Forms - Blue (Ex-Aviva)

Below forms are applicable for EX-AVIVA HK Customers with policies issued before 2018, please check your policy information before download.(Updated: 30 Aug 2024)

For Blue (Ex-Aviva) forms, you may download in https://www.blue.com.hk/other_products/en/customer_care/ or login https://www.blue.com.hk/my_account/home.do with personal account.

SAMPLE FOR REFERENCE ONLY

POS Forms

Form [A6] Application for Change of Financial Adviser Form (Updated: 24 Feb 2025) (For Transfer in Servicing Agent )

Form [B1] Beneficiary Nomination Form (For Beneficiary ) (Updated: 25 Feb 2025) [sample] (Updated: 3 Jul 2015)

Form [C3] Change of Policy Ownership (Updated: 24 Feb 2025)

Form [C5] Credit Card Payment Authorisation (Updated: 25 Feb 2025)

Form [D3] Direct Debit Authorisation (Updated: 24 Feb 2025) [sample] (For Change of Payment Method; New Expiry Date of Credit Card ) (updated: 29 Dec 2015)

Form [D4] Death Benefit – Claimant’s Statement (Updated: 10 Feb 2021)

Important facts statement and applicant's declarations for TOP UP applications (Updated: 02 Nov 2020) [sample(Updated: 2 Mar 2015)

          Form [I5] Global Investment Account (Single top-up premium) [CHI] [sample] OR [ENG] [sample] (Updated: 7 Feb 2017) 

          Form [I6] Global Savings Account (Regular top-up premium) [CHI]  [sample] OR [ENG] [sample] (Updated: 7 Feb 2017) 

          Form [I7] Global Savings Account (Single TOP UP Premium) [CHI]  [sample] OR [ENG]  [sample] (Updated: 7 Feb 2017) 

          Form [I8] LifeLink Insurance Plan (Single & Regular top-up premium) [CHI]  [ENG] [sample] (Updated: 7 Feb 2017) 

Form [F1] Future Premium Deposit (FPD) Account Application Form (Updated: 24 Feb 2025) [Sample] (Updated: 07 Jul 2015)

Form [F2] Financial Needs Analysis Form  (Updated: 02 Nov 2020)

Form [S4] Surrender Application Form (For Surrender) (Updated: 24 Feb 2025) [sample] (updated: 3 Jul 2015)

Form [R3] Request for Fund Transaction Application (For Contribution Holiday; Decrease Premium; Resume contribution from contribution holiday; Lump Sum Top Up; Regular Premium Top Up) (Updated: 10 Feb 2021) [sample] (Updated: 3 Jul 2015)

Form [R4] Request for Fund Switch / Fund Redirection Form (For Fund Switch, Fund Redirection)·(Updated: 9 Mar 2021) [sample] (Updated: 3 Jul 2015)

Form [R5] Request for Personal Details Change Form (For Update Personal Details; Change of Personal Information; Change of Signature) (Updated: 24 Feb 2025)

Form [R6] Request for Policy Service Change Form (With Health Declaration) (For Reinstatement from lapsed) (Updated: 10 Feb 2021)[sample] (updated: 3 Jul 2015)

Form [R7] Request for Policy Services Change Form  (For Change of Mode; Lost of Policy; Opt-out Procedure) (Updated: 24 Feb 2025) [sample](updated: 3 Jul 2015)

Form [R8] Request for Policy Value Withdrawal Application (For Encashment / Partial Surrender / Withdrawal ) (Updated: 24 Feb 2025) [sample] (updated: 3 Jul 2015)

Form [R9] Risk Profile Questionnaire (Updated: 24 Feb 2025) - [Sample] (Updated: 24 Dec 2015)

Form [R10] Request For Policy Loan Application (Updated: 24 Feb 2025)

Form [S3] Supplementary Statement for Application (Updated: 27 May 2022) [sample] (Updated: 19 Aug 2011)

Form [T1] Third Party Payment Declaration Form (Updated: 24 Feb 2025)

Others

Form [A2] Blue Code Creation Form & Application Form for Web Access (FA)  (Updated: 25 Aug 2021)

Form [A5] Advisor Particulars Change Form (Updated: 25 Aug 2021)

Form [S7] Self-Certification Form (Individual) (Updated: 24 Feb 2025)- Guideline (Updated: 10 Feb 2021)

Form [S8] Self-Certification Form (Entity) Updated: 24 Feb 2025)- Guideline (Updated: 10 Feb 2021)

Form [S9] Self-Certification Form (Controlling Person) Updated: 24 Feb 2025)- Guideline (Updated: 10 Feb 2021)

Blue Customer Hotline: 35509600/ 35509828/ 35509888

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