Application for The American Express®
BUSINESS Card
WELCOME TO THE CARD THAT HAS A
POSITIVE
To apply for The Business Card simply complete this application
and ensure that it is signed by an Authorised Signatory and return it
along with the required documents specified on this application to:
Amex (Saudi Arabia) Ltd.
P.O. Box 6624, Riyadh 11452, Saudi Arabia. Tel.: 800 440 0004
EFFECT ON YOUR BUSINESS
BANK DETAILS
Existing Personal American Express Card No.
Fax No.
No. of years at address
Home Address
Branch
Address
P.O. Box
Mobile No.
Bank account number(s)
Address for sending your Monthly Statements
E-mail
Year opened
D
D
M
M
Y
Y
Y
Y
• NO
PRE-SET
SPENDING
LIMIT.
As
a
Business
• EMERGENCY CARD REPLACEMENT usually within 24
hours in Saudi Arabia and two working days worldwide.
b)A regular monthly statement will be sent to your address specified in this application.
Type of account(s)
City
To help in the prompt processing of the Business Card
Contact person
Country
3- Supplementary Card
application, please ensure you have enclosed:
Tel.
1- Present/Former American Express Card Number(s)
Title
Fax
Member Since
2. Most recent audited balance sheet or a bank statement for
Other Bank
2- Present/Former American Express Card Number(s)
the last three months
Address
3. Copies of all applicants’ passports and copy of ID/IQAMA
Bank account number
equivalent of US$ 3,500 / SAR 13,500 from any Saudi
Please choose the billing currency you prefer:
Investment Bank branch and at over 600,000 ATMs
SAR US$
Tick here to enrol in Membership Rewards (first year free, US$25 per annum)
worldwide.
COMPANY DETAILS
Address
There are 2,200 Travel Service locations worldwide and you
Tel.
Title
can use this service once every 21 days.
Fax
Other
transport etc. It makes book keeping so much simpler.
D
D
M
M
Y
Y
Y
Y
Nature of Business
Middle Name
Date of Birth
Other
Mrs.
Miss
Home Address
Mobile No.
Position held
4- Supplementary Card
Signature of applicant
Title
Existing Personal American Express Card No.
D
D
M
M
Y
Y
Y
Y
Mr.
e)Detailed conditions governing the use of the Business Card are included in the Terms and
Conditions, which will accompany the Card(s) when issued. The signature of, or the use of the
Card(s) shall be deemed as formal approval of the said Terms and Conditions with any subsequent
amendments. The Terms and Conditions shall be unilaterally and periodically reviewed, updated
and amended by Amex (Saudi Arabia) Ltd, at any time. The up-to-date version displayed over this
web page shall contain any such amendment(s), and shall therefore be deemed valid, entering
into full effect, automatically replacing and superseding the previous provision(s) whether
contained in the Terms & Conditions in written form accompanying the card(s) when delivered to
you or previously displayed over this web page, merely and immediately upon the occurrence of
such update. You are invited to logon to this website regularly to be informed of such
amendments, therefore we hereby draw to your kind attention that your use or possession of the
Card(s) after the occurrence of such amendment(s) reflected by our update as provided for
hereunder, shall be deemed as your formal and absolute approval to such Terms and Conditions
and their subsequent amendment(s).
f) Upon its approval by Amex (Saudi Arabia) Ltd, this application and all supporting documents shall
constitute integral parts of the Terms & Conditions. I agree that American Express have the right to
keep all the documents supplied with this application.
E-mail
Dr.
d)We provide credit information relating to our Card members to The Saudi Credit Bureau (SIMAH)
on a monthly basis. The information provided reflects the status as at the previous month-end
and includes information regarding whether the card account is regular or delinquent. To avoid
any adverse credit history with SIMAH, cardholders should ensure that they make timely payment
of the amount due on the card account.
Mrs.
