–BankAccount更改缴费方式及直接付款授权书-银行户口.PDFVIP

Change of Payment Mode and Direct Debit Authorization Form – Bank Account 更改繳費方式及直接付款授權書－銀行戶口 Please darken the appropriate circle. Correct form 　 請塗黑適當的選項。 正確方式為：● Policy Number 保單號碼 Name of Policyowner * Please complete the boxes and darken the appropriate numbered circles to 保單持有人姓名 indicate the policy number. 請填寫方格和塗黑適當號碼格，以註明保單號碼。 Name of Life Assured