diff --git a/src/main/java/com/ffii/lioner/config/WebConfig.java b/src/main/java/com/ffii/lioner/config/WebConfig.java index 5de3580..7526050 100644 --- a/src/main/java/com/ffii/lioner/config/WebConfig.java +++ b/src/main/java/com/ffii/lioner/config/WebConfig.java @@ -14,6 +14,16 @@ public class WebConfig implements WebMvcConfigurer { @Value("${host.url}") private String url; + + + @Override + public void addCorsMappings(CorsRegistry registry) { + registry.addMapping("/**") + .allowedHeaders("*") + .allowedOrigins("*") + .exposedHeaders("filename") + .allowedMethods("GET", "POST", "PUT", "DELETE", "HEAD", "OPTION"); + } // @Override // public void addCorsMappings(CorsRegistry registry) { @@ -24,14 +34,14 @@ public class WebConfig implements WebMvcConfigurer { // .allowedMethods("GET", "POST", "PUT", "PATCH", "DELETE", "HEAD"); // } - @Override - public void addCorsMappings(CorsRegistry registry) { - registry.addMapping("/**") - .allowedOrigins("http://localhost:3000") // *Adjust to your React app's URL* - .allowedMethods("GET", "POST", "PUT", "DELETE", "OPTIONS") - .allowedHeaders("*") - .allowCredentials(true); - } + // @Override + // public void addCorsMappings(CorsRegistry registry) { + // registry.addMapping("/**") + // .allowedOrigins("http://localhost:3000") // *Adjust to your React app's URL* + // .allowedMethods("GET", "POST", "PUT", "DELETE", "OPTIONS") + // .allowedHeaders("*") + // .allowCredentials(true); + // } @Bean public InternalResourceViewResolver defaultViewResolver() { diff --git a/src/main/java/com/ffii/lioner/modules/lioner/web/PdfController.java b/src/main/java/com/ffii/lioner/modules/lioner/web/PdfController.java index 580f5f3..5dd2c3b 100644 --- a/src/main/java/com/ffii/lioner/modules/lioner/web/PdfController.java +++ b/src/main/java/com/ffii/lioner/modules/lioner/web/PdfController.java @@ -14,6 +14,7 @@ import org.springframework.http.HttpHeaders; import org.springframework.http.HttpStatus; import org.springframework.http.MediaType; import org.springframework.http.ResponseEntity; +import org.springframework.web.bind.annotation.CrossOrigin; import org.springframework.web.bind.annotation.GetMapping; import org.springframework.web.bind.annotation.PostMapping; import org.springframework.web.bind.annotation.RequestBody; @@ -23,9 +24,11 @@ import org.springframework.web.bind.annotation.RestController; import org.springframework.web.multipart.MultipartFile; @RestController -@RequestMapping("/api/pdf") -public class PdfController { +@RequestMapping("/pdf") +@CrossOrigin(origins = "", allowedHeaders = "") +public class PdfController { + // Endpoint to serve the initial template PDF @GetMapping(value = "/template", produces = MediaType.APPLICATION_PDF_VALUE) public ResponseEntity getPdfTemplate() throws IOException { @@ -42,6 +45,7 @@ public class PdfController { HttpHeaders headers = new HttpHeaders(); headers.setContentDispositionFormData("inline", "template_form.pdf"); headers.setContentType(MediaType.APPLICATION_PDF); + System.out.println("chk+ " + pdfBytes); return new ResponseEntity<>(pdfBytes, headers, HttpStatus.OK); } diff --git a/src/main/resources/static/HSBC B24102883_fillable_Financial Needs Analysis for Individual Nov2024.pdf b/src/main/resources/static/HSBC B24102883_fillable_Financial Needs Analysis for Individual Nov2024.pdf new file mode 100644 index 0000000..7a1e503 --- /dev/null +++ b/src/main/resources/static/HSBC B24102883_fillable_Financial Needs Analysis for Individual Nov2024.pdf @@ -0,0 +1,992 @@ + HSBCFIN + +PICS 2020Jun (CRS) (Nov 2024) + + Financial Needs Analysis (for Policyholder) + ৌਕცࠅʱؓ‫€ࣸڌ‬Զҳ‫ڭ‬ɛ෬ᄳ + +Note: Please answer all questions in this form. Do NOT sign on this form if any questions are unanswered and + have not been crossed out. + +ൗ : ሗΫഈৌਕცࠅʱؓ‫ࣸڌ‬ʫٙ‫ה‬ϞਪᕚfνϞ΂О͊Ϋഈٙਪᕚ͊஗м̘dሗʔࠅί‫ࣸڌ‬ɪᖦ໇f + +YOUR PROFILE આٙࡈɛ༟ࣘ Name in Chinese (if any) ʕ˖֑Τ€νϞ + Name in English ߵ˖֑Τ + +Gender ‫׌‬й Date of Birth ̈͛˚ಂ + +Marital Status ੎‫رًۿ‬ Number of dependents બԶቮɛᅰͦ + +Occupation ᔖุ Contact number ᑌഖཥ༑ + +Education Level ઺ԃ೻‫ܓ‬ Completed Secondary ʕኪଭุ + Primary 6 or below ʃʬ‫˸א‬ɨ Others Չ˼ + University or above ɽኪ‫˸א‬ɪ + +YOUR FINANCIAL INFORMATION આٙৌਕ༟ࣘ + +Average Monthly Income in the past 2 years [A] USD ߕʩ +(Examples: personal income and other types of income such as dividends, interest, rental income, +etc.) USD ߕʩ +ཀ̘Շϋٙӊ˜̻ѩϗɝ€Է : ࡈɛϗɝʿՉ˼ᗳۨٙϗɝdԷνٰࢹdлࢹdॡ‫ږ‬ϗɝഃ USD ߕʩ + USD ߕʩ +Average Monthly Expenses in the past 2 years [B] USD ߕʩ +(Examples: living expenses, repayment of loans, rent/mortgage redemption, existing life and Year ϋ +general insurance premiums, etc.) USD ߕʩ +ཀ̘Շϋٙӊ˜̻ѩක˕€Է : ͛‫̈˕ݺ‬d൲ಛᒔಛdॡ‫ږ‬Ŋܲ౧ᒔಛdତϞɛྪʿɓছ‫ڭ‬ᎈ‫ڭ‬൬ഃ + +Monthly Repayment Amount of Existing Premium Financing (if applicable) [C] = [Y] + [Z] +ӊ˜ٙତϞ‫ڭ‬൬ፄ༟ᒔಛᕘ€νቇ͜ + +Monthly Interest Repayment Amount [Y] +ӊ˜ٙ‫ڭ‬൬ፄ༟лࢹᒔಛᕘ + +Monthly Principal Repayment Amount [Z] +ӊ˜ٙ‫ڭ‬൬ፄ༟͉‫ږ‬ᒔಛᕘ + +Remaining Repayment Tenor of Existing Premium Financing (if applicable) [D] +௵ቱٙତϞ‫ڭ‬൬ፄ༟ᒔಛϋಂ€νቇ͜ +Note: Take the longest tenor if having more than one premium financing facility(ies) +ൗ : νܵϞε‫׵‬ɓධ‫ڭ‬൬ፄ༟τરd˸௰‫ڗ‬ϋಂ‫މ‬๟ + +Monthly Disposable Income ӊ˜̙ਗ͜ϗɝ [E] = [A] - [B] - [C] + +HSBC Life (International) Limited Incorporated in Bermuda with limited liability ‫׵‬ϵᅉ༺ൗ̅ϓͭʘϞࠢʮ̡ +滙 豐 人 壽 保 險（ 國 際 ）有 限 公 司 Hong Kong SAR Office Address: 18/F, Tower 1, HSBC Centre, 1 Sham Mong Road, Kowloon, Hong Kong + ࠰ಥतйБ݁ਜ፬ԫஈήѧj࠰ಥɘᎲଉ‫׶‬༸ 1 ໮䁩ᔮʕː 1 ࢭ 18 ᅽ + +Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓ‫€ࣸڌ‬Զҳ‫ڭ‬ɛ෬ᄳ Page ࠫϣc1/15 + ASSETS AND LIABILITIES ༟ପʿࠋව + +Liquid Assets [F] USD ߕʩ +‫ݴ‬ਗ༟ପ +Note: Liquid assets are assets which can be easily turned into cash. Real estate, coin collection USD ߕʩ +and artwork