Credit card application wizard

Statements and PIN / Agreements / Income / Offer and declaration / Authorisation / Confirmation /

Credit card application - authorisation

Personal details

Surname, name, title František Koudelka

Entity Entrepreneur

Permanent residence address Vinohradská 123, Praha, 120 00

Birth number / date of birth 8765242/2134

Proof of identity: type, number, issue date, validity,
issued by office / state Identification Document, 10222002, issued on 1. 1. 2001 do 1. 1. 2011,
issued by MěÚ Praha

Marital status Single

Matrimonial property settlement value

Married on 1. 1. 2000

Total number of people living at address 5

Of which number of children aged up to 6 years 1

Of which number of children aged between 7 and 10 1

Of which number of children aged between 11 and 15 1

Of which number of children aged between 16 and 25 2

Housing conditions Majitel/ka bytu

Living at permanent address since 1. 1. 2000

Education Středoškolské

Card parameters

Card type Lady karta Personal credit card terms and conditions

I hereby confirm that I have read the product list information.

Interested in the credit insurance Yes

Basic credit limit value

Individual credit limit value

Lump sum payment (100% instalment) Yes

Account from which the fees and regular instalments will be paid 23-33356333322/0100

Weekly limits ATMs 100 000,00 CZK

shops 100 000,00 CZK

total limit 100 000,00 CZK

Interested in the custom card design Yes

Enter e-mail address in order to obtain custom card design code name@domain.cz

Send notification upon processing the application SMS: 123456789

Statements and PIN

Statement settings Electronic, monthly

Postal address Zaplatílkova 65, Praha, 180 00

Card PIN to be sent to the address Ulice 4321, Praha

Card PIN to be sent to the branch Ulice 4321, Praha

Agreements

SOLUS registry I agree

Agreement with provision of data to the positive SOLUS registry I agree

Agreement with provision of data to the NRKI registry I agree

Note Confirming the agreement with provision of data in the SOLUS and NRKI registers has great influence on approval for a credit card.

Notification of client agreement with data processing View document

Income

Income from employment

Is your income from employment being regularly transferred to a KB account? Yes

You will be asked to provide confirmation of Income from employment after submitting the application. Please fill it in and have your employer confirm it.

Income from employment value

Occupation value

Work sector value

Employed since 1. 1. 2000

Employment contract Určitou, do 15. 12. 20012

Currently in trial period No

Currently in notice period No

Employer's name value

Employer's ID / birth no. value

Employer’s main field of business value

Employer's postcode value

Employer's town value

Employer's country value

Business revenues

Business revenues 0,00 CZK

Entrepreneur ID / birth no. value

Main business activities value

Occupation value

Entrepreneur's name value

Entrepreneur's postcode value

Entrepreneur town value

Entrepreneur's country value

Self-employed since 1. 1. 2000

Other income

Income from rent 0,00 CZK

Income of co-parner 0,00 CZK

Other verifiable income 0,00 CZK

Additional income name, 10 000,00 CZK

Offer and declaration

I confirm that I have read and agree to the policy terms and conditions of the credit card offer.

I confirm that I have read and agreed to the Income declaration.

I confirm that the above information is correct.

I agree and accept the terms and conditions of Personal Credit Card Services.

Certificate C:\Documents And Settings.\Admin...Koudelka_Frantisek_KB07.p12

Password

Authorisation SMS code

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