SAMPLE FOR REFERENCE ONLY!
New Business Forms
Form [A1] Additional lives assured / applicants (Sample)
Form [A7] Additional single premium application form (Updated: 6 May 2015)
Form [A8] Automatic Exchange of Information-Individual Self-Certification (Updated: 18 Feb 2022)
Form [B2] Business Financial Underwritting Questionnaire (For Corporate Application) (Updated: 15 Jul 2011)
Form [C2] Customer Declaration in relation to Needs Analysis Form (For Elite Application) (Sample)
Form [C3] Confirmation of Trust Account Form (For Corporate Application; ILAS product)
Form [C4] Commission Disclosure Declaration (Updated: 6 May 2015)
Form [D2] Direct Debit Authorisation (For Premier Application,Premier Ultra and IPA Application) (Updated: 3 Sep 2020) [Sample]
Form [F1] Financial Needs Analysis Form (Updated: 10 Sep 2020)
Form [H1] Customer Protection Declaration Form (Updated: 15 Dec 2011)
Important Facts Statement and Applicant’s Declarations Investment-Linked Assurance Scheme (“ILAS”)
[For Additional Premium Application only] (Updated: 3 Sep 2019)
Form [I1] For Premier (Updated: 2 Sep 2019)
Form [I2] For Premier Ultra
Form [I3] For Summit
Form [I4] For Zenith
Form [I5] For Summit II (Updated: 4 Sep 2019)
Form [I7] For Premier II (Updated: 4 Sep 2019)
Form [I8] Important Facts Statement for Mainland Policyholder (Updated: 2 Sep 2019)
Form [N1] Non Hong Kong Resident Declaration [Sample]
Form [R5] Risk Profile Questionnaire (Updated: 29 Oct 2020)
Form [R7] Request for premium policy contribution change (Updated: 3 Oct 2018)
Form [S1] Shareholders' / Partners' "Double (or Cross) Option" Agreement (For Corporate Application)
Form [S2] Source of Wealth form (Updated: 26 Apr 2021)
Form [S3] Sum Assured Reduction Request Form (For New Application)
Form [S7] Self-certification form - Declaration for an individual (Updated: 07 Jul 2022)
Form [S10] Supplementary statement for application form (Updated: 10 Jul 2018)
Form [U1] Ultimate Beneficial Owner of Policy Form (For New Application & Corporate Application)
Form [U2] US National Declaration (For New Application: Elite, Premier, Premier Ultra & Summit) (Updated: 15 Jul 2011)
Form [V1] Verification of PO Box Address / Confirmation of Residential Address
POS Forms
Form [A3] Appointment of third party as beneficiary/payee (Updated: 11 Sep 2018) [Sample] (For Beneficiary) (Updated: 03 Aug 2017)
Form [A4] Assignment of A Life Policy (For Assignment) (Updated: 23 Apr 2019)
Form [A10] Application to restart a policy (Statement of health questionnaire) (Updated: 25 May 2021)
Form [B1] Banker's Standing Order (BSO form) (For Assignment; Change of BSO Bank Account; Decrease Premium; Regular Premium Top up)(Updated: 10 Jul 2018) [Sample]
Form [B3] Bank instruction letter (Updated: 10 Jul 2018)
Form [C1] Cancellation Letter (For Cancellation of Application)
Form [D1] Credit Card Charge Authorisation (For Assignment; New Expiry Date of Credit Card; New Application)(Updated: 10 Jul 2018) [Sample]
Form [D3] Dual Authority Declaration (For Authorize to Accept any One Policy Owner Signature and New Application) (Updated: 7 May 2018) [Sample] (Updated: 6 May 2015)
Form [D4] Declaration and Indemnity in Anticipation of Payment of Death Benefit without Manx Grant of Representation (Updated: 15 May 2018)
Form [D5] Dealing instruction (Updated: 15 Jan 2019)
Form [L3] Letter of Transfer In Servicing Agent (For Transfer in Servicing Agent) (Updated: 6 Nov 2023)
Form [L4] Letter to explain the reason - Sample(For Third Party Payment) (Updated: 6 Nov 2023)
Form [L5] Letter to explain the relationship between the payer and the policyholder(For Third Party Payment) (Updated: 6 Nov 2023)
Form [L9] Letter to Show the amount of monetary exchange (For Assignment) (Updated: 6 Nov 2023)
Form [L10] Letter to show the reason of no monetary exchange (For Assignment) (Updated: 6 Nov 2023)
Form [L11] Loss/Non-Receipt of Policy Document (Updated: 19 Apr 2017) [Sample] (For Lost of Policy; Death Claim) (Updated: 15 Sep 2017)
Form [M1] Manx Grant of Probate Form [Sample] (For Death Claim)
Form [P5] Premium top up (Updated: 10 Sep 2020)
Form [R3] Request for withdrawal / surrender payment (Updated: 20 Feb 2025) withdrawal -withdrawal amount tick box [Sample] (Updated: 30 Oct 2018)
Form [R4] Request for Payment on Death (For Death Claim) (Updated: 4 Jan 2019)
Form [R7] Request for premium policy contribution change (Updated: 3 Oct 2018)
Form [R8] Request for personal particulars change / online service account registration (For Change of Address and contact details ) (Updated: 10 Jul 2018)
Form [R9] Request for Specimen Signature (For Update Personal Details) (Updated: 10 Jul 2018) [Sample] (Updated: 27Apr 2016)
Form [S5] FATCA-Supplementary application form [For Top Up-Individual case ] (Updated: 16 Dec 2014) [Sample] (Updated: 24 Dec 2014)
Form [S6] FATCA-Declaration for an Entity [For Top Up-Corporate case] (Updated: 16 Dec 2014)
Form [S9] Switch / Redirection instruction (For Fund Switching and Redirection) (Updated: 27 Oct 2022)
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