DINERSCLUB.AT DINERS CLUB CARD ORDER For internal use only The easy way to get your perfect Diners Club Card 2 for my partner daughter son other 2) The annual fee will be charged once a year for 12 months in advance. 3) Note that the add-on card must be the same type as the primary card.. 1 1) The annual fee will be charged once a year for 12 months in advance. Best Pay - Diners Club‘s smart instalment plan Diners Club Best Pay gives you even more flexibility when shopping. This new, smart instalment plan is unbureaucratic, fast and, above all, less expensive than most overdrafts. For more details on the current terms and interest rates, please go to www.dinersclub.at/bestpay. I hereby apply for Best Pay, Diners Club‘s smart instalment plan to cover any outstanding balances on my primary card: Yes No 4 page 1 / 4 Account statements by e-mail: easy, convenient and eco-friendly I hereby agree to have my account statements sent to the e-mail address specified, free of charge. Yes No 4) 4) Should you request postal delivery of your printed account statements, you will be charged a mailing fee of ¤ 2 for each account statement. 5 For your safety: your Diners Club Card with your photo I hereby order a Diners Club Card with my photo, at a fee of 70 cents per month in addition to the annual fee. • Recent personal photo in black and white or colour • Taken in full-face view, with the head centred and filling as much of the photograph as possible • Format: JPG 20x20 mm or 240x240 pixel, 300 dpi Primary card Yes No Add-on card Yes No 3 I hereby order a I hereby order a Card odered by: RV: VIC Staff Diners Club Gold Card: free of charge for the first year, from the second year ¤ 3.34 instead of ¤ 6.67 per month 1) Diners Club Golf Card: free of charge for the first year, from the second year ¤ 3.75 instead of ¤ 7.50 per month 1) Diners Club Gold Add-On Card: free of charge for the first year, from the second year ¤ 3.34 per month 2)3) Diners Club Golf Add-On Card: free of charge for the first year, from the second year ¤ 3.75 per month 2)3) FIRST YEAR FREE!
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DINERSCLUB.AT
DINERS CLUB CARD ORDER
For internal use onlyThe easy way to get your perfect Diners Club Card
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for my partner daughter son other
2) The annual fee will be charged once a year for 12 months in advance.3) Note that the add-on card must be the same type as the primary card..
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1) The annual fee will be charged once a year for 12 months in advance.
Best Pay - Diners Club‘s smart instalment plan
Diners Club Best Pay gives you even more flexibility when shopping. This new, smart instalment plan is unbureaucratic, fast and, above all, less expensive than most overdrafts. For more details on the current terms and interest rates, please go to www.dinersclub.at/bestpay. I hereby apply for Best Pay, Diners Club‘s smart instalment plan to cover any outstanding balances on my primary card:
Yes No
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Account statements by e-mail: easy, convenient and eco-friendly
I hereby agree to have my account statements sent to the e-mail address specified, free of charge.
Yes No4)
4) Should you request postal delivery of your printed account statements, you will be charged a mailing fee of ¤ 2 for each account statement.
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For your safety: your Diners Club Card with your photo
I hereby order a Diners Club Card with my photo, at a fee of 70 cents per month in addition to the annual fee.
• Recent personal photo in black and white or colour• Taken in full-face view, with the head centred and filling
as much of the photograph as possible • Format: JPG 20x20 mm or 240x240 pixel, 300 dpi
Primary card Yes No Add-on card Yes No
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I hereby order a
I hereby order a
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RV: VIC Staff
Diners Club Gold Card: free of charge for the first year, from the second year ¤ 3.34 instead of ¤ 6.67 per month1)
Diners Club Golf Card: free of charge for the first year, from the second year ¤ 3.75 instead of ¤ 7.50 per month1)
Diners Club Gold Add-On Card: free of charge for the first year, from the second year ¤ 3.34 per month 2)3)
Diners Club Golf Add-On Card: free of charge for the first year, from the second year ¤ 3.75 per month 2)3)
FIRST
YEAR
FREE!
DINERSCLUB.AT
Information pursuant to para. 6 of the Financial Markets Anti-Money Laundering Act (FM-GwG) relating to the primary card holder
For what purpose will you primarily use your Diners Club Card?
Cashless payment of goods/services Cash withdrawals Internet purchases
I explicitly declare that I am acting on my own account and my own behalf and undertake to inform you without delay of any changes in this regard for the duration of our business relations.
