The American Express Gold Business Card - Secure Application Form
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The American Express® Gold Business Card

Mandatory fields will be marked with an *

The American Express Gold Business Card
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  • Speak to a Small Business Services Specialist - Click here for a call back or please call 139 143
  • 1
    About You
  • 2
    Contact Details
  • 3
    Your Finances
  • 4
    Additional Benefits
  • 5
    Review And Send

Welcome to your application. Let's get started.

First tell us a few things about yourself.

The American Express Gold Business Card
Error: Please select your Title from the list. Click to Amend
Error: Please ensure First Name contains only letters (A-Z, upper and lower case), spaces, hyphens or apostrophes. Click to Amend
Error: Your Middle Name can contain letters (A-Z, upper and lower case), spaces, hyphens or apostrophes. Click to Amend
Error: Please ensure Surname contains only letters (A-Z, upper and lower case), spaces, hyphens or apostrophes and is more than 2 letters in length. Click to Amend
Error: Please recheck how you would like your name to appear on your Card. Click to Amend
Error: Please ensure you enter an email address and it's in the correct format (i.e. account@domain) Click to Amend
Error: Please ensure Date of Birth contains digits only and is a valid date. You need to be 18 or over to apply. Click to Amend
Error: Please ensure Postcode is in the correct format i.e. 4-digit number. Click to Amend
Error: Please check the box to confirm your acknowledgement. Click to Amend
Error: Please check the box to confirm you have read the above Declaration. Click to Amend
  1. How would you like your name to appear on the Card?

    The front of your American Express Card has room for up to 20 characters. You can select how you want your name to appear on the Card by clicking on the drop down box. Your surname must appear on the Card. If you have a long name, you may need to use just an initial and your surname

  2. Email Address

    Your email address is required so we may send you notification of your monthly statement availability. It will not be used for marketing purposes unless you select the Email Communications checkbox below.

  3.  /   /  Date of Birth (DD/MM/YYYY)

    We need this information to validate the Primary Cardmember's details.

Qualified Applicants must:

  • Be over 18 years of age.
  • Have a good credit history and no payment defaults.
  • Be an Australian citizen or a permanent resident.
  • Earn a personal gross (pre-tax) annual income of $24,000 or more.

 

By selecting this box, you agree to let American Express retain your information and contact you about the status of your application. For additional information, please read our Privacy statement. (Note the content contained in this link may not be viewable on a mobile device).

 

Please take this opportunity to read the application Declaration and how we will use your personal information. Please check the box to confirm you have read and agree to the above Declaration.

Contact Details

Hello , all your information is protected on this secure site, and only used to process your Application.

General And Contact Information

  1. Gross Annual Income

    Please enter your personal annual income for the year before taxes, from all sources.

We require your home phone number and your address as part of our credit checks. We may use these details to get in contact with you about your Application.

  1.    Home Phone Number

    Your home telephone number is required as part of our standard credit checks. Having it will help us to process your application as quickly as possible. Remember, it will never be given out to anyone else or used for marketing purposes without your permission.

  2. Mobile Telephone

    Your mobile phone number may help us to contact you quickly if we have any questions about your application. It will not be used for marketing purposes or given to anyone else, without your permission.

Email Communications:

Address Details

For your security a new Card must go to your residential address.

    Sorry we are unable to look up the address you have entered. Please enter the address in the section given below Sorry we are unable to process the address you have entered. Please enter the address in the section given below We are unable to process your application with a PO Box Address as it is not an acceptable address. Please enter a Non PO Box Address.
  1. Search Address

    Type in your address and please select from the list.

  2. Residential Street Address

    We need to know your residential address to help with our credit checks.

  3. Own Live With Parents
    Rent Mortgage Accommodation Status

    We need to know the status of your accommodation to complete our credit checks.

  4.    Time at this address (YY/MM)

    If you have lived at your current address for less than 5 years, we will ask for information on your previous address. Again, this information is required as part of our credit checks and will help speed up your application.

Previous Address Details

As you have lived at your current address for less than 5 years, we need your previous address to complete our credit checks.

  1. Search Address

    Type in your address and please select from the list.

  2. Sorry we are unable to look up the address you have entered. Please enter the address in the section given below Sorry we are unable to process the address you have entered. Please enter the address in the section given below
  3. Previous Residential Street Address

    We need to know your residential address to help with our credit checks.

Our Communications With You

Online statements

Enrolment in Online Statements:

Business Finances

Business Details

  1. Business legal name

    This should be your business name in full, as per registered ABN business name.

  2. Company Sole Trader Trust Partnership Association
  1.  /  Time in Business(YY/MM)

    To be eligible for the American Express Business Card your current business needs to be trading for 12 months or more. Please enter how many years your company has been trading.

