iChoose Visa Prepaid Reloadable Card Upgrade Application

Use this form to apply to upgrade your Visa Prepaid Reloadable Card.

To complete this application, please ensure you have:

Your Australian Driver's Licence
Your Visa Prepaid Card

Please allow 10-14 working days for your application to be reviewed. Once successfully verified, you will be notified by email that your card has been upgraded and your maximum limit increased.

There is a fee of $8.95 to upgrade your card which is deducted from the available funds on your card, so please ensure you have enough funds prior to submitting your application.

If you have any questions regarding the application process, please view our FAQs page or contact the iChoose team via email ichooseverify@212f.com.au

Please complete the form below to apply for a iChoose balance increase

All fields are required for verification and please double check your entries

Name

First Name (Exactly as it appears on Drivers Licence)

Middle Name(s) (Exactly as it appears on Drivers Licence)

Surname (Exactly as it appears on Drivers Licence)

Drivers Licence Number

Driver Licence Card Number

Drivers Licence Expiry Date

Date

Residential Address (As per Drivers Licence)

Flat Number

Street Number

Street Name

Suburb or Town

Postcode

4 characters left

Date of Birth (dd/mm/yyyy)

Date

Mobile Phone Number

Email Address

Confirm Email Address

Visa Card Provided By

LAST 10 Digits of Card

10 characters left

Electronic Declaration

By completing this application, I agree to the following:

I consent to the collection, use and disclosure of my personal information in accordance with your privacy policy, and consent to my personal information being used for the purpose of verifying my identity with (a) a credit reporting agency (this is NOT a credit check); (b) my information being checked with the document issuer or official record holder via third-party systems; and (c) with verification agent(s) acting as a nominated intermediary in accordance with Australian Privacy Act 1988, to access my personal information which is held by third parties.

Consent

I declare that the details as shown on this form are complete and accurate.

Privacy Agreement

I have read the Privacy Policy