Gem Visa Account Keeping Fee Waiver Form

Merchant Staff Offer Policy

I have read and accept the terms set out in this <a href="https://assets.latitudefinancial.com/brochures/nz/partner-perks-gemnz.pdf" target="_blank"> policy </a>. I confirm that the information given in this form is true, complete and accurate.

First name

Last name

Preferred Email

Once you have submitted the form a confirmation email will be sent to this address.

Account Number

Your unique, 16 digit code found on your Gem Visa statement.

Company Name/Store

Latitude merchant ID

The Latitude merchant ID must relate to company/store name you have entered.

I confirm that the information given in this form is true, complete and accurate.