CARDHOLDER AGREEMENTCardholder Agreement • December 3rd, 2019
Contract Type FiledDecember 3rd, 2019CUSTOMER INFORMATION & AGREEMENT By signing this agreement, the undersigned Customer acknowledges having (i) received and read the entire agreement, (ii) accepted the terms and conditions set outherein, and (iii) agreed to the card fees detailed herein. DCBank's acceptance of this agreement and the Cardholder Agreement (if fully completed) shall be evidenced by the issuance of a Card to Customer and the activation of that Card for use by Customer. Customer First Name: Customer Middle Name: Customer Last Name: Customer Phone Number (Home): Customer Phone Number (Work or other): Customer Street Address: City: Province: Postal Code: Customer Occupation: Customer Birthdate: Cell Phone Number: Customer Email: Customer's Signature: Date: