SAMPLE FOR REFERENCE ONLY!
New Business Forms
Form [B1] 銀行客戶背景及財產說明 (Updated: 28 Sep 2023)
Form [C2] Collateral Assignment / Release of Collateral Assignment Form (Updated: 19 Feb 2021) (Sample)
Form [C5] Credit Card Charge Form (Updated: 25 Oct 2021)
Form [D1] Direct Debit Authorization Form (Updated: 27 Aug 2025) (Sample)
Form [D2] Disclaimer 免責聲明 (Updated: 11 Dec 2019) [Sample]
Form [D6] Policy Assignment Declaration (Updated: 19 Dec 2025)
Form [F2] Financial Needs Analysis Form (Updated: 26 Nov 2025)
Form [H2] Health Declaration – For Voluntary Health Insurance Scheme Policy 「Guard Your Health / Healthy Life Medical Insurance Plan」(Updated: 23 Sep 2021)
Form [I1] Important Facts Statement for Mainland Policyholder (Updated: 19 Aug 2025)
Form [I2] Important Facts Statement — Policy Replacement (Updated: 24 Aug 2020)
Form [I3] Important Facts Statement for Premium Financing (Updated: 16 Nov 2022)
Form [P6] Policy Assignment or Release of Policy Assignment Form (Updated: 19 Dec 2025)
Form [R4] Replacement Declaration (Sample)
Form [R17] Risk Evaluation Information of Premium Financing (Updated: 1 Apr 2021)
Form [S1] Source of Wealth Declaration (Updated: 26 Aug 2025) (Sample)
Form [S2] Supplementary Financial Statement for Personal Covers (Updated: 19 Jul 2016) [Sample]
Form [S3] Business Financial Questionnaire (Updated: 10 Jul 2019)
Form [S4] Supplementary Information Form (Updated: 11 Dec 2019)
Form [S5] Supplementary Information Form - Applicable to Foreign Account Tax Compliance Act (FATCA) (Updated: 19 Jul 2016)
Form [S6] Self-Certification Form – Individual (For New Business Use) (Updated: 26 Aug 2025)
Form [S7] Self-Certification Form – Controlling Person (For New Business Use) (Updated: 26 Aug 2025)
Form [S8] Self-Certification Form – Entity (For New Business Use) (Updated: 26 Aug 2025)
Form [S15] Supplementary Information Form For Levy (Form effective date on 1 Jan 2018 to 28 Feb 2018) (Updated: 20 Dec 2017)
Form [S17] Suitability Assessment Questionnaire (SAQ) for Medical Insurance Product (Submit with FNA) (Updated: 23 Mar 2021)
Form [S18] Suitability Assessment Questionnaire (SAQ) for Medical Insurance Product (FNA Exempted Product) (Updated: 23 Mar 2021)
Form [S19] Supplementary Information Form - Applicable to Products that have interim policyholder’s clause (Updated: 02 Jul 2025) （Training Materials）
Form [T2] Third Party Payment Instruction Form (NB-TPP) (For Initial Premium Only) (Updated: 26 Aug 2025)
Form [W1] Witness Declaration Form (Updated: 10 Jul 2019)
POS Forms
Form [C3] Change of Servicing Broker (Updated: 19 Jul 2023)
Form [C4] Change of Policyholder Address /Contact Numbers / Email Address (Updated: 26 Aug 2025)
Form [D3] DECLARATION OF HOME VISIT BY INSURANCE INTERMEDIARY (For Hong Kong Resident and Hong Kong Residential Address Only) (Updated: 27 Sep 2017)
Form [D4] Direct Debit Authorization (Applicable to Cross Border Long Card Direct Debit Authorization) (Updated: 13 Dec 2019)
Form [D5] Declaration and Indemnity Form for Change of Policyholder/Beneficiary to Trustee (Updated: 26 Aug 2025)
Form [M1] MCV體檢醫生報告 (Updated: 18 Feb 2020)
Form [P2] Personal Information Collection Statement - Chinese Version / English Version (For Opt-out Procedure) (Updated: 11 Dec 2019)[Sample]
Form [P3] Policy Lost Declaration (Updated: 11 Dec 2019) [Sample]
Form [P4] Policy Donation and Change of Beneficiary Appointment Form (Applicable for Change of Beneficiary) (Updated: 29 Mar 2023)
- If new beneficiaries are Non-Immediate Family Members, ID copies of new beneficiaries are required
Form [R2] Request For Change of Policyholder Application Form [Guideline](Updated: 04 Aug 2025)
Form [R3] Request for Change of Payment (Updated: 13 Jun 2023) [Sample]
Form [R6] Request for Change of Policy Coverage (Updated: 19 Dec 2025)
Form [R7] Request for Policy Reinstatement (Updated: 29 Dec 2022)
Form [R8] Request for Change Reactivate Autopay Instruction (Updated: 11 Dec 2019)
Form [R9] Request for Change of Policy Information Form (IX) (Applicable for Cancel Autopay Instruction) (Updated: 11 Dec 2019)
Form [R10] Request for Change of Payment Options and Information Form (Updated: 11 Dec 2019)
Form [R11] Request For Financial Services / Surrender Form (Updated: 19 Dec 2025)
Form [R12] Request For Policy Maturity Benefit Form (Updated: 14 Dec 2021)
Form [R13] Change of Policyholder Insured Personal Information Occupation Signature Form (Updated: 13 Jun 2023)
Form [R14] Request for Appointment / Change / Termination of Contingent Policyholder Form [Guideline] (Updated: 04 Aug 2025)
Form [R15] Request for Change of Insured Form (Updated: 22 Mar 2021)
Form [R16] Request for Designation / Change / Termination of Contingent Insured Form (Updated: 22 Mar 2021)
Form [S9] Self-Certification Form – Individual (For Policy Service Use) (Updated: 26 Aug 2025)
Form [S10] Self-Certification Form – Controlling Person (For Policy Service Use) (Updated: 26 Aug 2025)
Form [S11] Self-Certification Form – Entity (For Policy Service Use) (Updated: 26 Aug 2025)
Form [S12] Self-Certification Form – Individual (For Claims) (Updated: 26 Aug 2025)
Form [S13] Self-Certification Form – Controlling Person (For Claims) (Updated: 26 Aug 2025)
Form [S14] Self-Certification Form – Entity (For Claims) (Updated: 26 Aug 2025)
Form [S15] Supplemental To Change of Policy Information – General Information (Updated: 13 Dec 2019)
Form [S16] Special Payment Arrangement Request Form (Updated: 13 Dec 2019)
Form [T1] Third Party Payment Instruction Form (PS -TPP) (For Renewal Premium Only) (Updated: 27 Aug 2025) [Sample]
Form [D1] Direct Debit Authorization Form (For Renewal Premium Only) (Updated: 27 Aug 2025)