SHAWS
CHARG
E CARD
TOP OF
SHAWS CHARGE CARD
APPLICATION FORM
REV
FACE O
F CAR
Colours
:
COMME
NTS:
n/a
TOP OF
S
CARD R
EVER
EMPLOYMENT DETAILS
FOR OFFICE USE ONLY
PROOF
CARD FA
CE
SE
REVER
SE OF
CARD
Colours
:
Black
Screen
Mag Ta
pe:
LoCo
Sig Pan
el:
Clear
COMME
NTS:
n/a
Occupation ..................................................................................................................
1. This card
2. This card is the proper ty
of
3. The hol is not transferable Shaw Department
der
Stores. and
and can
be
not accept shall be respons
ible for all withdrawn at any may be used by
any resp
4. The hol
the auth
credit obt
time by
orised sign
der must onsibility conseq
Sha
ained by
5. Credit
uen
atory only
notify Sha
the use of w Department
obtained
.
w Departm t upon the loss
Sto
this card
by use of
or mis
and Shaw res. without not
ent Stores.
month sub
this
ice.
Departm
sequent
IMMEDIAT use of the card.
ent Stores.
to month card will carr y a
ELY sho
monthly
of purcha
shall
ser vice cha uld the card be
se.
lost or stol
rge on all
en.
balances
not cleared
before end
of
Employer's Name .......................................................................................................
Address ........................................................................................................................
IMPORTANT INFORMATION
Please open a Shaws Charge Card account for me. I understand
that Shaws reserve the right to refuse this application or to impose
conditions (which may include a third party guarantee) other than
the terms and conditions printed at the end of this form.
A Shaws Charge Card allows you to obtain goods or services in
any Shaws store on credit. A Credit Limit will be assigned to your
account at the discretion of Shaws and you will be advised of this
limit pending approval of this application. The cash price of each
purchase will be charged to your Shaws Charge Card account and
will be repaid with a service charge by weekly/monthly installments,
as per the terms and conditions. The cash price of the goods or
services will be displayed or set out on the purchase invoice.
C
LIENT:
........................................................................................................................................
In
order th
accordan at we may pr
oceed,
ce w
ith yo
would yo
within ou
wishes.
How long at Present Employment:
Years
Months
r produc ur
se chec
Notifica u plea
mat
tion
erial m
k th
tion is re
schedu
le. In th
quired as at all details
type font ay need to be
e intere
of the su
soon as
reset di
s and st
sts of
pp
gitally w
lie
possible
quality
APPRO
yl
the supp
ithin ou
VING. C e, the result
to ensu d c
Previous Occupation .................................................................................................
r reprog
could di
lied artw
re ret
ustomer
text, it
ra
ffer
will be cu
ork, mec
ph
amendm
stomers
hanica
ents will slightly from th ic studio. Whils
responsi
t every
be char
e
bility to
ged at co original. PLE
ef
PROOF
check re
ASE CH fort
st. Whils
APPRO
ad
E
t
CK
V
and appr
ev
PLEAS
E PROC ED AND COR
ove all fo ery effort will be C
RECT A
EED TO
reign te
mad
SA
xt.
PRINT.
AMEND
I unders PPEARS ABO
MENT N
V
ta
End acce
EEDED
PLEAS
pt
ance of
E PROC
this proo
EED TO NO FURTHER
f is lega
PRINT.
P
AMEND
lly bindin
I unders ROOF REQUIR
M
tand ac
ED
FURTH ENT NEEDED
ce
ptance
ER PRO
of
th
OF REQ
is proof
UIRED
is legally
binding
SIGNED
: ............
............
............
............
SPECIF
............
IC REPR
............
O INST
RUCTIO
............
NS - IN
............
TERNAL
.. DATE
USE ONL
: ............
Y:
............
...
Name and Address of Previous Employer.............................................................
........................................................................................................................................
Spouse/Partner's Occupation .................................................................................
Spouse/Partner's Employer's Name and Address ...............................................
........................................................................................................................................
FINAL
VE
RSION
How long at Present
Employment
(Spouse/Partner): Years
PROOF
Pre Pr
CH
ess
Platemak
ing
Litho
Checke
ECK - IN
TERNAL
d by:
Checke
d by:
Checke
d by:
Months
USE ONL
Y:
Screen
Collatin
g
Punching
Checke
d by:
Checke
d by:
Checke
d by:
PERSONAL DETAILS
FINANCIAL DETAILS
Surname .....................................................................................................................