Miss
Other
Name you wish to appear on the Card (max. 20 letters & spaces)
Member Since
g)All transactions including Cash Withdrawals, incurred in currencies other than the billing currency
of the Card account («Non-Billing Currency»), will be converted into the Card accounts billing
currency («Billing Currency»). Unless a specific conversion rate is required by the applicable laws,
the American Express Global Network will use conversion rates based on interbank rates which
they select from customary industry sources on the business day prior to the date of processing
the transaction. A nominal conversion fee of 2.5% on the converted amount will be added by
Amex (Saudi Arabia) Ltd. («Amex»), the Issuer of your Card. An illustration is given below.
We warrant that the above information is correct and authorize Amex (Saudi Arabia) Ltd. and/or its
authorised representatives to contact our bankers or any other source to obtain any information it
may require. We understand that Amex (Saudi Arabia) Ltd. reserves the right to require a guarantee
acceptable to it as a condition for approving this application, and further that Amex (Saudi Arabia) Ltd.
reserves the right to decline this application without giving reasons and that no correspondence will
be entered into these circumstances. This application and all documents pertaining to it shall remain
the property of Amex (Saudi Arabia) Ltd. at all times.
The company confirms that the copies of the identification and documents provided with application
are true copies of the original documents. We confirm that the signature on the Card when issued
to each of the above named person(s) will bind the Company to the conditions of the issue and use
of such Card. If the Company application is approved we undertake to settle the Card account
immediately upon receipt of the monthly statements.
I hereby agree to provide Amex (Saudi Arabia) Ltd. with any information that it requires for
establishing and /or administering my accounts and facilities with Amex (Saudi Arabia) Ltd. and I
authorize Amex (Saudi Arabia) Ltd. to obtain and collect information as deemed necessary or in
regard of me, my accounts and facilities with Amex (Saudi Arabia) Ltd. from the Saudi Credit Bureau
(SIMAH) and to disclose that information to SIMAH or to any other agency approved by Saudi
Arabian Monetary agency (SAMA).
Reminder Note: To speed up processing of your application, please make sure you have enclosed all
required documents.
AUTHORISED SIGNATORY
Transaction value (Non-billing currency)
Euro100
Name
American Express Global Network exchange rate
1 Euro = 1.3572 USD
(Please print)
Position held
USD equivalent
USD135.72
Position held
Name
Nationality
Mobile No.
Signature of applicant
Currency conversion fee (@ 2.5%)
USD 3.39
Authorised Signature
Full Address
Passport No.
E-mail
Total transaction value in USD (If USD is the Billing Currency)
USD 139.11
USD to SAR conversion rate
3.75
Total transaction value in USD (If SAR is the Billing Currency)
SAR 521.67
Arabia and receive assistance 24 hours a day, 365 days a year,
tickets and upgrades, hotel nights and shopping vouchers.
appears in the passport and as it is to appear on the Card using no more
Position Held in Company
than 20 letters and spaces.
Send off the application form now
or call us on 800 440 0004
Existing Personal American Express Card No.
ID/IQAMA No.
2- Supplementary Card
Residential Address (current)
House/Flat No.
Title
Area
Mr.
Mrs.
City
per Commercial Registration/Trade Licence using no more than 20 letters
Country
Miss
Other
Name you wish to appear on the Card (max. 20 letters & spaces)
Street
Please spell out your Company’s name as it is to appear on the Card as
Home Address
Mobile No.
Cash withdrawal fee
5% or SAR 55 / US$ 15, which ever is higher
E-mail
Late payment fee
2.5% or SAR150 / US$ 40, which ever is higher
Currency conversion fee
2.5%
SAR 150 or US$ 40
Signature of applicant
Statement request fee (more than three months)
SAR 40 or US$ 10
Refund of credit balance
SAR 100 or US$ 27
delays, cancellations, missed connections, lost or delayed
Collection service charge (monthly)
SAR 150 or US$ 40
luggage and the inability to board due to overbooking.
Direct debit rejection fee
SAR 150 or US$ 40
Postal Code
Mobile No.
D
D
M
M
Y
Y
Y
Y
h)Applicable fees
Cheque returned fee
and spaces.
Date
Member Since
Position held
www.americanexpress.com.sa
The company shall be jointly and severally responsible with the Basic and Supplementary
Cardmembers for payments of charges incurred on the Card. It is essential that this form be signed
by a person authorised to sign on behalf of the Company with the Bank(s) and by the Basic and
Supplementary Cardmembers.