  2.   Business Phone Number

    Your business telephone number is required as part of our standard credit checks. Having it will help us to process your application as quickly as possible. Remember, it will never be given out to anyone else or used for marketing purposes without your permission.

  3. Search Address

    Type in your address and please select from the list.

  4. Sorry we are unable to look up the address you have entered. Please enter the address in the section given below Sorry we are unable to process the address you have entered. Please enter the address in the section given below
  5.   Business Address

    We need to verify your business address to process your application.

  6. Is the Principal Place of Business the same as the Registered Business Address? * Yes No
    1. Search Address

      Type in your address and please select from the list.

    2. Sorry we are unable to look up the address you have entered. Please enter the address in the section given below Sorry we are unable to process the address you have entered. Please enter the address in the section given below
    3.   Business Address

      We need to verify your business address to process your application.

    1. Full Address of the Association's/ Co-operative's Principal Place of Administration or Registered Office
      Residential address of the Association's/ Co-operative's Public Officer (or President, Secretary or Treasurer)
    2. Chairman Details

    3. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We need this information to validate the Primary Cardmember's details.

    4. Secretary Details

    5. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We need this information to validate the Primary Cardmember's details.

    6. Treasurer Details

    7. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We need this information to validate the Primary Cardmember's details.

    8. Public Officer Details

    9. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We need this information to validate the Primary Cardmember's details.

    1. Is the Company registered by ASIC (please tick one) Proprietary or Public company * Proprietary Public Company
    2. Director One Details

    3. Date of Birth (DD/MM/YYYY)*  /   /  Date of Birth (DD/MM/YYYY)

      We need this information to validate the Primary Cardmember's details.

    4. Director Two Details

    5. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We need this information to validate the Primary Cardmember's details.

    6. Director Details Three

    7. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We need this information to validate the Primary Cardmember's details.

    8. Director Details Four

    9. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We need this information to validate the Primary Cardmember's details.

    10. Director Details Five

    11. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We need this information to validate the Primary Cardmember's details.

    12. Director Six Details

    13. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We need this information to validate the Primary Cardmember's details.

    14. Beneficial Owners 

      Beneficial Owners

      Beneficial Ownership: List all beneficial owners with at least 25% ownership and all individuals deemed to have beneficial control of the entity. Beneficial control refers to the means of exercising direct or indirect control including but not limited to the capacity to significantly influence financial decisions, operating policies or the appointment/dismissal of a senior managing official of the Business. Such control may be by means of trusts, agreements, arrangements, understanding or practices, whether or not having legal or equitable force.

    15. Beneficial Owner Details One



    16. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We need this information to validate the Primary Cardmember's details.

    17. Does your Company have any additional Beneficial Owners? Yes No
    1. Beneficial Owner Details Two



    2. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We need this information to validate the Primary Cardmember's details.

    3. Does your Company have any additional Beneficial Owners? Yes No
    1. Beneficial Owner Details Three



    2. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We need this information to validate the Primary Cardmember's details.

    3. Does your Company have any additional Beneficial Owners? Yes No
    1. Beneficial Owner Details Four



    2. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We need this information to validate the Primary Cardmember's details.

    1. Partnership Details

      Partnership Details

      Please list a minimum of 2 Partners, Managing Partners and any individuals deemed to have control in the partnership. Control refers to the means of exercising direct or indirect control including but not limited to the capacity to significantly influence financial decisions, operating policies or the appointment/dismissal of a senior managing official of the Business. Such control may be by means of trusts, agreements, arrangements, understanding or practices, whether or not having legal or equitable force.

    2. Partner One Details

    3. Is the Partner an entity or individual? * Entity Individual


    4. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We are required to collect this information under our AML KYC requirements.

    1. Partner Two Details

    2. Is the Partner an entity or individual? * Entity Individual


    3. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We are required to collect this information under our AML KYC requirements.

    4. Does your Partnership have more Partners? Yes No
    1. Partner Three Details

    2. Is the Partner an entity or individual? Entity Individual


    3. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We are required to collect this information under our AML KYC requirements.

    4. Does your Partnership have more Partners? Yes No
    1. Partner Four Details

    2. Is the Partner an entity or individual? Entity Individual


    3. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

      We are required to collect this information under our AML KYC requirements.

      1. Trustee Details

      2. Is the Trustee a Company?* Yes No
      1. Name of Trustee

      2. Date of Birth (DD/MM/YYYY) *  /   /  Date of Birth (DD/MM/YYYY)

        We are required to collect this information under our AML KYC requirements.

