Forms - AIA

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Important Notice: 

  • To download the latest version of AIA forms, please login to AIA Partnership Distribution Corner (https://www3.aia.com.hk/ebusiness/login.do) > Resource Center > Forms Download".
  • The below sample forms are for reference only.

New Business Forms:

Form [A2] Amendment Form for Politically Exposted Person * For All application with paper form submission (Updated: 13 Nov 2023)

Form [A3] Amendment to Application for Policy  (Updated: 17 January 2014) No consultant’s signature is required for PRC case if the client actually signed this amendment in China; otherwise, AIA will require the client to provide the entry proof for this amendment if consultant signed on it. (Updated: 21 Feb 2018)

It is applicable for NB case follow up if old version of financial summary OPUAIFA62.0221 is submitted.

Form [A6] AIA Representative / Broker Confidential Report (Updated: 29 May 2014)

Form [A12] Accident & Health Insurance Application Form (Updated: 30 Jun 2023)

Form [A13] Amendment to Application for Policy (For High Net Worth only) (Updated: 8 Nov 2016)

Form [A16] Amendment to Application For Policy (For declaration that no change in Proposed Insured’s / Insured’s condition of health) (Updated: 5 Feb 2018)

Form [A19] AIA Deferred Annuity Plan Supplementary Form (Updated: 24 Apr 2019)

Form [A21] Acknowledgement to Application of Policy  (Updated: 16 May 2023)

Form [A23] Amendment to Application for Policy for Xtra (Updated: 10 Oct 2022)

Form [A25] Amendment to Application For Policy – Shared Mobile Number Form (Updated: 15 Nov 2022)

Form [A26] Amendment to Application For Policy – Shared Email Address (Updated: 17 Apr 2023)

Form [B3] Bonus Power Vantage / Global Power Series – Special Declaration Form (Updated: 21 Jul 2023)

Form [C3] Customer Protection Declaration Form [Eng] [Chi] (Updated: 29 Sept 2017)

Form [C4] Critical Illness Simplified Underwriting Form (Updated: 2 Feb 2018)

Form [C6] Credit Card Authorization Form (Applicable to Non-Face-to-Face Interviews application) (Updated: 1 Apr 2020)

Form [C8] Covid-19 Recovery Questionnaire (Updated: 25 May 2022)

Form [D3] Designation of Trustee of a Minor Beneficiary Form (Updated: 1 Jun 2020)

Form [D5] Direct Debit Authorisation for Credit Card Account (Updated: 5 Dec 2017) (For New Application; Top up)

Form [D8] Deed of Undertaking (English Version) (For PRC Business) (Updated: 4 Jun 2013)

Form [D9] Deed of Undertaking (Chinese Version) (For PRC Business) (Updated: 4 Jun 2013)

Form [D11] Declaration from Non-Hong Kong Cardholders (Updated: 26 May 2017)

Form [D12] Direct Debit Authorisation For Levy Payment (For Use by CCBA Premium Installment Plan) (Updated: 5 Dec 2017)

Form [D14] Declaration form for Cash Payment and Payment Form for New Policy (Updated: 30 Jan 2019)

Form [D17] Declaration Form for Existing Hospital Coverage Migrate to VHIS Certified Plan (Updated: 9 Apr 2019)

Form [E1] e-BankIn and Direct Debit Authorisation For Bank Account Application (Apply for both DDA and e-BankIn in one go) (Updated: 27 Nov 2024)

Form [F1] Financial Summary (FNA) (Updated: 24 Oct 2024)[Guideline] (Updated: 16 Apr 2021)

Form [F2] Financial Questionnaire (Updated: 17 Jan 2025)

Form [F3] Financial Planner's Reason For Product Recommendation(For Suitability Mismatch) OPUAIFA10 0116 FNA broker memo  (Updated: 8 Aug 2016)

Form [F4] Family Members Referral Promotion Enrolment Form (Updated: 28 Mar 2018)

Form [F6] Fact Sheet of AIA Deferred Annuity Plan(ADAP) (selling under non-face-to-face distribution) (Updated: 5 May 2020)

Form [G1] Grandparent as Owner – Trustee Declaration (Updated: 17 Nov 2016)

Form [G2] Grandparent as Owner – Authorization Letter (Updated: 17 Nov 2016)