are not considered to be liquid assets. +ൗ : ‫ݴ‬ਗ༟ପܸ̙݊˸࢙‫׸‬ᜊ‫މ‬ତ‫ږ‬ٙ༟ପf‫ุي‬e፺࿆ϗᔛʿᖵஔۜѩʔ஗ൖ‫ݴމ‬ਗ༟ପf USD ߕʩ +Examples: cash, savings in bank accounts & money market accounts, actively traded stocks, bonds USD ߕʩ +and mutual funds, US Treasury bills, etc. USD ߕʩ +Է : ତ‫ږ‬eვБሪ˒ʿ஬࿆̹ఙሪ˒πಛeʹҳ‫ݺ‬ᚔٰٙୃeවՎʿʝ౉ਿ‫ږ‬eߕ਷਷ࢫවՎഃ USD ߕʩ + +Other Personal Loans and Debts [G] +Չ˼ࡈɛ൲ಛʿවਕ +Examples: credit card loan, outstanding investment financing facilities, overdraft and any other +personal loans, etc. +Է : ‫̔͜ڦ‬൲ಛe͊Ꮅᒔٙҳ༟ፄ༟൲ಛeீ˕ʿ΂ОՉ˼ࡈɛ൲ಛഃ + +Outstanding Premium(s) of Pending Application(s)* and Existing Life Insurance to be paid by Liquid +Assets [H] +˸‫ݴ‬ਗ༟ପᖮ˹͍ίҳ‫ * ڭ‬ʿତϞɛྪ‫ڭ‬ఊٙ‫ڭ‬൬ +* Pending Application(s) refers to any life insurance application(s) other than this application that + + you have submitted to other insurer(s) and/or HSBC Life and the premium(s) of which will be + paid by you. ͍ίҳ‫ڭڭ‬ఊܸ݊ৰ͉͡ሗ̮આٙ΂Оʊ౤ʹʚՉ˼‫ڭ‬ᎈʮ̡ʿŊ‫א‬䁩ᔮ‫ڭ‬ᎈʿਗ਼͟આ + ᖮ˹‫ڭ‬൬ٙՉ˼ɛྪ‫ڭ‬ఊ͡ሗf + +Outstanding Repayment Amount of Existing Premium Financing (if applicable) +[I] = [C] x 12 x [D] +௵ቱٙ‫ڭ‬൬ፄ༟ᒔಛᕘ ( νቇ͜ ) + +Net Liquid Assets ଋ‫ݴ‬ਗ༟ପ [K] = [F] – [G] – [H] – [I] + +Outstanding Principal of Existing Premium Financing (if applicable) [J] +͊Ꮅᒔٙ‫ڭ‬൬ፄ༟͉‫€ږ‬νቇ͜ + +YOUR GOALS આٙͦᅺ +1. What are your objectives for seeking to purchase an insurance product? (tick one or more) + + ტɨ፯ᒅ‫ڭ‬ᎈପۜٙͦᅺ‫މ‬О ?€ʵ፯ɓධ‫א‬εධ + a) Financial protection against adversities (e.g. death, accident, disability etc) + ‫މ‬Ꮠ˹ʔࣛʘც౤Զৌਕ‫ڭ‬ღ€ԷνjԒ݂dจ̮dಞशഃ + b) Preparation for health care needs (e.g. critical illness, hospitalization etc) + ‫މ‬Ꮠ˹ᔼᐕ‫ڭ‬਄ცࠅ€ԷνjΚशdИ৫ഃ + Critical Illness Κश + + Medical Indemnity ᔼᐕሦᎵ + + Long Term Care ‫ڗ‬ಂᚐଣ + c) Providing regular income in the future (e.g. retirement income etc) + + ‫͊މ‬Ը౤Զ֛ಂٙϗɝ€Էνjৗ;ϗɝഃ + d) Saving up for the future (e.g. child education, retirement etc) + + ‫͊މ‬ԸცࠅЪᎷႅ€Էνjɿɾ઺ԃdৗ;ഃ + e) Investment ҳ༟ + + To meet your “Investment” objective indicated above, how would you prefer to manage different investment options/investment + choices, if available, under the insurance product? (tick one) + ‫ྼމ‬ତɪࠑ˜ҳ༟™ٙͦᅺdტɨҎૐνО၍ଣ‫ڭ‬ᎈପۜධɨٙʔΝҳ༟፯ධŊҳ༟፯኿€νϞk€ʵ፯ɓධ + + I want to make my own decisions (without any professional advice to be provided by the authorized insurer and/or licensed + insurance intermediaries) to choose and manage different investment options/investment choices, if available, under an + insurance product, and I am willing to do it throughout the entire duration of the target benefit/protection period of an + insurance product + ͉ɛᗴจܲࡈɛӔ֛€ˡ඲ᐏબᛆ‫ڭ‬ᎈɛʿŊ‫ܵא‬೐‫ڭ‬ᎈʕʧɛ౤Զ΂Оਖ਼ุจԈٙઋ‫ر‬፯኿ʿ၍ଣ‫ڭ‬ᎈପۜධɨٙʔΝҳ༟፯ධ + Ŋҳ༟፯኿€νϞdԨ˲ᗴจί‫ڭ‬ᎈପۜٙͦᅺлूŊ‫ڭ‬ღಂٙ዆ࡈಂගЪ̈ϤӔ֛f + + I want to make my own decisions (with professional advice to be provided by the authorized insurer and/or licensed + insurance intermediaries) to choose and manage different investment options/investment choices, if available, under an + insurance product, and I am willing to do it throughout the entire duration of the target benefit/protection period of an + insurance product + ͉ɛᗴจܲࡈɛӔ֛€຾ᐏબᛆ‫ڭ‬ᎈɛʿŊ‫ܵא‬೐‫ڭ‬ᎈʕʧɛ౤Զਖ਼ุจԈٙઋ‫ر‬፯኿ʿ၍ଣ‫ڭ‬ᎈପۜධɨٙʔΝҳ༟፯ධŊҳ༟ + ፯኿€νϞdԨ˲ᗴจί‫ڭ‬ᎈପۜٙͦᅺлूŊ‫ڭ‬ღಂٙ዆ࡈಂගЪ̈ϤӔ֛f + + I do not want to choose or manage different investment options/investment choices, if available, under an insurance product + ͉ɛʔᗴจ፯኿‫א‬၍ଣ‫ڭ‬ᎈପۜධɨٙʔΝҳ༟፯ධŊҳ༟፯኿€νϞf + + f) Others Չ˼€Please specify ሗႭ‫׼‬ +  + +Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓ‫€ࣸڌ‬Զҳ‫ڭ‬ɛ෬ᄳ Page ࠫϣc2/15 + TOTAL PROTECTION AND SAVINGS NEEDS + +2a) Life Protection needs ɛྪ‫ڭ‬ღცࠅ + + If you have selected “Financial protection against adversities” or¨Others©(a protection-related objective) as one of your objective(s) of + buying an insurance product in question 1, please answer the below question. (Please choose only one option) + + νტɨ‫׵‬ɪࠑਪᕚ 1 ʕ፯኿˜‫މ‬Ꮠ˹ʔࣛʘც౤Զৌਕ‫ڭ‬ღ™‫˜א‬Չ˼™€‫ڭ‬ღٙ޴ᗫͦᅺЪ‫މ‬፯ᒅ‫ڭ‬ᎈପۜٙՉʕɓࡈͦᅺdሗΫഈ˸ɨਪᕚf + €ሗ̥፯኿ɓධ + +The target life protection amount for the proposed Life Insured in this life insurance application is வ΅ɛྪ‫ڭ‬ᎈ͡ሗʕٙ๟ա‫ڭ‬ɛٙ + +ͦᅺɛྪ‫ڭ‬ღ‫ږ‬ᕘ‫ މ‬US$ ߕʩ . + +I wish to go through an evaluation to determine the life protection amount for the proposed Life Insured in this life insurance +application: +͉ɛҎૐீཀආБ൙П˸੻̈வ΅ɛྪ‫ڭ‬ᎈ͡ሗʕٙ๟ա‫ڭ‬ɛٙɛྪ‫ڭ‬ღ‫ږ‬ᕘ +[Note: Please conduct this evaluation for vulnerable customer.] +[ ൗ : ሗ‫މ‬तйᗫᚥٙ‫˒܄‬ආБϤ൙П ] + +Evaluation ൙П US$ ߕʩ + + +Family protection (e.g. living expenses of dependents, etc.) +࢕ࢬ‫ڭ‬ღ€ԷjաԶቮɛٙ͛‫ݺ‬ක˕ഃ + +Liabilities ࠋව + +Assets ༟ପ – + +Existing life insurance coverage, including group insurance benefits, etc. – +ତϞɛྪ‫ڭ‬ღܼ̍ྠ᜗ɛྪ‫ڭ‬ღഃ + +Protection amount I am looking for is estimated to be = + +͉ɛరӋٙ‫ڭ‬ღ‫ږ‬ᕘПၑ‫މ‬ + +Target life protection amount for the proposed Life Insured in this life insurance application is estimated to be வ΅ɛྪ‫ڭ‬ᎈ͡ሗʕٙ + +๟ա‫ڭ‬ɛٙͦᅺɛྪ‫ڭ‬ღ‫ږ‬ᕘߒ‫ މ‬US$ ߕʩ . + +2b) Critical Illness Protection Needs Κश‫ڭ‬ღცࠅ + If you have selected “Preparation for health care needs – Critical Illness” as one of your objective(s) of buying an insurance product in + question 1, please answer the below question. + νტɨ‫׵‬ɪࠑਪᕚ 1 ʕ፯኿˜‫މ‬Ꮠ˹ᔼᐕ‫ڭ‬਄ცࠅ – Κश™Ъ‫މ‬፯ᒅ‫ڭ‬ᎈପۜٙՉʕɓࡈͦᅺdሗΫഈ˸ɨਪᕚf + +The target critical illness protection amount for the life insured in this life insurance application is வ΅ɛྪ‫ڭ‬ᎈ͡ሗʕٙ๟ա‫ڭ‬ɛͦᅺΚ + +श‫ڭ‬ღ‫ږ‬ᕘ‫ މ‬US$ ߕʩ . + +2c) Savings Needs Ꮇႅცࠅ + + If you have selected “Providing regular income in the future” or “Saving up for the future” or “Investment” or “Others” (a wealth + accumulation-related objective) as one of your objective(s) of buying an insurance product in question 1, please answer the below + question. (Please choose only one option) + + νტɨ‫׵‬ɪࠑਪᕚ 1 ʕ፯኿˜‫͊މ‬Ը౤Զ֛ಂٙϗɝ™i‫͊މ˜א‬ԸცࠅЪᎷႅ™i‫˜א‬ҳ༟™i‫˜א‬Չ˼™€ৌబᄣ࠽ٙ޴ᗫͦᅺЪ‫މ‬፯ᒅ‫ڭ‬ᎈପۜ + ٙՉʕɓࡈͦᅺdሗΫഈ˸ɨਪᕚf€ሗ̥፯኿ɓධ + +My target saving amount on ( years) to be addressed by this life insurance application is ͉ɛ€‫׵‬ ϋீཀ + +வ΅ɛྪ‫ڭ‬ᎈ͡ሗ༺ߧٙͦᅺᎷႅ‫ږ‬ᕘ‫ މ‬US$ ߕʩ . + +I do not have a specific target saving amount, but I would like to use the total amount of premium payment for savings purpose. ͉ +ɛӚϞɓࡈत֛ཫಂࠅ༺ՑٙᎷႅ‫ږ‬ᕘdШ͉ɛึ͜ᖮ˹‫ڭ‬൬ٙᐼ‫ږ‬ᕘЪᎷႅʘ͜f + +3. What is your target benefit/protection period/expected timeframe for meeting the target amount for insurance policy? (tick one) + ტɨٙ‫ڭ‬ఊͦᅺлूŊ‫ڭ‬ღಂŊྼତͦᅺ‫ږ‬ᕘٙཫಂࣛග‫މ‬k€ʵ፯ɓධ + +< 1 year ϋ 1-5 years ϋ 6-10 years ϋ + +11-15 years ϋ 16-20 years ϋ > 20 Years ϋ +Whole of life ୞Ԓ + +Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓ‫€ࣸڌ‬Զҳ‫ڭ‬ɛ෬ᄳ Page ࠫϣc3/15 + 4. Your ability and willingness to pay insurance premiums ტɨᖮ˹‫ڭ‬൬ٙঐɢʿจᗴj + For how long are you able and willing to pay for an insurance policy? (tick one) + ტɨঐ੄ʿᗴจ‫ڭމ‬ఊ˕˹‫ڭ‬൬ٙϋಂ‫€? މ‬ʵ፯ɓධ + +2-5 years ϋ 6-10 years ϋ 11-15 years ϋ 16-20 years ϋ + +> ൴ཀ 20 Years ϋ + +Whole of life ୞Ԓ + +A single payment ɓϣ‫˹׌‬ಛ + +5. My planned/actual retirement age is ͉ɛཫಂŊྼყৗ;ϋᙧ‫މ‬j + +6. Will the premium payment term go beyond your planned/actual retirement age? ‫ڭ‬൬ᖮ˹ಂਗ਼൴൳આٙཫಂŊྼყৗ;ϋᙧk + +½ Yes ݊ + +½ No щ + +½ N/A (since single payment is selected as premium payment mode) ʔቇ͜€͟‫׵‬፯኿ᙌᖮЪ‫ڭމ‬൬ᖮ˹˙ό + +If ‘Yes’ is chosen above, please specify the source(s) of funds and provide the following information to facilitate affordability +assessment: + +νɪࠑഈࣩ፯኿˜݊™dሗႭ‫׼‬༟‫ږ‬ٙԸ๕ʿ౤Զ˸ɨ༉ઋ˸‫ک‬՘п൙Пტɨٙࠋዄঐɢj + +½ Expected monthly income following retirement ཫಂৗ;‫ܝ‬ٙӊ˜ϗɝ : US$ ߕʩ + Please specify source(s) of funds ሗႭ‫׼‬༟‫ږ‬ٙԸ๕ : + +½ Expected one-off amount receivable following retirement ཫಂৗ;‫ܝ‬ɓϣ‫੻̙׌‬ٙ‫ږ‬ᕘ : US$ ߕʩ + Please specify source(s) of funds ሗႭ‫׼‬༟‫ږ‬ٙԸ๕ : + +(Please complete the following if your monthly expenses following retirement will be different from your monthly expenses stated in +YOUR FINANCIAL INFORMATION above)€νტɨৗ;‫ܝ‬ٙӊ˜ක˕ၾɪࠑઆٙৌਕ༟ࣘٙӊ˜ක˕ʔ޴ୌdሗҁϓ˸ɨ௅΅ + +Expected monthly expense following retirement ཫಂৗ;‫ܝ‬ٙӊ˜ක˕ : US$ ߕʩ + +Please state the reason why your monthly expense following retirement will be different from your monthly expenses stated in YOUR +FINANCIAL INFORMATION above ሗႭ‫׼‬ৗ;‫ܝ‬ٙӊ˜ක˕ၾɪࠑઆٙৌਕ༟ࣘٙӊ˜ක˕ʔΝٙࡡΪ : + +Remarks ௪ൗ : + +• Monthly Disposable Income you have before retirement will not be used to assess your affordability for any premium payable + after your retirement. Monthly Disposable Income you expect to have following retirement will only be relevant for assessing your + affordability for any premium payable after your retirement. ტɨৗ;‫ۃ‬ٙӊ˜̙ਗ͜ϗɝਗ਼ʔึ͜Ъ൙Пტɨৗ;‫ܝ‬ცᖮ˹΂О‫ڭ‬൬ٙ + ࠋዄঐɢfϾტɨཫಂৗ;‫ܝ‬ٙӊ˜̙ਗ͜ϗɝ̥ึ͜Ъ൙Пტɨৗ;‫ܝ‬ცᖮ˹΂О‫ڭ‬൬ٙࠋዄঐɢf + +• Expected one-off amount receivable following retirement (if any) is only relevant to the assessment of your affordability for premium + payable after your retirement. ტɨཫಂৗ;‫ܝ‬ɓϣ‫੻̙׌‬ٙ‫ږ‬ᕘ€νϞ̥ึ͜Ъ൙Пტɨৗ;‫ܝ‬ٙᖮ˹‫ڭ‬൬ࠋዄঐɢf + +• If you choose to pay premium with net liquid asset and your monthly disposable income < 0, the shortfall in living expenses would + be first deducted from your net liquid assets before we conduct the affordability assessment. νტɨ፯኿˸ଋ‫ݴ‬ਗ༟ପᖮ˹‫ڭ‬൬Ͼტ + ɨٙӊ˜̙ਗ͜ϗɝ <0dҢࡁਗ਼ίආБࠋዄঐɢ൙Пʘ‫੽ۃ‬ტɨٙଋ‫ݴ‬ਗ༟ପϔಯ͛‫ݺ‬ක˕ٙʔԑᕘf + +Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓ‫€ࣸڌ‬Զҳ‫ڭ‬ɛ෬ᄳ Page ࠫϣc4/15 + 7. In considering your ability and willingness to make payments, what is/are your source(s) of funds? (You can choose more than one + option) + ఱტɨᖮ˹‫ڭ‬൬ٙঐɢʿจᗴdሗਪტɨٙ༟‫ږ‬Ը๕‫€? މ‬ტɨ̙፯ε‫׵‬ɓධ + + Disposable income, including salary, income, etc. ̙ਗ͜ϗɝdܼ̍ᑚཇdϗɝഃ + + Net liquid assets, including savings, investments, etc. ଋ‫ݴ‬ਗ༟ପdܼ̍Ꮇႅdҳ༟ഃ + + Premium Financing ‫ڭ‬൬ፄ༟ + + Others Չ˼ ^ + + Please specify the source(s) of funds ሗႭ‫׼‬༟‫ږ‬Ը๕j + + Expected monthly income starting in a month ཫಂɓࡈ˜ʫਗ਼ක֐ٙӊ˜ϗɝjUS$ ߕʩ + + Expected one-off amount in a month ཫಂɓࡈ˜ʫ̙੻ٙɓϣ‫ږ׌‬ᕘjUS$ ߕʩ + + ^ If any, expected monthly income starting in a month and expected one-off amount in a month from other source(s) of funds are + considered as part of your disposable income and your net liquid assets respectively for assessing your ability and willingness to pay + insurance premiums. + νϞd͟Չ˼༟‫ږ‬Ը๕‫੻ה‬ٙཫಂɓࡈ˜ʫਗ਼ක֐ٙӊ˜ϗɝʿཫಂɓࡈ˜ʫ̙੻ٙɓϣ‫ږ׌‬ᕘਗ਼ʱйॶɝίტɨ̙ٙਗ͜ϗɝʿଋ‫ݴ‬ਗ + ༟ପd˸Ъ൙Пტɨᖮ˹‫ڭ‬൬ٙঐɢʿจᗴf + +8a) If you have selected “Disposable income, including salary, income, etc.” as one of your sources of funds in question 7, please answer + the below question. + νტɨ‫׵‬ɪࠑਪᕚ 7 ʕ፯኿˜̙ਗ͜ϗɝdܼ̍ᑚཇdϗɝഃ™Ъ‫މ‬༟‫ږ‬Ը๕dሗΫഈ˸ɨਪᕚf + + What percentage of your monthly disposable income (i.e. after deducting the expenditure) from all sources (including income from liquid + assets) would you be able and willing to use to pay for the insurance premium (including your existing insurance policy(ies)) throughout + the entire term of the insurance policy? (tick one) + ί዆ࡈ‫ڭ‬ఊಂʫdტɨঐ੄ʿᗴจᖮ˹ٙ‫ڭ‬൬€ܼ̍ტɨତϞٙՉ˼‫ڭ‬ఊЦீཀ‫ה‬ϞϗɝԸ๕€ܼ̍‫ݴ‬ਗ༟ପϗɝᐏ੻ٙӊ˜̙ਗ͜ϗɝ€у + ຾ϔৰක˕ٙˢଟ‫މ‬k€ʵ፯ɓධ + + < 10% + + 10% – 20% + + 21% – 30% + + 31% – 40% + + 41% – 50% + + > 50% + +8b) If you have selected¨Net liquid assets, including savings, investments, etc.” as one of your sources of funds in question 7, please + answer the below question. + νტɨ‫׵‬ɪࠑਪᕚ 7 ʕ፯኿˜ଋ‫ݴ‬ਗ༟ପdܼ̍Ꮇႅdҳ༟ഃ™Ъ‫މ‬༟‫ږ‬Ը๕dሗΫഈ˸ɨਪᕚf + + What percentage of your net liquid assets would you be able and willing to use to pay for the insurance premium (including your existing + insurance policy(ies)) throughout the entire term of the insurance policy? + ί዆ࡈ‫ڭ‬ఊಂʫdტɨঐ੄ʿᗴจᖮ˹ٙ‫ڭ‬൬€ܼ̍ტɨତϞٙՉ˼‫ڭ‬ఊЦტɨଋ‫ݴ‬ਗ༟ପٙˢଟ‫މ‬k + + < 10% + + 10% – 20% + + 21% – 30% + + 31% – 40% + + 41% – 50% + + > 50% + +Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓ‫€ࣸڌ‬Զҳ‫ڭ‬ɛ෬ᄳ Page ࠫϣc5/15 + Please complete by the Licensed Insurance Intermediary if premium financing is selected +νʵ፯‫ڭ‬൬ፄ༟dܵ͟೐‫ڭ‬ᎈʕʧɛ෬ᄳ + +Information on the Proposed Policy with Premium Financing ‫ܔ‬ᙄ‫ڭ‬ఊʘ‫ڭ‬൬ፄ༟༉ઋ + +i. Name of Lender ‫׳‬වɛΤ၈ + +ii. Loan amount ൲ಛ‫ږ‬ᕘ USD ߕʩ + +iii. Loan tenor ൲ಛϋಂ Year ϋ + % +iv. Loan interest rate p.a. ஬ಛϋлଟ + No щ +v. Monthly repayment amount ӊ˜ᒔಛᕘ USD ߕʩ + +vi. Leveraging ratio ࿳૖ˢଟ ^ + +vii. Affordability assessment completed and passed? ࠋዄঐɢ൙Пʊҁϓʿஷཀ ? Yes ݊ + +^ Leveraging ratio = Loan principal of premium financing for proposed policy/(Net liquid assets* – Outstanding principal of existing + premium financing*) + + ࿳૖ˢଟ = ‫ܔ‬ᙄ‫ڭ‬ఊʘ‫ڭ‬൬ፄ༟൲ಛ͉‫ږ‬Ŋ ( ଋ‫ݴ‬ਗ༟ପ * – ͊Ꮅᒔٙ‫ڭ‬൬ፄ༟͉‫)* ږ‬ + +* Refer to¨Your Financial Information©on page 1 + ሗ䎦Ͻୋɓࠫٙœઆٙৌਕ༟ࣘ + +If the ratio is close to or equal to 1, it means that your loan amount is almost as much as or equivalent to your own existing financial +resources (e.g. net liquid assets). Where it exceeds 1, it represents that there will be an over-leveraging risk which means that you +may have to surrender your policy to repay your loan should your lender request for its full repayment before the end of tenor of your +premium financing facility. + +νˢଟટ‫אڐ‬ഃ‫ ׵‬1d‫ͪڌۆ‬ტɨٙ൲ಛ‫ږ‬ᕘ఻˷ഃΝ‫א‬ഃΝ‫׵‬ტɨІʉତϞٙৌਕ༟๕€Էνଋ‫ݴ‬ਗ༟ପf຅ˢଟɽ‫ ׵‬1d‫ڌ˾ۆ‬Ϟཀ‫ܓ‬ +࿳૖ࠬᎈdуνტɨٙවᛆɛ‫ڭ׵‬൬ፄ༟ಂഐҼ‫ࠅۃ‬ӋტɨΌᅰ૶ᒔ൲ಛdტɨ̙ঐცࠅৗ‫ڭ‬ʑঐᎵᒔ༈൲ಛf + +Important note to client: The above loan information provided by the client is solely for the purpose of conducting affordability +assessment# for the client’s current insurance application and it does not constitute any loan terms. The final loan information +including but not limited to loan amount, loan tenor, loan interest rate and monthly repayment amount is subject to credit +underwriting review and approval of the lender. + +‫˒܄‬඲ٝ : ˸ɪ͟‫˒܄‬౤Զٙ൲ಛ༉ઋ̥Ъ൙П‫˒܄‬຅‫ڭۃ‬ᎈ͡ሗٙࠋዄঐɢʘ͜dԨʔ࿴ϓ΂О൲ಛૢಛf௰୞൲ಛ༉ઋdܼ̍Шʔࠢ‫׵‬ +൲ಛ‫ږ‬ᕘd൲ಛϋಂd஬ಛϋлଟʿӊ˜ᒔಛᕘਗ਼՟Ӕ‫׵‬൲ಛዚ࿴ٙ‫ڦ‬൲‫ڭו‬ᄲҭϾ֛f + +# This assessment has taken into account the premium financing intended to be used for the proposed insurance policy. (including + the self-funded portion of the premium, all scheduled repayments (i.e. principal and/or interest repayments, where applicable) + over the entire tenure of premium financing facility, and your ability to repay the sum owed under the premium financing facility + if demanded by the lender before maturity of the policy with sufficient financial resources) + + Ϥ൙ПʊҪอ͡ሗ‫ڭ‬ఊٙ‫ڭ‬൬ፄ༟Ͻᅇίʫf€ܼ̍І༟‫ڭ‬൬ٙ௅΅d‫ڭ‬൬ፄ༟ಂʫٙཫಂᐼක˕˸ʿί൲ಛ˙ࠅӋ౤‫ۃ‬Ꮅᒔ‫ڭ‬൬ፄ༟ + ൲ಛᕘࣛdᆽ‫ڭ‬ტɨϞԑ੄ٙৌ݁༟๕Ꮅᒔ൲ಛ‫ږ‬ᕘ + +Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓ‫€ࣸڌ‬Զҳ‫ڭ‬ɛ෬ᄳ Page ࠫϣc6/15 + 9. Product Recommendation and Selection ପۜ‫ܔ‬ᙄʿ፯኿ + Based on your answers provided on this form, the intermediary concerned has discussed the following insurance options (as available + to the intermediary) to meet your objective(s) and need(s): + ࣬ኽტɨίϤ‫ࣸڌ‬౤ԶٙഈࣩdϞᗫʘ‫ڭ‬ᎈʕʧɛʊၾტɨীሞɨΐٙ‫ڭ‬ᎈପۜ˸တԑტɨٙͦᅺʿცࠅj + + Name of Name of Objective(s) that Product introduced Policy Currency Premium Premium Premium Sum Insured/ + Insurance Insurance Product can be met by the to you and selected ‫ڭ‬ఊ஬࿆ * ‫ڭ‬൬ * Payment Mode Payment Term Policy Amount/ + Company insurance product ‫ڭ‬൬˕˹˙ό * ‫ڭ‬൬˕˹ϋಂ * + ‫ڭ‬ᎈପۜΤ၈ Ϥ‫ڭ‬ᎈପۜঐတԑٙͦᅺ by you (if any) Notional +‫ڭ‬ᎈʮ̡Τ၈ ಀʧୗʿ௰୞፯ᒅ Amount + €νϞٙପۜ ‫ڭ‬ᕘŊ + ‫ڭ‬ఊ‫ږ‬ᕘŊ + Τ່‫ږ‬ᕘ * + + ½ Financial protection ½ Introduced ಀʧୗ + + against adversities ‫ ½ މ‬Introduced and + + Ꮠ˹ʔࣛʘც౤Զৌਕ Selected ಀʧୗʿ௰୞ + + ‫ڭ‬ღ ፯ᒅ + + ½ Preparation for health + + care needs – Critical + + Illness ‫މ‬Ꮠ˹ᔼᐕ‫ڭ‬਄ + + ცࠅ – Κश + + ½ Preparation for health + care needs – Long + Term Care ‫މ‬Ꮠ˹ᔼᐕ + ‫ڭ‬਄ცࠅ – ‫ڗ‬ಂᚐଣ + + ½ Providing regular + income in the future + ‫͊މ‬Ը౤Զ֛ಂٙ + ϗɝ + + ½ Saving up for the + future ‫͊މ‬ԸცࠅᎷႅ + + ½ Investment ҳ༟ + + ½ Others Չ˼j + + ½ Financial protection ½ Introduced ಀʧୗ + + against adversities ‫ ½ މ‬Introduced and + + Ꮠ˹ʔࣛʘც౤Զৌਕ Selected ಀʧୗʿ௰୞ + + ‫ڭ‬ღ ፯ᒅ + + ½ Preparation for health + + care needs – Critical + + Illness ‫މ‬Ꮠ˹ᔼᐕ‫ڭ‬਄ + + ცࠅ – Κश + + ½ Preparation for health + care needs – Long + Term Care ‫މ‬Ꮠ˹ᔼᐕ + ‫ڭ‬਄ცࠅ – ‫ڗ‬ಂᚐଣ + + ½ Providing regular + income in the future + + ‫͊މ‬Ը౤Զ֛ಂٙ + ϗɝ + + ½ Saving up for the + future ‫͊މ‬Ըცࠅ + Ꮇႅ + + ½ Investment ҳ༟ + + ½ Others Չ˼j + +Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓ‫€ࣸڌ‬Զҳ‫ڭ‬ɛ෬ᄳ Page ࠫϣc7/15 + Name of Name of Objective(s) that Product introduced Policy Currency Premium Premium Premium Sum Insured/ + Insurance Insurance Product can be met by the to you and selected ‫ڭ‬ఊ஬࿆ * ‫ڭ‬൬ * Payment Mode Payment Term Policy Amount/ + Company insurance product ‫ڭ‬൬˕˹˙ό * ‫ڭ‬൬˕˹ϋಂ * + ‫ڭ‬ᎈପۜΤ၈ Ϥ‫ڭ‬ᎈପۜঐတԑٙͦᅺ by you (if any) Notional +‫ڭ‬ᎈʮ̡Τ၈ ಀʧୗʿ௰୞፯ᒅ Amount + €νϞٙପۜ ‫ڭ‬ᕘŊ + ‫ڭ‬ఊ‫ږ‬ᕘŊ + Τ່‫ږ‬ᕘ * + + ½ Financial protection ½ Introduced ಀʧୗ + + against adversities ‫ ½ މ‬Introduced and + + Ꮠ˹ʔࣛʘც౤Զৌਕ Selected ಀʧୗʿ௰୞ + + ‫ڭ‬ღ ፯ᒅ + + ½ Preparation for health + + care needs – Critical + + Illness ‫މ‬Ꮠ˹ᔼᐕ‫ڭ‬਄ + ცࠅ – Κश + + ½ Preparation for health + care needs – Long + Term Care ‫މ‬Ꮠ˹ᔼᐕ + ‫ڭ‬਄ცࠅ – ‫ڗ‬ಂᚐଣ + + ½ Providing regular + income in the future + + ‫͊މ‬Ը౤Զ֛ಂٙ + ϗɝ + + ½ Saving up for the + future ‫͊މ‬Ըცࠅ + Ꮇႅ + + ½ Investment ҳ༟ + + ½ Others Չ˼j + +* Required to be completed only if the insurance product(s) is/are being selected ඲෬ᄳν‫ڭ‬ᎈପۜ஗௰୞፯ᒅ + +Note: Reason for only providing 1 insurance company suggestion, if any. +ൗjሗႭ‫̥׼‬౤Զɓ࢕‫ڭ‬ᎈʮ̡‫ܔ‬ᙄٙࡡΪdνቇ͜ + +Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓ‫€ࣸڌ‬Զҳ‫ڭ‬ɛ෬ᄳ Page ࠫϣc8/15 + Please complete by the Licensed Insurance Intermediary +ܵ͟೐‫ڭ‬ᎈʕʧɛ෬ᄳ + + Reason(s) for Recommendation ‫ܔ‬ᙄࡡΪ + + The product(s) listed in the table above was/were recommended to the client with the aim to fulfil the client’s current insurance + needs after considering the client’s financial situation, life protection needs, insurance