更改地址和通讯资料申请书.PDFVIP

Change Address Contact Information Form 更改地址及通訊資料申請書 Form submitted through consultant 表格經顧問遞交 (Consultant Code 顧問編號: ) Customer Information 客戶資料 Policy Owner ID / Policy No Name of Policy Owner Passport No. 保單號碼 保單主權人姓名 保單主權人身份證 或護照號碼 Important Notes 重要事項 1. If a PO Box is used as correspondence address, you must provide residential address as well. 如以郵政信箱為通訊地址，請同時提供住址。 2. Please provide at least one contact no. All contact no(s). should be with Country Code and it will be defaulted as Hong Kong if not provided. 請最少提供一個電話號碼。所 有電話號碼需包含國家代碼，如沒有提供 ，國家代碼將設定為香港。 3. You may return the completed form to our Customer Services by fax at (852) 2103 8938 閣下可以選擇將完成表格傳真至(852) 2103 8938 本公司之客戶服務部收 。 1. Change of Correspondence Address 更改通訊地址 The following address applies to 以下新地址將適用於： ALL policies under my ownership 本人為保單主權人之所有保單 Only the specified policy(ies) written above 此表格上方列明之保單 If no instruction is provided, the new address will be applied to all policies under your ownership 如不作出指示，新地址將適用於閣下作為保單主權人之所有保單 。 Room/Flat 室 Floor 樓數 Block 座 Name of Building 大廈名稱 Name of Estate 屋苑名稱 No of Street Street Name/Lot No. 街道號碼及名稱/地段號數 District/City/Postal Code 區域/城市/郵遞號碼 Hong Kong 香港 Kowloon 九龍 New Territories 新界 Other Countries (Please specify): 其他國家(請註明) If