Home Address
Please spell out the name of the basic Business Card applicant as it
• TRAVEL INCONVENIENCE INSURANCE against flight
The American Express Business Card is a charge card and does not offer revolving credit. Therefore,
the monthly statement must be settled in full upon receipt and before due date. Detailed conditions
governing the use of The American Express Business Card are included in the Terms and Conditions
which will accompany the Card(s) when issued. The signature of, or the use of the Card(s), shall be
deemed as formal approval of the said agreement with any subsequent amendments. Upon its
approval, Amex (Saudi Arabia) Ltd, this application and all supporting documents shall constitute
integral parts of the Terms & Conditions.
Country of Birth
to the Card and exchange them for rewards such as airline
US$ 100,000 against loss of life and injury.
This account will be billed in the currency you have chosen, either in US Dollars or Saudi Riyals.
The US$ 120 (SAR 450) annual subscription fee for the American Express Business Card will
be included on your first statement of account. Supplementary Business Cards are only US$ 60
(SAR 225) each per year. The use of the Card is subject to local rules and regulations.
If Subsidiary Company, please state Parent Company Name and Address
you can call free of charge from anywhere outside Saudi
• BUSINESS TRAVEL ACCIDENT INSURANCE up to
Member Since
Miss
Family Name
First Name
programme, earn points for virtually every dollar you charge
practitioners who will help you with whatever you need.
Mr.
Company Registration No.
• EMERGENCY ASSISTANCE With Emergency Assistance,
with immediate referral to expert medical, legal and travel
Mrs.
BASIC APPLICANT’S PERSONAL DETAILS
more, all tailored specially for independent businesses.
opt in to the American Express Membership Rewards
Mr.
Name you wish to appear on the Card (max. 20 letters & spaces)
Date Company Formed
• MEMBERSHIP REWARDS®. You can also choose to
Existing Personal American Express Card No.
Title
Company Name
Card, broken down into categories such as hotels, restaurants,
SUPPLEMENTARY CARDS
1- Supplementary Card
American Express Travel Service or Representative Office.
on office furniture, IT equipment and software, car hire and
Signature of applicant
Fax
cheque for up to the local equivalent of US$1000 at any
receive a fully itemised statement of your activity with the
Member Since
Telex
you and your Company have shown you can afford.
• ANNUAL FINANCIAL SUMMARY. At the end of the year you
Other
Tel.
pattern with the Business Card. You can spend as much as
• A CORPORATE PARTNER PROGRAMME with discounts
Miss
Position held
Contact person
• EMERGENCY CHEQUE CASHING. You can cash a personal
the currency that suits your business best.
Mrs.
Type of account:
limit. You set your own limit by your normal spending
• BILLING IN SAUDI RIYALS OR US DOLLARS. You choose
Mr.
c)A grace period of 25 days will be granted to settle the amount and the payment due date will be
indicated on your statement.
Name you wish to appear on the Card (max. 20 letters & spaces)
1. Copy of your Company’s Commercial Registration/Trade Licence
• EXPRESS CASH SERVICE up to the local currency
Cardmember, you are not restricted to any pre-set spending
a)All charges are due for payment in full immediately on receipt of your monthly statement and before
the payment due date shown on your statement. If the outstanding balance is not settled the Late
Payment Charges on overdue balances monthly in arrears is at the rate of 2.5% or US$ 40
(SAR 150), whichever is higher, of all outstanding sums.
P.O. Box
Telex
Successful all over the world and now available in
Saudi Arabia: the American Express Company Card,
designed especially for self employed entrepreneurs.
Take a look at all the features that make this Card
the perfect choice for any business.
DECLARATION & AUTHORITY
Please read the following important information carefully. If you have any questions, please call our
customer service toll-free on 800 440 0004.
Member Since
E-mail
Principal Bank
Initial Disclosure Statement
Please send this application to:
Amex (Saudi Arabia) Ltd.,
P.O. Box 6624,
Riyadh 11452,
Saudi Arabia.