preferences and ability and willingness to pay + premiums, and striking a balance between the above factors. + ɪ‫ڌ‬ٙପۜ‫ܔ‬ᙄϽᅇՑ‫˒܄‬ٙৌਕً‫ر‬dɛྪ‫ڭ‬ღცࠅd‫ڭ‬ᎈ਋λʿᖮ˹‫ڭ‬൬ٙঐɢձจᗴdԨί΢˙ࠦ՟੻̻ፅd˸တԑ‫˒܄‬຅‫ۃ‬ٙ‫ڭ‬ᎈ + ცࠅf + + Others Չ˼ (Please specify ሗ༉ࠑ ): + + Is there any mismatch(s) against client’s preference in such recommendation? ପۜ‫ܔ‬ᙄ݊щၾ‫˒܄‬ცࠅπί਋ࢨk + + No щ + + Yes, the mismatch(s) is/are ݊d਋ࢨٙઋ‫݊ر‬j + + i. Target protection amount ͦᅺ‫ڭ‬ღ‫ږ‬ᕘ + + ii. Target saving amount ͦᅺᎷႅ‫ږ‬ᕘ + + If yes, reason(s) for recommendation despite the mismatch(s) indicated above ν݊dኋ၍ପۜ‫ܔ‬ᙄၾɪࠑٙ‫˒܄‬ცࠅπί਋ࢨdШʥ + ್‫ܔ‬ᙄٙࡡΪ‫މ‬j + + There is a budget concern to fulfil all of client’s target protection amount and/or target saving amount in this same application. The + mismatch(es), the reason(s) behind the recommendation of the product(s) despite the mismatch(es), as well as the associated risks + that client’s needs could not be fully met by the recommended product(s) have been clearly explained to the client. + ‫˒܄‬ί݊ϣ͡ሗٙཫၑʕ͊ঐ੄တԑՑΌ௅ٙͦᅺ‫ڭ‬ღ‫ږ‬ᕘʿŊ‫ͦא‬ᅺᎷႅ‫ږ‬ᕘfܵ೐‫ڭ‬ᎈʕʧɛʊ૶ูΣ‫˒܄‬༆ᙑϤ਋ࢨdʥ್‫ܔ‬ᙄϤପ + ۜٙࡡΪʿ޴ᗫࠬᎈ˸ߧ‫ܔה׵‬ᙄٙପۜ͊ঐҁΌတԑ‫˒܄‬ٙცࠅf + + Client does not wish to fulfil the entire target protection amount and/or target saving amount with insurance product(s) offered by + the same insurer. The mismatch(es), the reason(s) behind the recommendation of the product(s) despite the mismatch(es), as well + as the associated risks that client’s needs could not be fully met by the recommended product(s) have been clearly explained to the + client. + ‫˒܄‬ʔҎૐ˸Νɓග‫ڭ‬ᎈʮ̡ٙ‫ڭ‬ᎈପۜတԑΌ௅ٙͦᅺ‫ڭ‬ღ‫ږ‬ᕘʿŊ‫ͦא‬ᅺᎷႅ‫ږ‬ᕘfܵ೐‫ڭ‬ᎈʕʧɛʊ૶ูΣ‫˒܄‬༆ᙑϤ਋ࢨdʥ್‫ܔ‬ + ᙄϤପۜٙࡡΪʿ޴ᗫࠬᎈ˸ߧ‫ܔה׵‬ᙄٙପۜ͊ঐҁΌတԑ‫˒܄‬ٙცࠅf + + Others Չ˼ (Please specify ሗ༉ࠑ ): + + Affordability Assessment Result of Proposed Policyholder ‫ܔ‬ᙄ‫ڭ‬ఊܵϞɛٙࠋዄঐɢ൙Пഐ؈ + + The client has passed the affordability assessment based on the selected source(s) of funds for premium payment, which factors in + the premium financing (if applicable). + ‫˒܄‬ʊஷཀࠋዄঐɢ൙П࣬ኽ‫ה‬፯Ъᖮ˹‫ڭ‬൬ٙ༟‫ږ‬Ը๕dϤ൙ПʊҪ‫ڭ‬൬ፄ༟Ͻᅇίʫ€νቇ͜f + +Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓ‫€ࣸڌ‬Զҳ‫ڭ‬ɛ෬ᄳ Page ࠫϣc9/15 + Client Acknowledgement and Declarations ‫˒܄‬ᆽႩʿᑊ‫׼‬ + Product Information ପۜ༟ࣘ + + I confirm that the licensed insurance intermediary has explained the product features, fees & charges, important notes, key risks, key + exclusions and cooling-off period, etc to me together with the presentation of product brochure/factsheet and insurance proposal. + ͉ɛᆽႩܵ೐‫ڭ‬ᎈʕʧɛʊΣ͉ɛ༆ᙑəପۜ̅ɿŊఊੵձ‫ڭ‬ᎈࠇྌ‫ܔ‬ᙄࣣd˸ʿ຅ʕٙପۜतᓃe൬͜ձϗ൬eࠠࠅԫධe˴ࠅࠬᎈe˴ + ࠅʔ‫ڭ‬ԫධeи᎑ಂഃf + +Target Protection Amount ͦᅺ‫ڭ‬ღ‫ږ‬ᕘ + +I confirm that the total sum insured of selected product(s) aligns with my target protection amount I wish to apply for. +͉ɛᆽႩ͉ɛ‫ה‬፯ପۜٙᐼ‫ڭ‬ღ‫ږ‬ᕘୌΥ͉ɛٙͦᅺ‫ڭ‬ღ‫ږ‬ᕘf + +I acknowledge that the total sum insured of selected product(s) is US$ , which is less than the target + +protection amount of US$ I wish to apply for and agree to proceed with the application because: + +͉ɛٝ઄͉ɛ‫ה‬፯ପۜٙᐼ‫ڭ‬ღ‫ږ‬ᕘ‫ߕމ‬ʩ dϤ‫ږ‬ᕘˢ͉ɛٙͦᅺ‫ڭ‬ღ‫ږ‬ᕘߕʩ ‫ˇމ‬d +ઓ͉ɛʥΝจᘱᚃϤ͡ሗdࡡΪ‫މ‬j + + Not Applicable. The objective(s) of “Financial protection against adversities” or others with a protection-related objective has/have + not been selected as my objective(s) in question 1. + ʔቇ͜f͉ɛӚϞ‫׵‬ɪࠑਪᕚ 1 ʕ፯኿˜‫މ‬Ꮠ˹ʔࣛʘც౤Զৌਕ‫ڭ‬ღ™‫א‬Չ˼ՈϞ‫ڭ‬ღٙ޴ᗫͦᅺЪ‫މ‬፯ᒅ‫ڭ‬ᎈପۜٙͦᅺʘɓf + +Target Saving Amount ͦᅺᎷႅ‫ږ‬ᕘ + +I confirm that the total projected return amount of the selected product(s) aligns with my target saving amount. +͉ɛᆽႩ͉ɛ‫ה‬፯ପۜٙཫಂΫజ‫ږ‬ᕘୌΥ͉ɛٙͦᅺᎷႅ‫ږ‬ᕘf + +I acknowledge that the total projected return amount of the selected product(s) may not match my target saving amount + +of US$ but I have made the decision to go ahead with the application because: + +͉ɛٝ઄͉ɛ‫ה‬፯ପۜٙཫಂΫజ‫ږ‬ᕘ̙ঐၾ͉ɛٙͦᅺᎷႅ‫ږ‬ᕘߕʩ ʔୌdઓ͉ɛӔ֛ᘱᚃϤ͡ሗdࡡΪ‫މ‬j + + Not applicable. The objective(s) of “Providing regular income in the future”, “Saving up for the future”, Investment” or others with + a wealth accumulation-related objective has/have not been selected as my objective(s) in question 1 OR I indicated I do not have a + specific target saving amount and would like to use the total amount of premium payment for saving in question 2c. + ʔቇ͜f͉ɛӚϞ‫׵‬ɪࠑਪᕚ 1 ʕ፯኿˜‫͊މ‬Ը౤Զ֛ಂٙϗɝ™d˜‫͊މ‬ԸცࠅЪᎷႅ™d˜ҳ༟™‫א‬Չ˼ՈϞৌబଢ଼ጐ޴ᗫͦᅺЪ‫މ‬፯ᒅ‫ڭ‬ᎈ + ପۜٙͦᅺʘɓ‫͉א‬ɛʊ‫׵‬ɪࠑਪᕚ 2c ʕ‫ͪڌ‬ӚϞɓࡈत֛ཫಂࠅ༺ՑٙᎷႅ‫ږ‬ᕘʿึ͜ᖮ˹‫ڭ‬൬ٙᐼ‫ږ‬ᕘЪᎷႅʘ͜f +Alternative Solution ಁ˾˙ࣩ + + An alternative life insurance product(s) which could meet my needs has/have been introduced to me. + ͉ɛʊə༆ՑୌΥ͉ɛცࠅٙɛྪ‫ڭ‬ᎈପۜಁ˾˙ࣩf + + I acknowledge that there is no alternative life insurance product which matches with my need. + ͉ɛٝ઄ӚϞୌΥ͉ɛცࠅٙɛྪ‫ڭ‬ᎈପۜಁ˾˙ࣩf +Purchasing/Applying for* Similar Life Insurance Product(s) in the past 12 months ‫׵‬ཀ̘ 12 ࡈ˜ʫᒅ൯Ŋ͡ሗ * ε΅ᗳΝɛྪ‫ڭ‬ᎈପ +ۜ + + I confirm that I have purchased/applied for* similar type of life insurance product(s) in the past 12 months. The reason of purchasing/ + applying for multiple policies is + ͉ɛᆽႩ‫׵‬ཀ̘ 12 ࡈ˜ʫಀᒅ൯Ŋ͡ሗ * ᗳΝٙɛྪ‫ڭ‬ᎈପۜdϾᒅ൯Ŋ͡ሗε΅ᗳΝପۜٙࡡΪ‫މ‬ + + Not applicable. I have NOT purchased/applied for* similar type of life insurance product(s) in the past 12 months. + ʔቇ͜f͉ɛӚϞ‫׵‬ཀ̘ 12 ࡈ˜ʫಀᒅ൯Ŋ͡ሗ * ᗳΝٙɛྪ‫ڭ‬ᎈପۜf + +* If there are more than one application of similar life insurance product covered by this FNA, it will also be defined as applying for + similar life insurance products in the past 12 months. + ν؈Ϥৌਕცࠅʱؓ‫ܼ̍ึࣸڌ‬ε‫׵‬ɓ΅ٙᗳΝ‫ڭ‬ᎈ͡ሗd͵஗່֛‫މ‬ཀ̘ 12 ࡈ˜ʫ͡ሗε΅ᗳΝɛྪ‫ڭ‬ᎈପۜf + +Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓ‫€ࣸڌ‬Զҳ‫ڭ‬ɛ෬ᄳ Page ࠫϣc10/15 + Information for Affordability and Suitability Assessment ͜‫ࠋ׵‬ዄঐɢձቇΥ‫׌‬൙Пٙ༟ࣘ + + I, the proposed policyholder, confirm that the information and details of my financial profile provided in this “Insurance – Financial + Needs Analysis”: + ͉ɛЪ‫ܔމ‬ᙄ‫ڭ‬ఊܵϞɛdᆽႩ͉ɛߘ‫ڭ‬ᎈ Ñ ৌਕცࠅʱؓ‫™ࣸڌ‬ʕ౤Զٙৌਕً‫ر‬༟ࣘձ୚ືj + (1) are true, valid and reliable and are disclosed by me in good faith with regard to the assessment of this particular insurance + + application; and + ݊ॆྼdϞࣖձ̙ቦٙd˸ʿ͉ɛ˸௰ɽ༐‫ڦ‬౤ԶdϞᗫ༟ࣘձ୚ືఱ͡ሗϤ΅‫ڭ‬ᎈ‫͜ה‬iʿ + (2) can be relied upon as adequate and sufficient by HSBC Life (International) Limited (“HSBC Life”) to conduct relevant affordability + and suitability assessment particular to this insurance application without regard to any other financial information I may have + provided/will provide to HSBC Life via other HSBC Life§s application channel(s). + ݊ԑ੄ձ̂ʱٙd䁩ᔮɛྪ‫ڭ‬ᎈ€਷ყϞࠢʮ̡€˜䁩ᔮ‫ڭ‬ᎈ™̙˸ኯᔟϞᗫ༟ࣘձ୚ື࿁Ϥ΅‫ڭ‬ᎈ͡ሗආБϞᗫࠋዄঐɢձቇΥ‫׌‬൙ + ПdϾʔึਞϽ͉ɛ̙ঐʊ຾Ŋਗ਼຾䁩ᔮ‫ڭ‬ᎈՉ˼͡ሗಬ༸Σ䁩ᔮ‫ڭ‬ᎈ౤Զٙ΂ОՉ˼ৌਕ༟ࣘf + +Applicant’s Name ҳ‫ڭ‬ɛ֑Τ Applicant’s Signature ҳ‫ڭ‬ɛᖦ໇ Date ˚ಂ + +WARNING: Please read and fill in this form carefully. Do not leave any questions blank. Do NOT sign if any questions are +unanswered and have not been crossed out. +ᙆѓjሗʃː୚ቡʿ෬ᄳ͉ৌਕცࠅʱؓ‫ࣸڌ‬fሗʔࠅव٤΂ОਪᕚfνϞ΂О͊Ϋഈٙਪᕚ͊஗м̘dሗʔࠅί‫ࣸڌ‬ɪᖦ໇f + +Note: You are required to inform us (the insurance company) if there is any substantial change of information provided in this form before the policy +is issued. +ൗ : ߰ৌਕცࠅʱؓ‫ࣸڌ‬ɪ෬జٙ༟ࣘϞࠠɽҷᜊdტɨί‫ڭ‬ఊ͊ᖦ೯‫ ۃ‬, ̀඲ஷٝ‫ڭו‬ɛŊʮ̡f + + For Licensed Intermediary Use Only + + Reason(s) for recognizing the insurance product recommended and selected in Q9 as suitable (for suitability mismatch scenario only) + +Name of Licensed Intermediary Signature of Licensed Intermediary + +Date + +Reminder to Brokers: +Please ensure the Broker’s Memo you submit to the insurer clearly sets out the factors considered and the reasons for the product +recommendations made to your customer. + +Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓ‫€ࣸڌ‬Զҳ‫ڭ‬ɛ෬ᄳ Page ࠫϣc11/15 + Personal Information Collection Statement ϗණࡈɛ༟ࣘᑊ‫׼‬ + + Data Privacy Notice + + Notice relating to the Personal Data (Privacy) Ordinance + +We protect your privacy. Read this notice to find out how we collect, store, +use and share your personal data. + +1 2 3 + +HOW WE COLLECT WHAT WE USE YOUR WHO WE SHARE +AND STORE YOUR DATA DATA FOR YOUR DATA WITH + +We collect your data We use your data We share your data with + +• when you interact with us, apply for • to send you direct marketing if you’ve • other HSBC group companies + and use our products and services consented to it + • third parties who help us to provide +• visit our websites (please see the • to consider applications for, offer, services to you or who act for us + “Privacy and Security” section of provide and manage products and + www.hsbc.com.hk and refer to “Use services • third parties who you consent to us + of cookies policy” for details of how sharing your data with + we use cookies) For example: (i) insurance, annuities, + pensions and health and wellness • local or overseas law enforcement +• from other people and companies, products and services; (ii) educational agencies, industry bodies, regulators + including other HSBC group companies materials; (iii) products and services or authorities + relating to campaigns and promotions +We may store your data locally or which you have signed up to • the other third parties set out in +overseas, including in the cloud. We section C +apply our global data standards and • to design and improve our products, +policies wherever your data is stored. services and marketing We may share your data locally or + overseas. +We’re responsible for keeping your • to help us and other HSBC group +data safe in compliance with Hong companies comply with laws, +Kong law. regulations and requirements, + including our internal policies, in or + outside Hong Kong + + • to detect, investigate and prevent + financial crimes + + • for the other purposes set out in + section B + +You can access your data You control your marketing You can contact us + preferences +You can request access to the data dfv.enquiry@hsbc.com.hk +we store about you. We may charge You control whether you receive The Data Protection Officer +a fee for this. marketing from us. HSBC, PO Box 72677, +You can also ask us to Kowloon Central Post Office, +• correct or update your data You can change this at any time by Hong Kong +• explain our data policies and practices contacting us. + +A B C + +Collect and store Use Share + +We may collect We use your data to We share your data with + +• biometric, medical and health/ • handle and take care of claims • local or overseas bodies or authorities + such as legal, regulatory, law +lifestyle data such as your heart rate, • help us to comply with requirements enforcement, government and tax +BMI and steps count or requests that we or the HSBC and any partnerships between law + enforcement and the financial sector +• your geographic data and location group have or receive such as legal or + • any person who is a party to a +data based on your mobile or other regulatory in or outside Hong Kong. transaction (or a potential transaction) + buying interest or assuming risk in an +electronic device Sometimes we may have to comply insurance policy, such as reinsurers + +• data from people who act for you and other times we may choose to • payment recipients, beneficiaries or + or who you deal with through our voluntarily comply any person who act for our customer + or you, or anyone whose data is +services • conduct identity, medical or credit provided for receiving benefits under + an insurance policy or otherwise +• data from public sources, aggregators checks + Page ࠫϣc12/15 +and other sources available to us • create and maintain the credit and + • hospitals, clinics, medical practitioners, +• data from policyholders or members risk related models of the HSBC laboratories, technicians, loss + +of our