Quilter International policies do not apply to these forms， please get it via Service Log to principal. (Updated: 13 Feb 2023)
SAMPLE FOR REFERENCE ONLY!
New Business Forms
Form [C4] Customer Protection Declaration (Updated: 16 Mar 2018)
Form [F1] Financial Needs Analysis (Updated: 18 Dec 2020)
Form [I5] International Tax Compliance (ITC) Form - Individuals (For New Application, Surrender & Withdrawal) (Updated: 10 May 2021)
Form [I6] International Tax Compliance (ITC) Form - Entities (For Corporate New Application, Surrender & Withdrawal) (Updated: 29 Nov 2019)
Form [R1] Select Additional Premium Request (Updated: 13 Feb 2018) - (Select will no longer accept NB submission and top-up from 23 May 2018).
Form [R2] Regular Premium Reduction Request Form (Updated: 23 Apr 2019) (For Decrease Premium)
Form [S1] Source of Funds Questionnaire (Updated: 23 Apr 2019)
(For Assignment; Top-up-Regular Premium; New application Choice)
Form [S3] Specimen Signature Form (Updated: 23 Apr 2019)
Form [S5] Supplementary Acknowledgement Form (Updated: 30 May 2016)
Form [U1] US National Declaration (Updated: 23 Apr 2019)
Form [V2] Verification of Corporate or Trustee Applicant Identity (For Corporate Application) (Updated: 23 Apr 2019)
POS Forms
Form [A1] Alteration of Funds (Updated: 17 Dec 2020) (For Fund Switching / Redirection)
Form [C1] Payment Card Mandate Form (Updated: 29 Nov 2019)
(For Assignment; New Expiry Date of Credit Card; Outstanding Payment; Reinstatement; Top-up-Regular Premium)
Form [C2] Change of Address Form (Update Personal Details) (Updated:27 Jul 2022)
Form [C5] Claim for Death Benefit (Updated: 29 Nov 2019)
Form [D1] Deed of Assignment (For Assignment) (Updated: 23 Apr 2019)
(For Assignment; Decrease Premium; Outstanding Payment; Reinstatement; Top-up-Regular Premium; new application Choice)
Important facts statement and applicant's declarations for Single Premium TOP UP applications and New application of Select ( Please submit original form. If it is a softcopy, client is required to sign on each page.)
Form [I7] Income Payment Request (Updated: 29 Nov 2019)
Form [I8] Investment Service Authority (Updated: 29 Dec 2025)
Form [L1] Letter of Transfer In Servicing Agent (For Transfer in Servicing Agent)
Form [N1] Never Received / Lost of Policy Declaration (Updated: 23 Apr 2019) (For Lost of Policy; Surrender)
Form [N2] Nomination of Beneficiary Form (For Beneficiary) (Updated: 29 Nov 2019)
Form [M1] Managing Arrears on your Vision Plan (For premium suspension/ payment of arrears/ cancellation of arrears) (Updated: 15 Jul 2021)
Form [P2] Payment Instruction Form - For International - Choice, Vision or FOCUS plan (Updated: 23 Apr 2019) For Assignment; Decrease Premium; Outstanding Payment; Reinstatement; Top-up-Regular Premium)
Form [R3] Regular Contribution and Single Top Up Request Form (For use with FOCUS, Vision and Choice) (Updated: 29 Nov 2019)
Form [S2] Partial Surrender Request (Updated: 11 Aug 2025) - (For Encashment / Partial Surrender / Withdrawal)
Form [S4] Full Surrender Request (Updated: 18 Dec 2025)
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