Tel.: 800 440 0004
Company Stamp
Application for The American Express®
BUSINESS Card
WELCOME TO THE CARD THAT HAS A
POSITIVE
To apply for The Business Card simply complete this application
and ensure that it is signed by an Authorised Signatory and return it
along with the required documents specified on this application to:
Amex (Saudi Arabia) Ltd.
P.O. Box 6624, Riyadh 11452, Saudi Arabia. Tel.: 800 440 0004
EFFECT ON YOUR BUSINESS
BANK DETAILS
Existing Personal American Express Card No.
Fax No.
No. of years at address
Home Address
Branch
Address
P.O. Box
Mobile No.
Bank account number(s)
Address for sending your Monthly Statements
E-mail
Year opened
D
D
M
M
Y
Y
Y
Y
• NO
PRE-SET
SPENDING
LIMIT.
As
a
Business
• EMERGENCY CARD REPLACEMENT usually within 24
hours in Saudi Arabia and two working days worldwide.
b)A regular monthly statement will be sent to your address specified in this application.
Type of account(s)
City
To help in the prompt processing of the Business Card
Contact person
Country
3- Supplementary Card
application, please ensure you have enclosed:
Tel.
1- Present/Former American Express Card Number(s)
Title
Fax
Member Since
2. Most recent audited balance sheet or a bank statement for
Other Bank
2- Present/Former American Express Card Number(s)
the last three months
Address
3. Copies of all applicants’ passports and copy of ID/IQAMA
Bank account number
equivalent of US$ 3,500 / SAR 13,500 from any Saudi
Please choose the billing currency you prefer:
Investment Bank branch and at over 600,000 ATMs
SAR US$
Tick here to enrol in Membership Rewards (first year free, US$25 per annum)
worldwide.
COMPANY DETAILS
Address
There are 2,200 Travel Service locations worldwide and you
Tel.
Title
can use this service once every 21 days.
Fax
Other
transport etc. It makes book keeping so much simpler.
D
D
M
M
Y
Y
Y
Y
Nature of Business
Middle Name
Date of Birth
Other
Mrs.
Miss
Home Address
Mobile No.
Position held
4- Supplementary Card
Signature of applicant
Title
Existing Personal American Express Card No.
D
D
M
M
Y
Y
Y
Y
Mr.
e)Detailed conditions governing the use of the Business Card are included in the Terms and
Conditions, which will accompany the Card(s) when issued. The signature of, or the use of the
Card(s) shall be deemed as formal approval of the said Terms and Conditions with any subsequent
amendments. The Terms and Conditions shall be unilaterally and periodically reviewed, updated
and amended by Amex (Saudi Arabia) Ltd, at any time. The up-to-date version displayed over this
web page shall contain any such amendment(s), and shall therefore be deemed valid, entering
into full effect, automatically replacing and superseding the previous provision(s) whether
contained in the Terms & Conditions in written form accompanying the card(s) when delivered to
you or previously displayed over this web page, merely and immediately upon the occurrence of
such update. You are invited to logon to this website regularly to be informed of such
amendments, therefore we hereby draw to your kind attention that your use or possession of the
Card(s) after the occurrence of such amendment(s) reflected by our update as provided for
hereunder, shall be deemed as your formal and absolute approval to such Terms and Conditions
and their subsequent amendment(s).
f) Upon its approval by Amex (Saudi Arabia) Ltd, this application and all supporting documents shall
constitute integral parts of the Terms & Conditions. I agree that American Express have the right to
keep all the documents supplied with this application.
E-mail
Dr.
d)We provide credit information relating to our Card members to The Saudi Credit Bureau (SIMAH)
on a monthly basis. The information provided reflects the status as at the previous month-end
and includes information regarding whether the card account is regular or delinquent. To avoid
any adverse credit history with SIMAH, cardholders should ensure that they make timely payment
of the amount due on the card account.
Mrs.