Yes No
Are you a politically exposed person and/or a direct family member of a politically exposed person and/or a party who is known to be related to a politically exposed person?5)
Yes No
If yes:
Last name First name
Title Date of birth
Street name / No. Postcode / City
Country Nationality
Position as a politically exposed person
5) Pursuant to sec. 6 et seq. para. 2 of the Financial Markets Anti-Money Laundering Act (FM-GwG), a politically exposed person (PEP) is de-fined as a natural person who has been entrusted with a prominent public function (e.g. head of state or government, minister, member of parliament, ambassador, etc.), or a direct family member of such a person, or a party who is known to be related to such a person. A per-son who has not exercised a prominent public function for at least a year is ex lege no longer regarded as a politically exposed person.
Personal information of primary card holder Mrs. / Ms. Mr.
Last name First name
Title Date of birth Nationality
Street name / No.
Postcode / City Country
E-mail address Daytime phone
Employment information of primary card holder
Name of employer
Street name / No.
Postcode / City
Country Employed since
Net monthly income Phone number
Current employment details: Position:
Self-employed Salaried employee Wage earner Managing director Department head Shareholder
In training Civil servant Non-tenured public employee Clerk Other
Retired Unemployed
Sector:
Production / Industry Construction / Transport Public sector Media IT / Telecommunications
Financial services / Insurance Commerce Tourism Other
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Mailing address
The card, the PIN and the account statements are to be mailed to my Home address Business address
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DINERS CLUB CARD ORDER
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DINERSCLUB.AT
Information pursuant to para. 6 of the Financial Markets Anti-Money Laundering Act (FM-GwG) relating to the add-on card holder
For what purpose will you primarily use your Diners Club Card?
Cashless payment of goods/services Cash withdrawals Internet purchases
I explicitly declare that I am acting on my own account and my own behalf and undertake to inform you without delay of any changes in this regard for the duration of our business relations.
Yes No
Are you a politically exposed person and/or a direct family member of a politically exposed person and/or a party who is known to be related to a politically exposed person?6)
Yes No
If yes:
Last name First name
Title Date of birth
Street name / No. Postcode / City
Country Nationality
Position as a politically exposed person
6) Pursuant to sec. 6 et seq. para. 2 of the Financial Markets Anti-Money Laundering Act (FM-GwG), a politically exposed person (PEP) is de-fined as a natural person who has been entrusted with a prominent public function (e.g. head of state or government, minister, member of parliament, ambassador, etc.), or a direct family member of such a person, or a party who is known to be related to such a person. A per-son who has not exercised a prominent public function for at least a year is ex lege no longer regarded as a politically exposed person.
Employment information of add-on card holder
Name of employer
Street name / No.
Postcode / City
Country Employed since
Net monthly income Phone number
Current employment details: Position:
Self-employed Salaried employee Wage earner Managing director Department head Shareholder
In training Civil servant Non-tenured public employee Clerk Other
Retired Unemployed
Sector:
Production / Industry Construction / Transport Public sector Media IT / Telecommunications
Financial services / Insurance Commerce Tourism Other
Personal information of add-on card holder Mrs. / Ms. Mr.
Last name First name
Title Date of birth Nationality
Street name / No.
Postcode / City Country
E-mail address Daytime phone
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DINERS CLUB CARD ORDER
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DINERSCLUB.AT
DC Bank AG, Lassallestraße 3, 1020 Vienna, Austria, t: +43 1 50 135-14, f: +43 1 50 135-111, [email protected]: AT611100000404118200, BIC: BKAUATWW, Commercial Court of Vienna, registered office: Vienna, FN 57273a, DVR: 0011665, VATIN: ATU15349601Competent supervisory authority: Financial Market Authority (Banking Supervision Department), Otto-Wagner-Platz 5, 1090 Vienna, valid as of July 2017
For bank use only (to be completed by your bank):
Volljährigkeit Ja Nein Girokonto seit
Girokontoverbindung einwandfrei Ja Nein
Mahnungen wegen Überziehung Ja Nein
Politisch exponierte Person(en) gemäߧ 2 Z 6 ff Ja Nein
Durchschnittliche monatliche Eingänge in Höhe von ¤
Die Identität des Auftraggebers wurde von uns gemäß § 6 ff FM-GwG festgestellt und auf Ersuchen stellen wir der DC Bank AG unverzüglich die Identitäts unterlagen/Ausweisdaten zur Verfügung.
