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Oracle Landed Cost Management

This document contains a declaration and authorization section of a life insurance application form. The applicant declares that all information provided is complete and true. The applicant authorizes the insurance company to obtain medical reports if necessary. The applicant and policy owner signatures are required, with the policy owner signature only needed if the insured is under age 16. Contact information is also provided for the financial services consultant processing the application.

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39 views

Oracle Landed Cost Management

This document contains a declaration and authorization section of a life insurance application form. The applicant declares that all information provided is complete and true. The applicant authorizes the insurance company to obtain medical reports if necessary. The applicant and policy owner signatures are required, with the policy owner signature only needed if the insured is under age 16. Contact information is also provided for the financial services consultant processing the application.

Uploaded by

rpillz
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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12. Remarks – Please provide any additional information which you feel will be helpful in processing your application.

Declaration and Authorisation


I hereby declare and agree that the above particulars and answer are complete and true, and this questionnaire will form part of the contract for the desired insurance on
my life. I also authorise AIA Singapore Private Limited to obtain, if necessary, confidential reports from any doctor/clinic/hospital that I have referred above.

Signature of Policy Owner


Signature of Insured * Applicable if Insured is under age 16

Date Date

FSC/IR’s Name FSC/IR’s Code FSC/IR Unit Name Mobile No.

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