Miss
Other
Name you wish to appear on the Card (max. 20 letters & spaces)
Member Since
g)All transactions including Cash Withdrawals, incurred in currencies other than the billing currency
of the Card account («Non-Billing Currency»), will be converted into the Card accounts billing
currency («Billing Currency»). Unless a specific conversion rate is required by the applicable laws,
the American Express Global Network will use conversion rates based on interbank rates which
they select from customary industry sources on the business day prior to the date of processing
the transaction. A nominal conversion fee of 2.5% on the converted amount will be added by
Amex (Saudi Arabia) Ltd. («Amex»), the Issuer of your Card. An illustration is given below.
We warrant that the above information is correct and authorize Amex (Saudi Arabia) Ltd. and/or its
authorised representatives to contact our bankers or any other source to obtain any information it
may require. We understand that Amex (Saudi Arabia) Ltd. reserves the right to require a guarantee
acceptable to it as a condition for approving this application, and further that Amex (Saudi Arabia) Ltd.
reserves the right to decline this application without giving reasons and that no correspondence will
be entered into these circumstances. This application and all documents pertaining to it shall remain
the property of Amex (Saudi Arabia) Ltd. at all times.
The company confirms that the copies of the identification and documents provided with application
are true copies of the original documents. We confirm that the signature on the Card when issued
to each of the above named person(s) will bind the Company to the conditions of the issue and use
of such Card. If the Company application is approved we undertake to settle the Card account
immediately upon receipt of the monthly statements.
I hereby agree to provide Amex (Saudi Arabia) Ltd. with any information that it requires for
establishing and /or administering my accounts and facilities with Amex (Saudi Arabia) Ltd. and I
authorize Amex (Saudi Arabia) Ltd. to obtain and collect information as deemed necessary or in
regard of me, my accounts and facilities with Amex (Saudi Arabia) Ltd. from the Saudi Credit Bureau
(SIMAH) and to disclose that information to SIMAH or to any other agency approved by Saudi
Arabian Monetary agency (SAMA).
Reminder Note: To speed up processing of your application, please make sure you have enclosed all
required documents.
AUTHORISED SIGNATORY
Transaction value (Non-billing currency)
Euro100
Name
American Express Global Network exchange rate
1 Euro = 1.3572 USD
(Please print)
Position held
USD equivalent
USD135.72
Position held
Name
Nationality
Mobile No.
Signature of applicant
Currency conversion fee (@ 2.5%)
USD 3.39
Authorised Signature
Full Address
Passport No.
E-mail
Total transaction value in USD (If USD is the Billing Currency)
USD 139.11
USD to SAR conversion rate
3.75
Total transaction value in USD (If SAR is the Billing Currency)
SAR 521.67
Arabia and receive assistance 24 hours a day, 365 days a year,
tickets and upgrades, hotel nights and shopping vouchers.
appears in the passport and as it is to appear on the Card using no more
Position Held in Company
than 20 letters and spaces.
Send off the application form now
or call us on 800 440 0004
Existing Personal American Express Card No.
ID/IQAMA No.
2- Supplementary Card
Residential Address (current)
House/Flat No.
Title
Area
Mr.
Mrs.
City
per Commercial Registration/Trade Licence using no more than 20 letters
Country
Miss
Other
Name you wish to appear on the Card (max. 20 letters & spaces)
Street
Please spell out your Company’s name as it is to appear on the Card as
Home Address
Mobile No.
Cash withdrawal fee
5% or SAR 55 / US$ 15, which ever is higher
E-mail
Late payment fee
2.5% or SAR150 / US$ 40, which ever is higher
Currency conversion fee
2.5%
SAR 150 or US$ 40
Signature of applicant
Statement request fee (more than three months)
SAR 40 or US$ 10
Refund of credit balance
SAR 100 or US$ 27
delays, cancellations, missed connections, lost or delayed
Collection service charge (monthly)
SAR 150 or US$ 40
luggage and the inability to board due to overbooking.
Direct debit rejection fee
SAR 150 or US$ 40
Postal Code
Mobile No.
D
D
M
M
Y
Y
Y
Y
h)Applicable fees
Cheque returned fee
and spaces.
Date
Member Since
Position held
www.americanexpress.com.sa
The company shall be jointly and severally responsible with the Basic and Supplementary
Cardmembers for payments of charges incurred on the Card. It is essential that this form be signed
by a person authorised to sign on behalf of the Company with the Bank(s) and by the Basic and
Supplementary Cardmembers.