Form [G3] Grandparent as Owner – Consent Letter (Updated: 17 Nov 2016)

Form [I1] Income and Duties Questionnaire (Updated: 13 May 2013)

Form [I2] Individual AIA Vitality Membership Application Form (Updated: 26 Sep 2022)

Form [I3] Important Facts Statement for Mainland Policyholder (For PRC Business )(Required for application signed on/after 1 Sept 2016. Please refer to PRC_IFS notice for details) (Updated: 24 Oct 2023)

Form [I4] Important Facts Statement and Applicant's Declarations (For Treasure Advantage 2) [Eng]/[Chi] (Updated: 02 Dec 2022)(Note: PART 1, Question (1) both client’s own handwriting and pre-print version will be accepted by AIA.) (Updated: 26 Aug 2020)

Form [I6] Important Facts Statement and Applicant's Declarations for Top Up Applications (Updated: 9 Dec 2024) [Sample] (Updated: 9 Dec 2024)

Form [I11] Important Facts Statement - Policy Replacement (Chi)(Eng) (Updated: 9 Dec 2024)

Form [I12] Important Facts Statement and Applicant's Declarations (For U-Select) [Eng]/[Chi] (Updated: 02 Dec 2022)

Form [I13] Important Facts Statement - Premium Financing (Updated: 14 Nov 2022)

Form [I14] Important Facts Statement and Applicant's Declarations AIA 2-in-1 Protection Linked Plan (Single Premium) (Updated: 9 Dec 2024)

Form [I15] Important Facts Statement and Applicant's Declarations Investment Linked Assurance Scheme "ILAS" Policy (For Treasure Master Plus 2) [Eng]/[Chi] (Updated: 01 Dec 2023)

Form [J1] Juvenile Health Declaration Form (Sample) (For PRC Business Guideline)  (Updated: 3 May 2013)

Form [L1] Letter of Consent/Authorization Form for Attending Physician's Statement (APS)  (Updated: 7 Feb 2020)

Form [L3] Life and Personal Accident Insurance Application Form (Updated: 21 Nov 2023)

Form [P1] Pending Follow Up Letter (Sample)(For PRC Business Guideline)  (Updated: 20 Oct 2015)

Form [P2] Payor Information Form (Updated: 04 Apr 2022)

Form [P11] Payment Form for New Policy (Updated: 11 Apr 2023)

Form [R7] Residence Questionnaire  (Updated: 25 Jul 2016)

Form [R10] Risk Profile Questionnaire (Updated: 24 Oct 2023) [Sample] (Updated: 24 Oct 2023)

Form [R13] Request for Return of Original Document(s)  (Updated: 17 Jan 2024)

Form [S2] Source of Wealth Declaration (Updated: 21 Nov 2023)

Form [S4] Self-Certification Form - Individual (For Hong Kong) (Updated: 17 Jan 2024)

Form [S5] Self-Certification Form - Entity (For Hong Kong) (Updated: 17 Jan 2024)

Form [S6] Self-Certification Form - Controlling Person (For Hong Kong) (Updated: 17 Jan 2024)

Form [S7] Simplified Underwriting Form - Cancer Care Essence (Updated: 25 Oct 2018)

Form [S8] Simplified Underwriting Form - Level-Up Protect Cancer Plan (Updated: 30 Jan 2019)

Form [S9] Simplified Underwriting Form - On Your Side Plan series First Gift (Updated: 21 Dec 2022)

Form [S10] Simplified Underwriting Form-Voluntary Health Insurance Scheme (Updated: 20 Oct 2021)

Form [S12] Simplified Underwriting form and Employment Declaration -  Voluntary Medical Insurance Scheme or for Civil Servants and Non-Civil Servants Employed by the Government (Application Submission Period: 1 July 2019 – 31 December 2019) (Updated: 20 Oct 2021)

Form [S13] Supplementary Form for Common Reporting Standard (Updated: 24 Oct 2024)

Form [S14] Supplementary Form For AIA 2-in-1 Protection Linked Plan (Single Premium) (Updated: 12 May 2023)

Form [S15] Supplement To Risk Profile Questionnaire (Applicable to owners of Treasure Master Plus or Treasure Master Plus 2 or AIA 2-in-1) (Updated: 24 Oct 2023)