Bank Branch ................................................................................................................
First Name .................................................................................................................
Account No. ................................................................................................................
Date of Birth .............................................................................................................
Visa/Mastercard ..........................................................................................................
Surname Joint Applicant/Additional Cardholder
Any Other Storecards ..............................................................................................
......................................................................................................................................
First Name Joint Applicant/Additional Cardholder
Have you previously had a Shaws Charge Card account? Yes
No
......................................................................................................................................
Date of Birth .............................................................................................................
Please tick: Single
Married
Widowed
Separated
Address.......................................................................................................................
......................................................................................................................................
Time at this Address: Years
Owner
Joint Owner
Months
Tenant
PERSONAL REFERENCE
(This person should not be your spouse, or live at the same address.)
Name ..........................................................................................................................................................................................
Address ....................................................................................................................................................................................
............................................................................................................................................................................................................
Telephone ..............................................................................................................................................................................
Living with Parents
No. of Dependant Children
Home Telephone.......................................................................................................
Mobile Telephone......................................................................................................
CONTACT AT WORK
Please tick this box if we may contact you at work,
strictly confidentially, in connection with this agreement
Work Telephone........................................................................................................
Email ...........................................................................................................................
Previous Address ......................................................................................................
......................................................................................................................................
PAGE 1
SHAWS
CHARG
E CARD
TOP OF
SHAWS CHARGE CARD
APPLICATION FORM
You may not obtain goods with your Shaws Charge Card
during the cooling off period. You may forego your right
to a cooling off period by signing a waiver.
WARNING
This waiver means you are giving up your right to a ten day
period to re-consider your commitment to the agreement.
WAIVER
I waive my right to a ten day cooling of period and acknowledge
that I have received a copy of this agreement today.
day of
20
Dated this ....................................................................................................................
Customer's Signature ..............................................................................................
Second Customer's Signature..................................................................................
Witness to Customer's Signature (for Shaws)
........................................................................................................................................
PRODUCT INFORMATION
If you do not wish to receive details of special offers and
services which we have arranged for cardholders please tick
here:
Do not send me details of Shaws special offers and events.
The details you are being asked to provide may be used to
provide you with information about other products and
services which Shaws may arrange for its card holders with
third parties.You have the right at any time to object (free of
charge) to the use of this information for this purpose, and if
you do not wish to receive details of such offers and services
please tick here:
COMME
NTS:
n/a
SE
THIS AGREEMENT is made between Shaw & RSons
EVERS
E OF C
ARD
Colours
Limited (hereafter referred to as “Shaws Department
:
Black
Screen
Stores” or “Shaws”) and
Mag Ta
pe:
APPLICANT 1
APPLICANT 2
1. This card
2. This card is the proper ty
of
3. The hol is not transferable Shaw Department
der
Stores. and
and can
be
not accept shall be respons
ible for all withdrawn at any may be used by
any resp
4. The hol
the auth
credit obt
time by
orised sign
der must onsibility conseq
Sha
ained by
5. Credit
uen
atory only
notify Sha
the use of w Department
obtained
.
w Departm t upon the loss
Sto
this card
by use of
or mis
and Shaw res. without not
ent Stores.
month sub
this
ice.
Departm
sequent
IMMEDIAT use of the card.
ent Stores.
to month card will carr y a
ELY sho
monthly
of purcha
shall
ser vice cha uld the card be
se.
lost or stol
rge on all
en.
balances
not cleared
before end
of
Sig Pan
el:
COMME
NTS:
n/a
(Insert Name and Address of the Cardholders whether one of them
or two of them.)
This agreement will commence on the date it is signed on
behalf of Shaws Department Stores.
Shaws Department Stores agrees to issue you a Shaws Charge
Card by means of which goods and services may be obtained
by you in any Shaws store on credit.
FINAL
VERSIO
N PROO
F CHEC
Pre Pres
K - INTE
s
RNAL US
Checke
Platemak
E ONLY:
d by:
ing
Checke
Litho
d by:
Checke
d by:
Each month, amounts in respect of the goods or services
obtained by you will be charged to your Shaws Charge Card
account.
Screen
Collatin
g
Punching
Checke
d by:
Checke
d by:
Checke
d by:
Please sign your Shaws Charge Card on receipt. The card will
remain the property of Shaws Department Stores and you
must return it upon request.
