®MasterCard is a registered trademark of MasterCard International Incorporated. American Airlines reserves the right to change AAdvantage® program rules, regulations, travel awards and special offers at any time without notice, and to end the AAdvantage® program with six months notice. Any such changes may affect your ability to use the awards or mileage credits that you have accumulated. Unless specified, AAdvantage® miles earned through this promotion/offer do not count toward elite-status qualification or Million MilerSM status. American Airlines is not responsible for products or services offered by other participating companies. For complete details about the AAdvantage® program, visit www.aa.com/aadvantage. Scotiabank issues the Scotiabank / AAdvantage® card. ®AmericanAirlines, AAdvantage and Million Miler are trademarks of American Airlines, Inc.
SV-08/12
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 EC$35,000 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 licensed insurance companies.
