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Get Centurion Supplementary Card Application Form

Black ink and CAPITAL LETTERS. Please indicate which card you would like to apply for and which currency you would like your billings and Card fees in by ticking the appropriate box: US Dollar Green PT0 Gold PT1 Platinum PT5 Euro Green PT0 Gold PT1 Platinum PT5 Green P1T Gold 55B Platinum 57B The annual fee for The Green Card is US$100/d100/ 60, The Gold Card is US$300/d300/ 95 and US$550/d550/ 300 for The Platinum Card. Sterling Personal Details Title: First names: Family name: M.

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