To American Express Australia Limited (“American Express”)

By submitting this application, you request us to issue you the card specified in the application, and declare that:

• you understand that this is a card offered and issued by American Express;
• the information given on this application is true and complete and you authorise us to check that information. You acknowledge that we rely on this information to consider this application; and
• if you reside in the ACT, you will provide further financial information, if required, prior to your application being assessed.

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Invitation to American Express and David Jones Limited (“David Jones”)

You invite American Express, David Jones, our respective agents and preferred alliance organisations (including insurance companies) to share and use your personal information to inform you and offer you products or services from American Express or a related company, David Jones, or any third party providing products marketed jointly with either of us. We may contact you by phone, mail or electronically to do this.  If you wish to withdraw this invitation and remove your name from the American Express or the David Jones marketing lists, please call 1300 36 89 89.

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Authority to American Express and David Jones under the Privacy Act:

To asses this application, and if it is approved, to establish and manage the card account, you understand American Express and David Jones need to:

• collect your personal information in this application and from other sources; and
• obtain your agreement in relation to the handling of your personal information;

If you do not provide the information requested in the application or do not agree to the matters set out in this declaration, American Express may decline your application or may be unable to provide you with certain benefits associated with the credit account.

The Joint American Express and David Jones Privacy Notice (included in the terms and conditions for this card account) sets out our policies on the management of personal information.  In accordance with the Privacy Act 1988, any person may access their personal information held by us, and advise if they think it is inaccurate, incomplete or out of date.

To arrange access to personal information, request a copy of the Joint American Express and David Jones Privacy Notice or enquire about privacy matters write to The Privacy Officer, American Express, 12 Shelley Street, GPO Box 1582, Sydney NSW 2001.

American Express and David Jones Joint Privacy Policy

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Collection, use and disclosure of credit information by American Express

American Express may obtain credit reports about you from a credit reporting agency to assess your application, to collect overdue payments from you, or for any other use in connection with your credit account as permitted under the Privacy Act, and obtain personal information about you from a business which provides commercial credit worthiness information.  American Express may disclose information about you to credit reporting agencies before, during or after credit is provided to you.  This includes:

• the fact that you have applied for a card account and the credit limit, and that American Express is a credit provider to you;
• advice about card payments that are at least 60 days overdue and in collection (and advice that payments are no longer overdue);
• advice that cheques drawn by you, or Direct Debit requests which you have authorised American Express to make (greater than $100) have been dishonoured more than once;
• American Express’ opinion that you do not intend to meet your credit obligations or have committed another serious credit infringement; and
• that credit provided to you has been paid or otherwise discharged.

American Express may exchange information about you with credit providers named in your application or in a credit report issued by a credit reporting agency. Amongst other things, this is to:

• assess your credit worthiness in this and future applications for credit;
• notify other credit providers of a default by you;
• exchange information about your credit account when you are in default with other credit providers;
• complete any approval process as to any transactions you wish to make on your credit account; and
• administer your account.

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Collection, use and disclosure of personal information by American Express and David Jones for the purpose of assessing this application

American Express and David Jones will collect personal information about you in a number of ways, including from you and people named in your credit application (eg your employer) and we may share your personal information with each other and with:

• persons (eg supplementary cardholders) you authorise to use or access your credit account;
• persons named in your application (eg to confirm employment and income details);
• service providers who provide services related to your credit account (eg card manufacturers, collection agents and mail houses); and
• other organisations, including government and regulatory bodies, as required or authorised by law.

American Express may also monitor and record your telephone conversations with us for staff training and service quality control purposes and may transfer your personal information to the United States or other countries for data processing and servicing.

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Information about supplementary cardholders and other persons

If you nominate an supplementary cardholder or provide personal information about someone else to American Express, you must make sure that the individual has seen, understood and agreed to their personal information being collected, used and disclosed in accordance with this notice.

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I have read the Authorisation above and by clicking on Submit, acknowledge that I agree to its terms and conditions. I can cancel my application at any time prior to submitting my form.