insurance policies of which group (such as underwriting models, + +Financiayl oNueebdesnAenfaitlyfsriosm(foorrPaorleicyinhsouldreerd) ৌbyਕცࠅʱؓhe‫ڌ‬aࣸl€thԶaҳn‫ڭ‬dɛw෬eᄳllness models and + models/algorithms for data analytics +If you don’t give us data then we + and artificial intelligence) + You can also ask us to contacting us. HSBC, PO Box 72677, + Kowloon Central Post Office, +• correct or update your data Hong Kong + +Perso•naelxIpnlafoinrmouartdioatnaCpoollilceiectsioanndSptraatcetmiceesnt (Cont’d) ϗණࡈɛ༟ࣘᑊ‫€׼‬ᚃ + +A B C + +Collect and store Use Share + +We may collect We use your data to We share your data with + +• biometric, medical and health/ • handle and take care of claims • local or overseas bodies or authorities + lifestyle data such as your heart rate, such as legal, regulatory, law + BMI and steps count • help us to comply with requirements enforcement, government and tax + or requests that we or the HSBC and any partnerships between law +• your geographic data and location group have or receive such as legal or enforcement and the financial sector + data based on your mobile or other regulatory in or outside Hong Kong. + electronic device Sometimes we may have to comply • any person who is a party to a + and other times we may choose to transaction (or a potential transaction) +• data from people who act for you voluntarily comply buying interest or assuming risk in an + or who you deal with through our insurance policy, such as reinsurers + services • conduct identity, medical or credit + checks • payment recipients, beneficiaries or +• data from public sources, aggregators any person who act for our customer + and other sources available to us • create and maintain the credit and or you, or anyone whose data is + risk related models of the HSBC provided for receiving benefits under +• data from policyholders or members group (such as underwriting models, an insurance policy or otherwise + of our insurance policies of which health and wellness models and + you benefit from or are insured by models/algorithms for data analytics • hospitals, clinics, medical practitioners, + and artificial intelligence) laboratories, technicians, loss +If you don’t give us data then we adjustors, risk intelligence providers, +may be unable to provide products or • manage our business, including legal advisers or private investigators +services. exercising our legal rights who act for us + +We may also generate data about you • determine, pay or collect money • any third party who we may transfer + owed to you or to us our business, policies or assets to so +• by combining information that we it can evaluate our business and use + and other HSBC group companies • match data held by HSBC group your data after any transfer + have collected about you companies for purposes listed in + this notice • partners and providers of reward, +• based on the analysis of your co-branding or loyalty programs, + interactions with us and information • provide personalised advertising to charities or non-profit organisations + which we have collected about you you on third party websites (this may + involve us aggregating your data with • social media advertising partners +• through the use of cookies and data of others) (who can check if you have or use + similar technology when you access our products and services and send + our website or apps • other uses relating to the above or our adverts to you and advertise to + to which you have consented people who have a similar profile to + you) + If you provide data about others + We may share your anonymised data + If you provide data to us about another with other parties not listed above. If + person, you should tell that person how we do this you won’t be identifiable + we will collect, use and share their data from this data. + as explained in this notice. + +D We may use data such as your This notice will apply for as long as we + demographics, the products and store your data. We’ll send you the +Direct Marketing services that you’re interested in, latest version at least once a year. If + transaction behaviour, portfolio we use your data for a new purpose, +This is when we use your data to send information, location data, social media we’ll get your consent. +you details about financial, insurance, data, analytics, health and wellness +pensions, annuities or related products, data and information from third parties +services and offers (such as health when we market to you. +and wellness) and promotional +campaigns provided or hosted by us We don’t give your data to others for +or our co-branding, rewards or loyalty them to market their products and +programme partners, charities or other services to you. If we ever wanted +third party financial institutions and to do this, we’d get your separate +service providers. consent. + +Note: In case of any discrepancies between the English and Chinese versions, the English version shall apply and prevail. N_PDPO_PICS_Jun2020 +This notice may also be referred to as “Personal Information Collection Statement”. + + HSBC Life (International) Limited 滙豐人壽保險（國際）有限公司 Page ࠫϣc13/15 + + Incorporated in Bermuda with limited liability 於百慕達註冊成立之有限公司 + +Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓ‫€ࣸڌ‬Զҳ‫ڭ‬ɛ෬ᄳ + Personal Information Collection Statement (Cont’d) ϗණࡈɛ༟ࣘᑊ‫€׼‬ᚃ + + 資料私隱通知 + + 關於個人資料（私隱）條例的通知 + +我們致力保護您的私隱。請閱讀此通知，了解我們如何收集、儲存、使用及 +披露您的個人資料。 + +1 2 3 + +我們如何收集及儲存您的資料 我們如何使用您的資料 我們與誰披露您的資料 + +我們收集您資料的途徑包括 我們將您的資料用於 我們與下列人士披露您的資料 + +• 您與我們互動，向我們申請及使用 • 經您同意後向您發送直接促銷資料 • 其他滙豐集團旗下公司 + 我們的產品和服務 + • 考慮申請、為您推薦、提供及管理 • 幫助我們向您提供服務或代表我們 +• 您瀏覽我們網站（有關我們如何使 產品與服務 行事的第三方 + 用「cookies」的 詳 情， 請 參 閱 我 們 + 網 站 www.hsbc.com.hk 進 入「私 例如：(i) 保險、年金、退休金、健 • 您同意我們與之披露您資料的第三 + 隱與保安」閱覽「Use of cookies 政 康 與 保 健 產 品 及 服 務；(ii) 教 育 材 方 + 策」） 料；(iii) 關於您已報名參與之活動及 + 推廣的產品與服務 • 本地或海外執法機構、行業組織、 +• 其他人士及公司（包括其他滙豐集 監管機構或權力機關 + 團旗下公司） • 設計及改進我們的產品、服務及市 + 場推廣活動 • C 部分所列的其他第三方 +我們可能將您的資料儲存於本地或海 +外，包括雲端。