FOXE 9977-5 2103
Providing / Amendment
Visa Corporate Card
Enterprises & Public
1/2
You can complete this document electronically, as well as save and print it off.
Document to be returned to:
Belfius Bank SA/NV – IBAN BE23 0529 0064 6991 – BIC GKCCBEBB – Insurance agent FSMA no. 019649 A
Belfius Bank SA/NV
Place Charles Rogier 11 - 1210 Brussels
Tel. + 32 2 222 11 11 - www.belfius.be
RPM Brussels VAT BE 0403.201.185
Account number of entity BE
Providing Visa Corporate Card
Cardholder last name First name
Pers. identification nº:
Limit
Card limit (the monthly spending limi t for the card).
Fixed card limit = 250 0 € (standard limit). If a dif ferent fixed card limit is requi red, please enter the require d limit below.
Fixed card limit:
€
(minimum 500 €)
Recurrent card limit: +
€
van tot (max. 3 Months)
A recurrent limit change is an increa se in the limit that is automatical ly activated annually.
Billing Level
Payment account (the account that will be de bited. This payment mus t be a Belfius payment):
q payment account of the entity BE
q private payment account of the cardholder BE
NB: the entity is ultimately respons ible for the payment. This m eans that the payment account of the e ntity will be debite d if it is not possible to
debit the private paym ent account of the cardholder (e.g. beca use the account is blocked).
Payment Delay
Standard method of payment = p ayment is made 9 calendar d ays after the perio d closes (the closure date is al ways the 25th of the month). If the
9th calendar day falls on a pub lic holiday or weekend, payme nt will be made on the nex t working day.
If an additional deferre d payment is required (subje ct to acceptance by the bank), pl ease select th e required deferred payme nt period below:
q + 30 calendar days q + 60 calendar days
q + 90 calendar days (this op tion is not possible if t he payment account is the cardho lder’s private payment account ).
Sending of a card
q Dispatch address of the entity
q Address of the entity's registered office
q Home address of the card holder
q Domicile Branch
q Other Branch: CI
q Free address:
Secret code (Attention: card address must always be different from code address)
Providing for secret code:
q via PIN setting in branch, or
q via PIN mailer sent to: q postal address of the entity
q domicile address of the entity
q home address of the card holder
q other address:
q via PIN text → Mobile number
Attention: any other operational notices will also be sent to this mobile number.
Spending statements
Choice of method for spending statements to be sent:
q Electronically via BelfiusWeb
q In paper form to q pos tal address of the entity
q domicile address of the e ntity
q home address of the card holder
q other address:
ServicingPCB
@belfius.be
Belfius Bank, Place Charles Rogier 11 - 1210 Brussels, RT 28/02