Form [T2] Treasure Series Plan Application Form  (Updated: 21 Nov 2023)

Form [V1] Voluntary Health Insurance Scheme (VHIS) Supplementary Form (Updated: 9 Apr 2019)

Form [W1] Wealth Series Application form (Updated: 3 Dec 2019)

POS Forms:

Form [A1] AIG Capital Saver by AIA Client's Declaration (For Reinstatement) (Updated: 24 Oct 2023)

Form [A9] Simplified Issued Offer (SIO) Plan and Accident Plan Reinstatement Form (Only applicable to “B” & “G” policy prefix) (Updated: 24 Oct 2023)

Form [A11] AIA administration Charge Acceptance Slip (Sample)(Updated: 31 Aug 2015)

Form [A14] Agreement and Assignment of Policy As Collateral Security for Overdraft Facility (Updated: 24 Oct 2024)

Form [A15] Agreement - Assignment of Policy as Collateral Security for Mortgage Loan (Updated: 24 Oct 2023)

Form [A18] Assignment - Collateral Security for Personal Loan (Updated: 24 Oct 2024)

Form [A20] Application Form for AIA VHIS Standard Scheme Upgrade to AIA VHIS Flexi Scheme (Ward) (Updated: 28 Apr 2023)

Form [A22] Application Form for Standing Instructions  (Only Applicable to "Forever Love Coupon Plan" & "designated plan") (Updated: 24 Oct 2024)

Form [B2] Beneficial Owner Data Form (Updated: 21 Nov 2023)

Form [C2] Cancellation Letter (For Cancellation of Application/Policy)

Form [D2] Direct Debit Authorisation for Bank Account (Updated: 10 Sep 2025)

Form [D15] Declaration of Policy Lost (Updated: 16 May 2018)

Form [H1] Handling Fee Acceptance Slip (For Credit Card payment - except CCBA) (Updated: 5 Dec 2017)

Form [H2] Health Certificate (Updated: 24 Oct 2024)

Form [I7] Important Notes and Risk / Implications Disclosure on Assignment of Life Insurance Policy (Updated: 24 Oct 2024)

Form [I16] Request for Lump Sum Premium of AIA 2-in-1 Protection Linked Plan (Single Premium) (Updated: 01 Dec 2023)

Form [L4] Lost Cheque Reissue Request Form (Updated: 09 Nov 2021)

Form [P3] POS Supplementary Form (Updated: 24 Oct 2024)

Form [P4] Policy Account Value Request Form (Updated: 17 Feb 2025)

Form [P5] Policy Lost Declaration (Updated: 24 Oct 2024) [sample] (Lost of Policy) (Updated: 3 May 2013)

Form [P6] PA Reinstatement Application Form (Only applicable to “A”, “E”, “P” or “M” policy prefix) (Updated: 24 Oct 2024)

Form [P7] Payment Declaration Form – Bank Draft (Updated: 01 Nov 2023)

Form [P8] Payment Declaration Form (Updated: 03 May 2023)

Form [P9] POS Supplementary Form for Financial Needs Analysis (Updated: 24 Oct 2023)

Form [P10] Premium Repayment for Premium Holiday (Updated: 24 Oct 2024)

Form [R1] Request Form for Change of Address / Telephone Numbers / Fax / Email Address / Apply "AIA e-Advice"  (Update Personal Details) (Updated: 24 Oct 2023)

Form [R2] Request for Change Form / Subsequent Application for Personal Accident Contract (Updated: 24 Oct 2024) (For Reissue PIN/update personal Particular/Change mode etc) (For Opt-out Procedure; For Add or Delete Riders, Change of Benefit or Change of Basic Plan or Face Amount, please kindly use form [R6]) (Updated: 28 Nov 2019)

* For Rider Addition/Plan Change/Top-up, if the policyholder is a PRC customer, he/she is required to sign and submit the Important Fact Statement-MP(refer to Form [I3] with all other required documents within 7 calendar days to AIA and 2 business days to OnePlatform before the deadline.)