IMPORTANT INFORMATION
1. Amount of credit
advanced:
2. Period of Agreement:
As at date:
€ ––––––––––
(Credit Limit) which
Shaws may extend
Indefinite
Do not pass my details on to a third party.
I/we hereby certify that all the information given is true
and hereby confirm that I/we have read and agree to the
Terms and Conditions of the agreement.
5. Annual percentage rate
of charge: (APR)
Currently 22.8% but
subject to variation.
Agreed repayment
N.B. You may withdraw from this Agreement at any time within ten
days of receiving this Agreement, or a copy of it.
SIGNATURE OF APPLICANT 1
DATE:
LoCo
Clear
CLIENT:
In orde
r th
accordan at we may pr
oceed,
ce with
wou
within ou
yo
r produc ur wishes. Not ld you please
ch
materia
ification
l may ne tion schedule.
is require eck that all de
In th
ed
tails of
type font
d as so
the supp
s and st to be reset digi e interests of
on
lied c
qu
APPRO
yle, the
ta
ality the as possible to
VING. C
result co lly within our
supplied
ensure
reprogra
ustomer
text, it w
uld diffe
ar
tw
ork, mec ret
ph
amendm
ill be cu
r
stomers
hanica
ents will slightly from th ic studio. Whils
responsi
t every
be char
e
bility to
ged at co original. PLE
ef
PROOF
check re
ASE CH fort
st. Whils
A
ad and
ECK
t every
PLEAS PPROVED AN
approve
ef
E PROC
fo
D COR
rt will be C
all foreig
RECT A
EED TO
mad
n text.
SA
PRINT.
AMEND
I unders PPEARS ABO
M
VE tand ac
PLEAS ENT NEEDED
ce
pt
ance of
E PROC
this proo
EED TO NO FURTHER
f is lega
PRINT.
P
AMEND
lly bindin
I unders ROOF REQUIR
M
tand ac
ED
FURTH ENT NEEDED
ce
ptance
ER PRO
of
th
OF REQ
is proof
UIRED
is legally
binding
SIGNED
: ............
............
............
............
SPECIF
............
IC REPR
............
O INST
RUCTIO
............
NS - IN
............
TERNAL
.. DATE
USE ONL
: ............
Y:
............
...
One each week/month
SIGNATURE OF APPLICANT 2
S
CARD R
EVER
3. Frequency of repayment
installments:
4. Minimum amount of
each installment:
PLEASE SIGN HERE:
REV
FACE O
F CAR
Colours
:
TOP OF
COOLING OFF PERIOD
PROOF
CARD FA
CE
*PLEASE SIGN WHERE MARKED ON PAGE 3.
..........................................................................................................................
PAGE 2
SHAWS
CHARG
E CARD
TOP OF
SHAWS CHARGE CARD
APPLICATION FORM
PROOF
CARD FA
CE
FACE O
F CAR
Colours
:
COMME
NTS:
n/a
TOP OF
SE
GENERAL
A statement of your Shaws Charge Card account will be sent
to you each month and you agree to pay your weekly/monthly
amount together with the service charge of the full statement
balance. A Service Charge will be added to your statement
at the end of the month following the date of purchase less
any payments made or goods credited.
You must inform Shaws should you change address.
APR stands for "Annual Percentage Rate" and is the equivalent
on an annual basis of the present value of all commitments
(loans repayments and charges), future or existing, agreed by
you and Shaws. It is calculated in accordance with a formula
set out in the Consumer Credit Act of 1995. Shaws reserves
the right to alter this rate by giving notice to the card holder(s).
EXTRA CARDS
Shaws may agree on written application to issue additional
Shaws Charge Card(s) to person(s) nominated by you. If such
cards are issued, you agree to be responsible for purchases
made to additional Shaws Charge Card(s).
LOSS OF CARD
If your Shaws Charge Card(s) is lost or stolen then you
must immediately give written notice to [email protected] or
The Credit Manager, Shaws Department Stores, Tea Lane,
Portlaoise, Co. Laois. You agree that, until such notice is
received by Shaws, you will be liable for any purchases made
with the missing card.
DEFAULT
If you are in breach of a term of this Agreement, Shaws may
suspend your credit and serve on you a Termination Notice.
If you fail to rectify the breach within the time allowed the
Agreement will then terminate.
TERMINATION
On termination, you the customer(s) agree to repay to Shaws
the whole sum then remaining due to Shaws. The balance
due at termination shall be paid immediately and if it is not
paid then you agree to pay Shaws a service charge at the
then current APR until the termination balance is paid. Shaws
reserves the right to terminate on notice at any time without
stating a reason.