      3. Beneficial Owner

        Beneficial Owner

        Beneficial Ownership: List all beneficial owners with at least 25% ownership and all individuals deemed to have beneficial control of the entity. Beneficial control refers to the means of exercising direct or indirect control including but not limited to the capacity to significantly influence financial decisions, operating policies or the appointment/dismissal of a senior managing official of the Business. Such control may be by means of trusts, agreements, arrangements, understanding or practices, whether or not having legal or equitable force.

      4. Beneficial Owner One Details



      5. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We are required to collect this information under our AML KYC requirements.

      6. Yes No
      1. Name of Trustee

      2. Is the Company registered by ASIC? * Proprietary Public
      3. Director One Details

      4. Date of Birth (DD/MM/YYYY)*  /   /  Date of Birth (DD/MM/YYYY)

        We need this information to validate the Primary Cardmember's details.

      5. Director Two Details

      6. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We need this information to validate the Primary Cardmember's details.

      7. Director Three Details

      8. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We need this information to validate the Primary Cardmember's details.

      9. Director Four Details

      10. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We need this information to validate the Primary Cardmember's details.

      11. Director Five Details

      12. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We need this information to validate the Primary Cardmember's details.

      13. Director Six Details

      14. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We need this information to validate the Primary Cardmember's details.

      15. Beneficial Owners of the Trustee

        Beneficial Owner

        Beneficial Ownership: List all beneficial owners with at least 25% ownership and all individuals deemed to have beneficial control of the entity. Beneficial control refers to the means of exercising direct or indirect control including but not limited to the capacity to significantly influence financial decisions, operating policies or the appointment/dismissal of a senior managing official of the Business. Such control may be by means of trusts, agreements, arrangements, understanding or practices, whether or not having legal or equitable force.

        Beneficial Owner One Details



      16. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We are required to collect this information under our AML KYC requirements.

      17. Yes No
      1. Beneficial Owner Two Details



      2. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We are required to collect this information under our AML KYC requirements.

      3. Yes No
      1. Beneficial Owner Three Details



      2. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We are required to collect this information under our AML KYC requirements.

      3. Yes No
      1. Beneficial Owner Four Details



      2. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We are required to collect this information under our AML KYC requirements.

      3. Yes No
      1. Beneficial Owner Five Details



      2. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We are required to collect this information under our AML KYC requirements.

      3. Yes No
      1. Beneficial Owner Six Details



      2. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We are required to collect this information under our AML KYC requirements.

      1. Beneficial Owner Two Details



      2. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We are required to collect this information under our AML KYC requirements.

      1. Beneficial Owners of the Trust

        Beneficial Owner

        Beneficial Ownership: List all beneficial owners with at least 25% ownership and all individuals deemed to have beneficial control of the entity. Beneficial control refers to the means of exercising direct or indirect control including but not limited to the capacity to significantly influence financial decisions, operating policies or the appointment/dismissal of a senior managing official of the Business. Such control may be by means of trusts, agreements, arrangements, understanding or practices, whether or not having legal or equitable force.

        Beneficial Owner One Details



      2. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We are required to collect this information under our AML KYC requirements.

      3. Yes No
      1. Beneficial Owner Two Details



      2. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We are required to collect this information under our AML KYC requirements.

      3. Yes No
      1. Beneficial Owner Three Details



      2. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We are required to collect this information under our AML KYC requirements.

      3. Yes No
      1. Beneficial Owner Four Details



      2. Date of Birth (DD/MM/YYYY)  /   /  Date of Birth (DD/MM/YYYY)

        We are required to collect this information under our AML KYC requirements.

Business Financial Details

Please indicate the details of an external source that will confirm your business financial details. Eg Registered Accountant or Auditor. Please also enter your business financial details below.



  1.  
  2. Existing Merchant Relationship * Yes No

Cards Held

  1. Do you already have an American Express Card? * Yes No Do you already have an American Express Card?

    If you already have an American Express Card please enter the Card number. We need to know this information to process your application correctly.

  1. Card Number *  -   - 

Extra Options

Membership Rewards

Why not add to the great features of the Card by joining one of the leading global rewards programs?Membership Rewards Ascent gives you up to 1 point for every dollar spent.


Membership Rewards Ascent , at $80 p.a.your points can be redeemed for a wide range or merchandise, gift cards and travel rewards. You can also redeem for airlines rewards points with eight of the worlds major airlines including Singapore Airlines and Cathay Pacific (excluding Qantas), and 57 other partner airlines flying to hundreds of destinations worldwide. Ascent also offers great retail rewards with the latest hi-tech products like Wii games. You can even redeem your points for gift cards at leading retailers such as David Jones and Tiffany & Co.


No, I do not wish to enrol at this time.

Monthly Statement Option

Cancel your Application