Name des Sachbearbeiters und Telefonnummer bei Bonitätsrückfragen
Ort und Datum/bankmäßige Fertigung (Stempel & 2 Unterschriften)
I hereby authorise my bank to provide DC Bank AG with all data and documents required to establish and verify my identity and creditworthiness, and in this regard I release my bank from its obligation to maintain banking secrecy pursuant to sec. 38 para. 2(5) of the Austrian Banking Act. I also authorise my bank to provide DC Bank AG with all information and personal data, as well as copies of my photo identifica-tion and of the questionnaires completed by me at my bank, for the purpose of fulfilling the obligations to prevent money laundering and financing terrorism pur-suant to sec. 6 et seq. of the Financial Markets Anti-Money Laundering Act, and I give my consent thereto pursuant to sec. 38 para. 2(5) of the Austrian Banking Act and sec. 8 para. 1(2) of the Data Protection Act 2000 (DSG 2000).
I understand and acknowledge that DC Bank AG, to the extent required for ful-filling and/or performing the contractual obligations, in particular for payment transactions, will electronically process my data specified in the card order and disclose such data to my bank, the international companies of the Diners Club International network and its partner companies (= merchants accepting Diners Club credit cards).
Pursuant to sec. 38 para. 2(5) of the Austrian Banking Act and sec. 8 para. 1(2) of the Data Protection Act 2000, I agree that all information relating to my address, card order, payment history concerning the observance of payment periods and uncontested accounts that have not been paid after their due dates may be disc-losed to CRIF GmbH, Diefenbachgasse 35, 1150 Vienna, for the purpose of carrying on a trade pursuant to sec. 152 (credit reporting agency) and sec. 153 (services in automatic data processing and computer technology) of the 1994 Austrian Busi-ness and Trade Code (GewO 1994). My consent may be revoked at any time.
I agree that in the event of a qualified default in payment, my address information as well as my date of birth, the amount of the liability, repayment modalities, and any steps taken in connection with the acceleration of maturity and the institution of legal proceedings, may be transmitted to the small loan register kept with the Kreditschutzverband von 1870 (KSV). This small loan register is a joint database (sec. 50 of the Data Protection Act 2000) that is operated (within the meaning of sec. 50 of the Data Protection Act 2000) by KSV and is kept for the purpose of protecting the creditors and minimising the risk of banks as well as of insurance companies and leasing companies granting loans. The purpose of such trans-mission is to enable KSV to store and merge said data and, upon request, to pass it on exclusively to banks as well as insurance companies and leasing companies granting loans that have their corporate seat in a member state of the European Economic Area (EEA), provided that they have a legal obligation to correctly evaluate the credit risk constituted by a loan applicant. In the event that an entry is made into the small loan register, the legal remedies that I may take are the right to obtain information, the right to correction or deletion and the right to object pursuant to secs. 26 to 28 of the Data Protection Act 2000 to the extent as defined therein. These rights are to be asserted in writing to the Kreditschutz-verband von 1870, 1120 Vienna, Wagenseilgasse 7.
I have received, or obtained from www.dinersclub.at, the General Terms and Conditions of Business for the Use of Diners Club Credit Cards prior to signing this order and confirm acceptance thereof.
I agree that, pursuant to sec. 8 para. 5 of the Austrian Act on Distance Selling of Financial Services (FernFinG), performance of the contract will commence within the rescission period if I make use of services by using the card prior to expiration of the rescission period. DC Bank AG is entitled to charge the agreed fees and rates for any services rendered prior to expiration of the rescission period.
I agree to DC Bank AG’s processing the data indicated by me in this order form for the purpose of advertising products of DC Bank AG and contacting me as follows.
E-mail Yes Text message Yes Phone Yes Fax Yes
I am entitled to revoke my consent vis-à-vis DC Bank AG at any time.
I agree that general information of DC Bank AG may be sent to me to the e-mail address last announced. If no e-mail address has been provided, such information is to be sent to the address specified for delivery of the card and PIN.
Deposit protection: DC Bank AG is a member of the deposit insurance institution Einlagensicherung der österreichischen Banken & Bankiers Gesellschaft m.b.H. (www.einlagensicherung.at). By signing this card order, I confirm that I received the “Information sheet for depositors” (also available at www.dinersclub.at) together with the card order form and that I have read and understood the relevant information.
By signing this card order, I confirm that I received the information sheet - “Data processing according to the Financial Markets Anti-Money Laundering Act (FMGwG)” together with the card order form and that I have read and un-derstood the relevant information.
Photo Card: I hereby declare that all the information given by me in this order is true and correct and that the photograph attached is a photo of me. I consent to the transfer of my photograph and data to third parties to be processed and stored for the purpose for issuing the Photo Card. Any rejection of the Photo Card due to complaints about the quality of the printed photo is explicitly excluded. The transmitted photo will not be returned.
The English translation of this order is provided solely for convenience. Only the original German text is legally binding.
Date Signature of the party ordering the add-on card
Date Signature of the party ordering the primary card
In order to be able to process your order quickly, please submit• a signed order • a salary statement • a copy of an official ID • a photograph (for a Photo Card)
in a sealed envelope to: DC Bank AG, Lassallestraße 3, 1020 Vienna or by e-mail to [email protected]
SEPA Direct Debit Core mandate
Mandate reference: generated by DC Bank AG and indicated on the account statement.Creditor: DC Bank AG, Lassallestraße 3, 1020 Vienna, AustriaCreditor-ID: AT03DCB00000010455
I hereby authorise DC Bank AG to collect monthly payments (as specified in my account statements) from my account via the SEPA Direct Debit procedure. At the same time, I instruct my bank to honour the SEPA Direct Debit payments drawn on my account by DC Bank AG. I am entitled to request a refund of the amount debited within eight weeks following the debiting of my account. The terms and conditions agreed with my bank are applicable in this regard.
Name of account holder Address
IBAN BIC
The following contains information pursuant to the Austrian Act on Distance Selling of Financial Services:
For any details regarding the payments and the performance of the card contract, as well as any additional information regarding the financial services, please see the General Terms and Conditions of Business for the Use of Diners Club Credit Cards (GTC) at www.dinersclub.at or contact Diners Club’s customer support by phone at +43 1 50 135-14 or by e-mail at [email protected] to sec. 8 of the Austrian Act on Distance Selling of Financial Services you have the right to rescind the contract within a period of 14 days. The statutory time limit for rescission commences on the date of conclusion of the contract. Rescission of the contract is to be declared in writing to DC Bank AG at Lassallestraße 3, 1020 Vienna or by e-mail to [email protected]. The period will be deemed to have been observed if rescission is declared in writing or via another durable medium and such declaration is transmitted prior to the expiry of the statutory time limit.
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INFORMATION ON DATA PROCESSING
Information on data processing under the Austrian Financial Markets Anti-Money Laundering Act (FM-GwG)
institutions, in the context of duties of due diligence for the prevention of money laundering and terrorist financing, to obtain data,
information and documents from persons when establishing a business relationship or carrying out an occasional transaction and
to store and update such data, information and documents.
According to the FM-GwG, credit institutions must identify and verify the identity of clients, beneficial owners or any
trustor/settlors of the client. Furthermore, it has to assess the objective pursued by the client and the type of business relationship
desired by the client and obtain and verify information and, if necessary, to proof of the source of the funds used. Continuous
monitoring of the business relationship and of transactions carried out within its scope is likewise required of credit institutions.
In this respect, credit institutions must retain documentation including, without limitation, the following
• copies of the (personal/company identification) documents and information which are necessary to comply with the
described due diligence requirements;
• supporting evidence and records of transactions which are necessary for checking the plausibility of transactions.
The FM-GwG grants credit institutions the legal authorisation within the meaning of the Data Protection Act 2000
(DSG 2000) to use said client data in the context of complying with the duties of due diligence for the prevention of money
laundering and terrorist financing, which the institution is obligated by law to comply with and which serve public interests.
The data processing operations performed within the framework of the described due diligence processes are based on a
legal obligation imposed on credit institutions.
All personal data processed and/or stored by credit institutions only on the basis of the FM-GwG for the purposes of the
prevention of money laundering and terrorist financing must be deleted by the credit institution after a retention period of
5 years unless a longer retention period is required or permitted under the provisions of other federal laws or longer retention
periods have been specified by the Financial Market Authority.
Personal data used by credit institutions only on the basis of the FM-GwG for the purposes of the prevention of money
laundering and terrorist financing shall not be further processed in a way that is incompatible with those purposes. These
personal data shall not be processed for any other purposes, for example commercial purposes.
