MASTERCARD CORPORATE CARD - Danske Bank

OccupationEmployeeSelf-employed Employer or company Telephone No.Employee or self-employed since (month/year)Previous occupation within the past five years, including starting and ending dates(mount/yearI am a member of an unemployment insurance fund Yes NoOther payment cardsI have a DankortNoYesCard numberI have a petrol cardYesNoI have a Visa/DankortNoYesCard numberI have a Diners cardYesNoI have a MasterCardNoYesI have a Eurocard Yes NoI have a department store credit card or other retailers association credit cardsCertificationNoYesI confirm that the information given in this application is true and complete, and I certify by my signature that I haveread and accepted the MasterCard Dobbeltkort conditions.I recognise that I owe Danske Bank for any withdrawals made from the card account, including any interest, interest on excess, feesand charges, always subject, however, to the rules laid down in section 11 of the Danish Act on Certain Payment Instruments.I accept that– Danske Bank makes a credit assessment of my financial standing, which may include obtaining information from or passingon information to credit institutions, credit-rating agencies and banks as well as an assessment of my present (and previous)facilities with any company of the Danske Bank Group– Danske Bank will make continuous assessment of my financial standing, including any facilities I may have with othercompanies of the Danske Bank Group. Consequently, information on my customer relationships, including my CPR number,may be passed on to and received from other companies of the Danske Bank Group– additional benefits may be attached to the card– Danske Bank exchanges information with business partners for the establishment and administration of additional benefitsto the card – and for the processing of any claims– the basis of the MasterCard Dobbeltkort agreement is this application, the card conditions and the list of charges.I am aware that Danske Bank receives a commission on my use of the card in shops and other outlets.DateApplicant’s signatureIdentificationAs proof of identity, I enclose a copy of myID cardNoYesSerial No.ExpiryDriver’s licenceNoYesSerial No.ExpiryPassportNoYesSerial No.Expiry

Application for a Familiekort(family card)MandateThe principal cardholder’s MasterCard No. (see front of the card)I (applicant’s/cardholder’s name)authorise (mandatary’s CPR No.)Mandatary’s first nameMandatary’s surnameAddressPostal code and citywho is my spouse, cohabitant or child above the age of 18 living at hometo operate my card account(only to be filled in if you know the card number)by Familiekort.I recognise that as cardholder I am liable for every transaction made from the card account irrespective of the payments’ having been made withthe Familiekort or my own card, see the card conditions (see the card conditions).The mandate will remain in force until Danske Bank receives written revocation. The Familiekort must be cut up in half and submitted to Danske Bankas soon as it has been revoked.DateCardholder’s signatureMandataryOn the basis of the mandate, I wish to have a Familiekort issued for the above Dobbeltkort account.I acknowledge having received, read and accepted the card conditions, and I confirm the correctness of the information given on my name and CPRnumber.DateApplicant’s signatureIdentificationAs proof of identity, I enclose a copy of myID cardNoYesSerial No.ExpiryDriver’s licenceNoYesSerial No.ExpiryPassportNoYesSerial No.Expiry