JOINT LIABILITY
Each customer who signs this agreement will be jointly
responsible to Shaws. You agree to indemnify Shaws against
expenses incurred by Shaws as a result of a default.
S
CARD R
EVER
PAYMENTS
APR
REV
1. This card
2. This card is the proper ty
of
3. The hol is not transferable Shaw Department
der
Stores. and
and can
be
not accept shall be respons
ible for all withdrawn at any may be used by
any resp
4. The hol
the auth
credit obt
time by
orised sign
der must onsibility conseq
Sha
ained by
5. Credit
uen
atory only
notify Sha
the use of w Department
obtained
.
w Departm t upon the loss
Sto
this card
by use of
or mis
and Shaw res. without not
ent Stores.
month sub
this
ice.
Departm
sequent
IMMEDIAT use of the card.
ent Stores.
to month card will carr y a
ELY sho
monthly
of purcha
shall
ser vice cha uld the card be
se.
lost or stol
rge on all
en.
balances
not cleared
before end
of
REVER
SE OF
CARD
Colours
:
Black
Screen
Mag Ta
pe:
LoCo
Sig Pan
el:
Clear
COMME
NTS:
n/a
You may not deduct from any payment due under this
agreement any credit not approved by Shaws.
The personal dataCLIEsupplied
by you will be processed
NT:
In orde
electronically and will
be
r th used for the purpose of operating
accordan at we may pr
oceed,
ce with
would yo
your wis
our prod
u please
your account andmwatitherinfor
marketing
to opt-out).
uction sc hes. Notifi(subject
check th
cation
ial may
hedule.
ne
In the in is required as at all details of
ed to be
type font
te
soon as
the supp
rest
s andunder
set digi protection
You have certain Arights
style, th redata
lied c
po
tally with s of quality th legislation
PPROV
e result
e supplie ssible to ensu
ING. Cus
in our re
could di
re
text, it w
d
pr
to
ar
og
m
tw
er
ra
ffe
ork, mec ret
phic stud
amendm
ill be cu
r
st
ha
including rights of access
to
rectification
data
held.
ents will slightly fromof
io
omersand
ni
. Whilst
the
responsi
be char
every ef ca
bility to
ged at co original. PLE
PROOF
check re
ASE CH fort
st. Whils
APPRO
ad and enquiries
ECK C
t every in
VED AN appropriate
PLEAmay
You agree that Shaws
ap
ef
SE PRO make
pr
fo
D
ov
rt
e all fore
will be m
CEED TO CORRECT
ign text
ad
AS A
PRINT.
.
AMEND
I unders PPEARS ABO
MENT Nthis application
relation to and arising
VE - credit
tand with
PLEAfrom
acceptan any
SE PRO EEDED - NO
ce of th
FURTH
CEED TO
is proof
ER P
PRINT.
is legally
MENDM
F REQUShaws may
reference bureau orFAUagency,
that
I unders ROO
bindin
EN and you confirm
IR
tand ac
ceptance ED
RTHER T NEEDED PROOF
of this pr
REQU
oof is le
disclose information relating to
your
account to any credit
IRED
gally bind
ing
SIGNED
: ............
............
reference bureau or
agency.
............
......
SPECIF
IC REPR
O
INSTRU
CTIONS
............
............
............
...
............
..... D
To enable Shaws to meet obligations in regard
to
the
ATE: ...
............
............
prevention of Money Laundering, under the Criminal Justice
Act 1994, you agree to furnish Shaws with suitable evidence
of identity and permanent residence. You consent to Shaws
making such enquiries in connection with this application as
they deem appropriate.
- INTERN
AL USE
ONLY:
FINAL
VERSIO
N PROO
F CHEC
Pre Pres
K - INTE
s
RNAL US
Checke
Platemak
E ONLY:
d by:
ing
Checke
Litho
d by:
Checke
d by:
Screen
Collatin
g
Punching
Checke
d by:
Checke
d by:
Checke
d by:
Shaws reserve the right to assign their interests in this
agreement.
These Terms are agreed:
FIRST CUSTOMER'S SIGNATURE
X
SECOND CUSTOMER'S SIGNATURE
X
WITNESS TO CUSTOMER'S SIGNATURE
X
PRINT NAME HERE (BLOCK CAPITALS)
ADDRESS
SIGNED FOR SHAWS
X
DATE
PLEASE SIGN WHERE MARKED X.