DC Bank AG, Lassallestraße 3, 1020 Vienna, Austria, t: +43 1 50 135-14, f: +43 1 50 135-111, [email protected]: AT611100000404118200, BIC: BKAUATWW, Commercial Court of Vienna, registered office: Vienna, FN 57273a, DVR: 0011665, VATIN: ATU15349601Competent supervisory authority: Financial Market Authority (Banking Supervision Department), Otto-Wagner-Platz 5, 1090 Vienna, valid as of January 2017
DINERSCLUB.AT
DC Bank AG, Lassallestraße 3, 1020 Vienna, Austria, t: +43 1 50 135-14, f: +43 1 50 135-111, [email protected]: AT611100000404118200, BIC: BKAUATWW, Commercial Court of Vienna, registered office: Vienna, FN 57273a, DVR: 0011665, VATIN: ATU15349601Competent supervisory authority: Financial Market Authority (Banking Supervision Department), Otto-Wagner-Platz 5, 1090 Vienna, valid as of January 2016
INFORMATION SHEET FOR DEPOSITORS
Deposits at DC Bank AG are guaranteed by: Einlagensicherung der Banken & Bankiers Gesellschaft m.b.H.1)
Guarantee limit: EUR 100,000 per depositor per credit institution2)
If you have placed several deposits with All your deposits placed with one and the same credit institution willthe same credit institution: be “added up”, and the total amount will be subject to the limit of EUR 100,0002)
If you hold a joint account with one The limit of EUR 100,000 applies to each individual depositor3)
or several other persons:
Time limit for a refund in the event of default Until 31 Dec. 2018: 20 business daysby a credit institution: From 01 Jan. 2019 to 31 Dec. 2020: 15 business days
From 01 Jan. 2021 to 31 Dec. 2023: 10 business days From 01 Jan. 2024 onwards: 7 business days4)
Additional information (on all or some of the following items)
1) Deposit-guarantee scheme responsible for your deposit: Your deposit is guaranteed by a contractual deposit-guarantee scheme which is officially recognised as such. In the event of in-
solvency of your credit institution, your deposits will be refunded to you up to a maximum amount of EUR 100,000 or the equi-valent amount in a foreign currency.
2) General limit of guarantee: If a deposit is not available because a credit institution does not meet its financial obligations, the depositors will be compensa-
ted by the deposit-guarantee scheme. The maximum amount paid under the guarantee is EUR 100,000, or the equivalent amount in a foreign currency, per credit institution, which means that when determining this amount, the sum total of deposits placed by one depositor with one and the same credit institution will be calculated. If, for example, a depositor has EUR 90,000 in a savings account and EUR 20,000 in a current account, s/he will only be paid EUR 100,000 under the guarantee.
3) Limit of guarantee for joint accounts: For joint accounts, the limit of EUR 100,000 applies to each depositor.
4) Payment: The competent deposit-guarantee scheme is Einlagensicherung der Banken & Bankiers Gesellschaft m.b.H. Börsegasse 11, 1010
Vienna, Austria, Phone: +43 1 533 98 03-0, fax: +43 1 533 98 03-5, e-mail: [email protected], www.einlagensicherung.at. It will refund your deposits (up to EUR 100,000 or the equivalent amount in a foreign currency) no later than within 20 business days (until 31 December 2018), from 1 January 2019 to 31 December 2020 within 15 business days, from 1 January 2021 to 31 De-cember 2023 within 10 business days and from 1 January 2024 onwards within 7 business days.
If, during these transitional periods, a deposit-guarantee scheme is unable to pay the entire amount of the guaranteed deposits to the depositor within seven business days after a guarantee becomes applicable, it is required to pay to the depositor, upon his/her request, an adequate portion of the guaranteed deposits within five business days following such request in order to cover the depositor’s cost of living. The deposit-guarantee scheme must effect payment of such adequate amount on the basis of and following the review of the depositor’s request, any data previously submitted, and any data to be provided by the member institutions. In such a case, the depositor’s initial claim to payment of a sum in the amount of his/her guaranteed deposits pursuant to sec. 13 of the (Austrian) Act on Deposit Guarantee Schemes and Investor Compensation (ESAEG; Einlagensicherungs- und Anlegerentschädigungsgesetz) will be reduced by the amount of the adequate portion paid out by the deposit-guarantee scheme to cover the depositor’s cost of living.
In the event that you do not receive your refund within these periods, you should contact the deposit-guarantee scheme, as the period for claiming a refund may expire after a certain length of time. Further information is available at www.einlagensicherung.at.
Important additional information:Deposits made by retail customers and businesses are in principle protected by deposit-guarantee schemes. Any exceptions appli-cable to certain deposits are disclosed at the website of the competent deposit-guarantee scheme. Upon request, your credit institu-tion will inform you whether certain products are covered by the guarantee or not. If any deposits are refundable, your credit instituti-on will confirm this on your account statements as well.
The English translation of this order is provided solely for convenience. Only the original German text is legally binding.
