商业保险补充表格-英国保诚.PDF

Supplementary Form for Business Insurance 商業保險補充表格 Proposal No. / Policy No. CONFIDENTIAL 保密 申請書編號 / 保單編號 BIF IMPORTANT NOTE 重要提示：  Any changes or amendments in this form must be countersigned by the Account Holder (in general includes proposer / policyowner, collateral assignee and beneficiary) in full signature. 帳戶持有人(一般包括投保人/保單持有人，抵押轉讓之承讓人及受益人)必須在此表格內任何更改或修 改的地方簽署作實。  This is a self-certification form provided by Account Holder to a reporting financial institution for the purpose of automatic exchange of financial account information. The data collected may be transmitted by the reporting financial institution to the Inland Revenue Department for transfer to the tax authority of another jurisdiction. 這是帳戶持有人向申報財務機構提供的自我證明表格，以作自動交換財務帳戶資料用途。申報財務機構可把收 集所得的資料交給稅務局，稅務局會將資料轉交到另一稅務管轄區的稅務當局。  Account Holder should report all changes in its tax residency status to the reporting financial institution. 如帳戶持有人的稅務居民身分有所改變， 應盡快將所有變更通知申報財務機構。  Entity includes company. Please read instructions and glossary for full definition in below websites before completing the form: 實體包括公司。填表前請先細閱以下連結之指引及定義摘要以知詳細解釋： CRS .hk/eng/tax/aeoi/self_cert.htm 《共同匯報標準》： FATCA 《海外帳戶稅收合規法案》： /businesses/corporations/foreign-account-tax-compliance-act-fatca Part I Identification of Entity 第一部分 實體身分識辨資料  Questions 1-5 are mandatory. 必須回答以下問題1-5 。 1. Name of Entity (Account Holder) 實體名稱 (帳戶持有人) 2. Name and Title of Authorised Signatory Name : Title : 授權人姓名及職銜 姓名 職銜 3. Business Registration No. 商業登記號碼 4. Country of Incorporation /