PAGE 3
SHAWS
CHARG
E CARD
TOP OF
STANDING ORDER
MANDATE
PROOF
CARD FA
CE
FACE O
F CAR
Colours
:
COMME
NTS:
n/a
TOP OF
SE
1. This card
2. This card is the proper ty
of
3. The hol is not transferable Shaw Department
der
Stores. and
and can
be
not accept shall be respons
ible for all withdrawn at any may be used by
any resp
4. The hol
the auth
credit obt
time by
orised sign
der must onsibility conseq
Sha
ained by
5. Credit
uen
atory only
notify Sha
the use of w Department
obtained
.
w Departm t upon the loss
Sto
this card
by use of
or mis
and Shaw res. without not
ent Stores.
month sub
this
ice.
Departm
sequent
IMMEDIAT use of the card.
ent Stores.
to month card will carr y a
ELY sho
monthly
of purcha
shall
ser vice cha uld the card be
se.
lost or stol
rge on all
en.
balances
not cleared
before end
of
REVER
SE OF
CARD
Colours
:
Black
Screen
Mag Ta
pe:
LoCo
Sig Pan
el:
Clear
COMME
NTS:
n/a
To: ....................................................................................................................................................................................................................................................
(your bank’s name)
CLIENT:
In orde
r th
accordan at we may pr
oceed,
ce with
wou
within ou
yo
r produc ur wishes. Not ld you please
ch
materia
ification
l may ne tion schedule.
is require eck that all de
In th
ed
tails of
type font
d as so
the supp
s and st to be reset digi e interests of
on
lied c
qu
APPRO
yle, the
ta
ality the as possible to
VING. C
result co lly within our
supplied
ensure
reprogra
ustomer
text, it w
uld diffe
ar
tw
ork, mec ret
ph
amendm
ill be cu
r
stomers
hanica
ents will slightly from th ic studio. Whils
responsi
t every
be char
e
bility to
ged at co original. PLE
ef
PROOF
check re
ASE CH fort
st. Whils
A
ad and
ECK
t every
PLEAS PPROVED AN
approve
ef
E PROC
fo
D COR
rt will be C
all foreig
RECT A
EED TO
mad
n text.
SA
PRINT.
AMEND
I unders PPEARS ABO
M
VE tand ac
PLEAS ENT NEEDED
ce
pt
ance of
E PROC
this proo
EED TO NO FURTHER
f is lega
PRINT.
P
AMEND
lly bindin
I unders ROOF REQUIR
M
tand ac
ED
FURTH ENT NEEDED
ce
ptance
ER PRO
of
th
OF REQ
is proof
UIRED
is legally
binding
SIGNED
: ............
............
............
............
SPECIF
............
IC REPR
............
O INST
RUCTIO
............
NS - IN
............
TERNAL
.. DATE
USE ONL
: ............
Y:
............
...
Branch address: .......................................................................................................................................................................................................................
Please set up a standing order as follows:
. each week / month (circle as appropriate)
The first payment to be made on: D D
/ MM /
Y Y Y Y (Starting date)
And the same sum, on the same day each: week / month (circle as appropriate) until such time as I give notice
otherwise.
FINAL
VERSIO
N PROO
F CHEC
Pre Pres
K - INTE
s
RNAL US
Checke
Platemak
E ONLY:
d by:
ing
Checke
Litho
d by:
Checke
d by:
SHAWS BANK DETAILS (To be completed by a member of Shaws staff ):
Screen
Collatin
g
Punching
Checke
d by:
Checke
d by:
Checke
d by:
Account Name: .......................................................................................................................................................................................................................
Address: .......................................................................................................................................................................................................................................
IBAN:
BIC/SWIFT Address:
Store Manager Signature:................................................................................... Date: D D
CUSTOMER DETAILS:
/ MM /
Y Y Y Y
(PLEASE COMPLETE IN BLOCK CAPITALS)
Account Holder Name(s): ................................................................................................................................................................................................
Account Holder Address: .................................................................................................................................................................................................
Town: .............................................................................................................................................................................................................................................
County: ........................................................................................................................................................................................................................................
IBAN:
Signature: ........................................................................ . Date: D D
BIC/SWIFT Address:
/ MM /
S
CARD R
EVER
Complete the form below, including your bank details, the amount you would like
to regularly pay, and the frequency of the payments. Then bring the form to your bank.
€
REV
Y Y Y Y
PAGE 4