1) Application Form
"Proposal for Assurance" – Orange Form
"Proposal for Assurance (No Health Declaration)" – Purple Form
2) Copy of ID / Passport / Birth Cert for Minor Application
For Passport Copy:
- Full set copy of whole Passport / Visa / Entry Permit (including empty pages) with proposer
- & insurance broker’s signature and company chop on all pages for verification purpose
For Birth Cert Copy for Minor Application:
Copy of Birth Cert for Minor Application with proposer & insurance broker’s signature and
company chop for verification purpose
For Mainland Chinese:
Declaration for Insurance Application (Form M1A) for Mainland Chinese only
3) Sales Illustration (SI)
4) Prudential Needs Analysis Form (NAF)
5) Insurance Broker Report (IBR)
6) Initial Premium (Cheque / Bank Draft / Credit Card – Visa / Master Card / China UnionPay Debit/Credit Card* only)
For Monthly Payment Mode:
2 months premium payment
For credit card payment method (applicable for initial payment only but NOT single premium) -
Credit Card Authorization Agreement
*China UnionPay Debit/Credit Credit Card is only available at Prudential Service Centre.
7) Customer Protection Declaration Form (CPD) – For policy replacement only
8) Change of Payment Mode and Direct Debit Authorization Form(DDA) - For monthly mode
Prudential Customer Hotline: 22811333