Financial SOD Global Card

FINANCIAL SOD GLOBAL CARD

Applicant Name:   Account Reference/Client ID:

Applicant Information

Individual    Corporation    Trust    Other:

Card Request Details

Card Product Requested:   Primary Currency:

Source of Funds (SOD) Declaration

Primary Source of Funds (check applicable):

Employment    Business Income    Savings    Investments    Other

Anti‑Money Laundering, Certifications & Authorizations

By signing below, I certify under penalty of perjury that the information provided in this Financial SOD Global Card form is true, complete, and accurate to the best of my knowledge. I further certify that the funds to be used with the issued card are derived from legitimate sources and I will notify the issuer promptly of any material change in my financial circumstances that would affect any representation in this form.

I authorize the institution and its agents to verify any information provided, to obtain consumer or commercial credit reports, to share and receive information with payment networks, correspondent banks, and regulatory authorities for purposes of card issuance, ongoing account monitoring, anti‑money laundering compliance, sanctions screening, and fraud prevention. I acknowledge that the institution may suspend or close card privileges if suspicious activity is detected or for non‑compliance with applicable laws and policies.

I represent that neither I nor any beneficial owner of the account is subject to sanctions or prohibited from receiving financial services in the jurisdictions applicable to card operations. I will provide, upon request, supporting documentation to substantiate the stated source of funds, ownership, and identity.

I acknowledge and certify the statements above and consent to the authorizations contained herein.

Fees, Limits and Payment Authorization

I acknowledge that fees, charges, foreign transaction fees, and applicable taxes may be assessed on use of the card. I agree to be bound by the issuer’s fee schedule and accept responsibility for payment of all amounts charged to the card unless otherwise prohibited by applicable law. Late payment fees and interest may be applied in accordance with the card terms.

ACH Debit from Bank Account    Wire Transfer    Manual Payment

If ACH Debit selected: Account Holder Name:   Routing Number:

Consent to Data Processing & Electronic Communications

I consent to electronic delivery of cardholder agreements, statements, notices, and disclosures related to the Financial SOD Global Card and associated accounts. I understand that I may receive communications by email, secure portal message, or other electronic means, and that I may withdraw consent to electronic delivery in accordance with the issuer’s procedures.

I consent to electronic delivery and communications as described above.

Additional Instructions / Notes

Acknowledgment

By signing below I acknowledge that I have read, understand, and agree to be bound by the terms set forth in this Financial SOD Global Card form and any supplemental cardholder agreement provided by the issuer. I understand that submission of this form does not guarantee issuance of a card and that the issuer reserves the right to request additional documentation or decline issuance in its sole discretion.

Sign Now