Form [R3] Request for Cash Surrender (For Surrender; Policy Maturity) (Updated: 24 Oct 2024) (Sample)

Form [R4] Request Form for Maturity Benefit (Updated: 24 Oct 2024)

Form [R5] Request for Change of Beneficiary / Signature / Ownership / Trustee (Updated: 30 Oct 2025) (For Change Ownership, Signature and Beneficiary - please be reminded to write your PIBA no. on the top of the form.) (Updated: 28 Nov 2019)

* For change of policy ownership or policy assignment where the new policyholder/ assignee is a PRC customer that required to sign and submit the Important Fact Statement-MP (refer to Form [I3] with all other required documents )

Form [R6] Request Form for Change of Basic Plan/Supplementary Contract (Updated: 17 Jan 2024) (For Add or Delete Riders, Change of Benefit or Change of Basic Plan or Face Amount) (Updated: 28 Nov 2019)

Form [R8] Request for Premium Holiday Form (Contribution Holiday) (Updated: 24 Oct 2024)(Sample)

Form [R11] Request for Investment-linked / Universal Life Plan Services(Applicable to IFA & Brokers) (Fund Switching; Encashment / Partial Surrender/ Withdrawal) (Updated: 24 Oct 2024) [Sample] (Updated: 28 Nov 2019)

Form [R15] Request for Cash Withdrawal Form (Updated: 24 Oct 2024)

Form [R16] Request for Change for Insured Form (Updated: 17 Jan 2025) [Guideline] (Updated: 4 Feb 2020)

Form [R17] Request for Change of Beneficiary and Appointment of Trustee of a Minor Beneficiary (Updated: 17 Jan 2025)

Form [R18] Request for Change of Insured under Newborn Option Form [Guideline] [Only applicable for Simply Love Encore 3] (Updated: 24 Oct 2024)

Form [R19] Request for Investment-linked / Universal Life Plan Services (Applicable to applications submitted by customers only) (Fund Switching; Encashment / Partial Surrender/ Withdrawal) (Updated: 24 Oct 2024)

Form [R20] Request For Allinpay Settlement Form (Updated: 08 Oct 2020)

Form [R21] Request to Change Servicing Broker (Updated: 7 Nov 2024)

Form [S11] Simplified Underwriting Form – Voluntary Health Insurance Scheme (POS)  (Updated: 24 Oct 2023)

Form [T1]  Payment Declaration Form - Company Account (Updated: 03 May 2023)

Form [V2] Verification of Trust Agreement (Updated: 17 Jan 2024)

Claims Forms:

Form [A7] Application Form for Death Claim (Physician's Statement)  (For Death Claim)

Form [A8] Application Form for Death Claim (Claimant's Statement) (For Death Claim) (Updated: 21 Jul 2025) (Sample) (Updated: 15 Aug 2018)

Form [A17] Accident Claim Form (Updated: 21 Jul 2025) (Sample) (Updated: 15 Aug 2018)

Form [C5] Critical Illness Claim Form (Updated: 21 Jul 2025) (Sample) (Updated: 15 Aug 2018)

Form [C7] CONFIDENTIAL MEDICAL CERTIFICATE-SEVERITY-BASED HEALTH PROTECTION (Updated: 9 Jun 2020)

Form [D13] Dismemberment Claim Form (Updated: 21 Jul 2025)

Form [D16] Death Benefit Settlement Option Application Form (Updated: 17 Jan 2025)

Form [F5] Female Product Claim Form (Updated: 30 Jun 2023)

Form [I8] Individual Life & Group Claims Arrangement Form (Updated: 21 May 2019)

Form [I9] Individual Life – Outpatient & Dental Benefits Claim Form (Updated: 30 Jun 2023)

Form [N1] Network Surgery / Medical Claim Form (Updated: 21 Jul 2025)

Form [S3] Supplementary Information of Claimant (Updated: 21 Jul 2025)

Form [T3] Total & Permanent Disability Claim Form (Updated: 21 Jul 2025)

Group Insurance Forms:

Form [L1] Letter of Authorization [Sample] (For new application) (Updated: 24 Jul 2014)

Form [B1] Beneficial Owner# Data Form(For new application) (Updated: 24 Jul 2014)

Form [H1] Health Declaration Form (For CEO PRO new application) (Updated: 9 Oct 2015)

Form [G1] Group Insurance Medical Claim Form (Updated: 8 Jan 2016)

AIA Customer Hotline: 22328888

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