Home Address
Please spell out the name of the basic Business Card applicant as it
• TRAVEL INCONVENIENCE INSURANCE against flight
The American Express Business Card is a charge card and does not offer revolving credit. Therefore,
the monthly statement must be settled in full upon receipt and before due date. Detailed conditions
governing the use of The American Express Business Card are included in the Terms and Conditions
which will accompany the Card(s) when issued. The signature of, or the use of the Card(s), shall be
deemed as formal approval of the said agreement with any subsequent amendments. Upon its
approval, Amex (Saudi Arabia) Ltd, this application and all supporting documents shall constitute
integral parts of the Terms & Conditions.
Country of Birth
to the Card and exchange them for rewards such as airline
US$ 100,000 against loss of life and injury.
This account will be billed in the currency you have chosen, either in US Dollars or Saudi Riyals.
The US$ 120 (SAR 450) annual subscription fee for the American Express Business Card will
be included on your first statement of account. Supplementary Business Cards are only US$ 60
(SAR 225) each per year. The use of the Card is subject to local rules and regulations.
If Subsidiary Company, please state Parent Company Name and Address
you can call free of charge from anywhere outside Saudi
• BUSINESS TRAVEL ACCIDENT INSURANCE up to
Member Since
Miss
Family Name
First Name
programme, earn points for virtually every dollar you charge
practitioners who will help you with whatever you need.
Mr.
Company Registration No.
• EMERGENCY ASSISTANCE With Emergency Assistance,
with immediate referral to expert medical, legal and travel
Mrs.
BASIC APPLICANT’S PERSONAL DETAILS
more, all tailored specially for independent businesses.
opt in to the American Express Membership Rewards
Mr.
Name you wish to appear on the Card (max. 20 letters & spaces)
Date Company Formed
• MEMBERSHIP REWARDS®. You can also choose to
Existing Personal American Express Card No.
Title
Company Name
Card, broken down into categories such as hotels, restaurants,
SUPPLEMENTARY CARDS
1- Supplementary Card
American Express Travel Service or Representative Office.
on office furniture, IT equipment and software, car hire and
Signature of applicant
Fax
cheque for up to the local equivalent of US$1000 at any
receive a fully itemised statement of your activity with the
Member Since
Telex
you and your Company have shown you can afford.
• ANNUAL FINANCIAL SUMMARY. At the end of the year you
Other
Tel.
pattern with the Business Card. You can spend as much as
• A CORPORATE PARTNER PROGRAMME with discounts
Miss
Position held
Contact person
• EMERGENCY CHEQUE CASHING. You can cash a personal
the currency that suits your business best.
Mrs.
Type of account:
limit. You set your own limit by your normal spending
• BILLING IN SAUDI RIYALS OR US DOLLARS. You choose
Mr.
c)A grace period of 25 days will be granted to settle the amount and the payment due date will be
indicated on your statement.
Name you wish to appear on the Card (max. 20 letters & spaces)
1. Copy of your Company’s Commercial Registration/Trade Licence
• EXPRESS CASH SERVICE up to the local currency
Cardmember, you are not restricted to any pre-set spending
a)All charges are due for payment in full immediately on receipt of your monthly statement and before
the payment due date shown on your statement. If the outstanding balance is not settled the Late
Payment Charges on overdue balances monthly in arrears is at the rate of 2.5% or US$ 40
(SAR 150), whichever is higher, of all outstanding sums.
P.O. Box
Telex
Successful all over the world and now available in
Saudi Arabia: the American Express Company Card,
designed especially for self employed entrepreneurs.
Take a look at all the features that make this Card
the perfect choice for any business.
DECLARATION & AUTHORITY
Please read the following important information carefully. If you have any questions, please call our
customer service toll-free on 800 440 0004.
Member Since
E-mail
Principal Bank
Initial Disclosure Statement
Please send this application to:
Amex (Saudi Arabia) Ltd.,
P.O. Box 6624,
Riyadh 11452,
Saudi Arabia.
Tel.: 800 440 0004
Company Stamp