無論您的資料儲存於 • 幫助我們及其他滙豐集團旗下公司 我們可能在本地或海外披露您的資 +何處，均受我們的環球資料標準及政 遵守香港或其以外的國家或地區的 料。 +策約束。 法律、法規和要求，包括我們的內 + 部政策 +我們有責任根據香港法律保護您的資 +料安全。 • 偵測、調查及預防金融罪案 + + • B 部分所列的其他目的 + +您可查閱自己的資料 您可控制自己的市場推廣偏好 您可聯絡我們 + +您可要求查閱我們所儲存有關您的資 您可控制您會否從我們收取市場推廣 dfv.enquiry@hsbc.com.hk +料。我們可能就此向您收取費用。 資料。 +您可要求我們 資料保護主任 +• 改正或更新您的資料 您可隨時聯絡我們對此作出更改。 +• 說明我們的資料政策及慣例 香港上海滙豐銀行有限公司 + 香港九龍中央郵政局 + 郵政信箱 72677 號 + +A B C + +收集及儲存 使用 披露 + +我們或會 我們將您的資料用於 我們與下列人士披露您的資料 + +• 收集生物辨識、醫療及健康 / 生活 • 處理及安排索償 • 本地或海外的法律、監管、執法、 + 政府和稅務等機構或權力機關，以 +模式資料，例如您的心跳率、身高 • 幫助我們遵守包括香港或其以外的 及執法機構與金融業界之間的任何 +體重指數及步數統計 合作夥伴 + 地區或國家的法律或監管機構對我 + • 交易(或潛在交易)下收購保單權益 +• 基於您的流動或其他電子裝置收集 們或滙豐集團現有或所收到的相關 或承擔保單風險的一方，例如再承 + 保人 +您的地域及位置資料 監管規定或要求。這些監管規定或 + • 收款人、受益人或任何為我們的客 +• 從代表您的人士或您透過我們服務 要求可能是我們必須遵從或選擇自 戶或您行事的人；或任何為收取保 + 與之往來的人士收集資料 願遵從的 單賠償或為其他目的而資料被提供 + 的人 +• 從公開渠道、資料整合機構及其他 • 進行身份審查、身體檢查或信用審 + 查 • 代表或為我們提供服務的醫院、診 +我們接觸得到的渠道收集資料 所、醫生、化驗所、技術員、理賠 + 員、風險情報提供機構、法律顧問 +• 從您受益或受保於我們的保險下的 • 設立及維持滙豐集團的信貸及風險 或私家偵探 + 保單持有人或保單成員收集資料 相 關 準 則（例 如 承 保 準 則、 健 康 及 + 保健準則，以及用於資料分析及人 • 我們可能轉讓業務、保單或資產P的age ࠫϣc14/15 +若您不向我們提供資料，我們可能無 任何第三方，以便其評估我們的業 + 工智能的準則 / 算法） +法提供產品或服務。 + • 管理我們業務，包括行使我們的法 +我們亦可能透過以下途徑衍生有關您 + 律權利 + 的資料 +Financial Needs Analysis (for Policyholder) ৌਕცࠅʱ• ؓ釐‫ڌ‬定ࣸ€、Զ支ҳ付‫ڭ‬ɛ或෬收ᄳ取欠您或欠我們的 +• 整合我們及其他滙豐集團旗下公司 + 款項 + 您可要求我們 您可隨時聯絡我們對此作出更改。 香港上海滙豐銀行有限公司 + 香港九龍中央郵政局 +• 改正或更新您的資料 郵政信箱 72677 號 + +Perso•na說l I明nf我or們ma的ti資on料C政oll策ec及tio慣n例Statement (Cont’d) ϗණࡈɛ༟ࣘᑊ‫€׼‬ᚃ + +A B C + +收集及儲存 使用 披露 + +我們或會 我們將您的資料用於 我們與下列人士披露您的資料 + +• 收集生物辨識、醫療及健康 / 生活 • 處理及安排索償 • 本地或海外的法律、監管、執法、 + 模式資料，例如您的心跳率、身高 政府和稅務等機構或權力機關，以 + 體重指數及步數統計 • 幫助我們遵守包括香港或其以外的 及執法機構與金融業界之間的任何 + 地區或國家的法律或監管機構對我 合作夥伴 +• 基於您的流動或其他電子裝置收集 們或滙豐集團現有或所收到的相關 + 您的地域及位置資料 監管規定或要求。這些監管規定或 • 交易(或潛在交易)下收購保單權益 + 要求可能是我們必須遵從或選擇自 或承擔保單風險的一方，例如再承 +• 從代表您的人士或您透過我們服務 願遵從的 保人 + 與之往來的人士收集資料 + • 進行身份審查、身體檢查或信用審 • 收款人、受益人或任何為我們的客 +• 從公開渠道、資料整合機構及其他 查 戶或您行事的人；或任何為收取保 + 我們接觸得到的渠道收集資料 單賠償或為其他目的而資料被提供 + • 設立及維持滙豐集團的信貸及風險 的人 +• 從您受益或受保於我們的保險下的 相 關 準 則（例 如 承 保 準 則、 健 康 及 + 保單持有人或保單成員收集資料 保健準則，以及用於資料分析及人 • 代表或為我們提供服務的醫院、診 + 工智能的準則 / 算法） 所、醫生、化驗所、技術員、理賠 +若您不向我們提供資料，我們可能無 員、風險情報提供機構、法律顧問 +法提供產品或服務。 • 管理我們業務，包括行使我們的法 或私家偵探 + 律權利 +我們亦可能透過以下途徑衍生有關您 • 我們可能轉讓業務、保單或資產的 +的資料 • 釐定、支付或收取欠您或欠我們的 任何第三方，以便其評估我們的業 + 款項 務及在轉讓後使用您的資料 +• 整合我們及其他滙豐集團旗下公司 + 收集的有關您的資料 • 與滙豐集團旗下公司所持有的資料 • 獎賞、合作品牌或忠誠計劃的合作 + 核對，以供作本通知所列明的用途 夥伴及供應商，以及慈善或非牟利 +• 分析您與我們的互動及我們已收集 機構 + 得來有關您的資料 • 於第三方網站上為您提供個人化廣 + 告（這 可 能 涉 及 我 們 將 您 與 他 人 的 • 社交媒體廣告合作夥伴（可查看您 +• 於您瀏覽我們網站或應用程式時使 資料進行整合） 是否擁有或使用我們的產品及服 + 用 cookies 或類似技術 務，並向您及與您個人資料相似的 + • 與上述用途相關或經您同意的其他 人士發送我們的廣告） + 用途 + 我們可能與上文並未列出的其他人士 + 若您提供他人的資料 披露您的匿名資料。在此情況下，有 + 關資料將無法識別出您的身分。 + 若您向我們提供有關其他人士的資 + 料，您應按本通知所述，告知該人士 + 我 們 將 如 何 收 集、 使 用 和 披 露 其 資 + 料。 + +D + +直接促銷 + +指我們使用您的資料向您發送由我們 向您進行市場推廣時，我們或會使用 本通知於我們儲存您的資料期間適 +或我們的合作品牌、獎賞或忠誠計劃 您的資料，例如人口統計資料、您感 用。我們亦會每年向您提供此通知的 +合作夥伴、慈善機構或其他第三方金 興趣的產品及服務、交易行為、投資 最新版本。若我們將您的資料用於新 +融機構及服務供應商所提供或舉辦的 組 合 資 料、 位 置 資 料、 社 交 媒 體 資 用途，則會徵求您的同意。 +金融、保險、退休金、年金或相關產 料、分析、健康及保健資料和來自第 +品、 服 務 和 優 惠 詳 情（例 如 健 康 與 保 三方的資料。 +健）及推廣活動的詳細資料。 + 我們不會向他人提供您的資料，以供 + 其向您推廣產品及服務。如有此意， + 我們會另行徵求您的同意。 + +注意：中英文本如有任何歧義，概以英文本為準。 +此通知亦稱為「收集個人資料聲明」。 + +Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓ‫€ࣸڌ‬Զҳ‫ڭ‬ɛ෬ᄳ Page ࠫϣc15/15 N_PDPO_PICS_Jun2020 + HSBC Life (International) Limited 滙豐人壽保險（國際）有限公司 + \ No newline at end of file diff --git a/src/main/resources/static/template_form.pdf b/src/main/resources/static/template_form.pdf index 005993c..5f84dc9 100644 --- a/src/main/resources/static/template_form.pdf +++ b/src/main/resources/static/template_form.pdf @@ -1,563 +1 @@ - INFORMATION DISCLOSURE AND AUTHORIZATION FORM - 個人資料披露及授權表格 - -ALL RESPONSES MUST BE COMPLETED IN ENGLISH. NON-ENGLISH ANNOTATIONS ARE INCLUDED ON THE FORM AS A COURTESY - ONLY. 所有回覆都必須以英文填寫。 表格上英文之外的翻譯只是為了方便提供。 - -SECTION 1: PERSONAL INFORMATION 第一章節：個人資料 - -Name in English 英文姓名: Name in Chinese (if any) 中文姓名（如有）: - -Alias, Former Name or Maiden Name 別名/ 原名: - -Date of Birth 出生日期 (DD/MM/YYYY): Gender 性別: ☐ Male 男 ☐ Female 女 - Country of Issue 簽發國家: - / / - -Identification No. 身份證號碼: - -Passport No. 護照號碼: Country of Issue 簽發國家: -Place of Birth 出生國家: Date of Expiry 有效日期 (DD/MM/YYYY): - - Country(ies) of Citizenship 國籍: - -Holding other passport / Residency status 持有其他國家護照 / 居民身份: ☐ Yes 是 ☐No 否 - -If Yes, which country 若是，請填寫國家: ______________________________ - -Status 身份: ☐ PR 永久居民 ☐ Working Visa 工作簽證 ☐ Citizen 公民 - -Phone No. 電話號碼: Email Address 電郵地址: - -Current Permanent Residential Address 現居地址: - -No. of Years If <5 years, please provide previous Residential Address 若於現有住宅地址居住少於 5 年請提供前居住 -居住年期: 地址： - -If <10 years and you have resided in a different country, please state previous country of residence 若您於現有住宅地址居住少 -於 10 年及曾在其他國家居住， 請填寫之前的居住國家： - -Correspondence Address 郵寄地址: ☐Same as Current Permanent Residential Address 與現居地址相同 - -Highest Academic Qualification 最高學歷: -☐ Primary or below 小學或以下 ☐ Secondary 中學 ☐ Post-Secondary or above 大專或以上 - -Institution (s) 學院: _____________________________________________ Course of Study 學科: __________________________ - -Language Proficiency 熟練語言: -Oral Comprehension 口語理解: ☐ English 英語 ☐ Mandarin 國語 ☐ Cantonese 粵語 ☐ Others 其他: ___________________ -Reading Ability 閲讀能力: ☐ English 英文 ☐ Chinese 中文 ☐ Others 其他: _________________ - -V3.202505 P. 1 of 11 - SECTION 2: FAMILY BACKGROUND 第二章節：家庭背景 - -Relationship Name Age Occupation Marital status Dependent - 關係 姓名 年齡 職業 婚姻狀況 受撫養人 - - (Y 是 / N 否) - -Father 父親 - -Mother 母親 - -Spouse 配偶 - -Son(s) 兒子 - -Daughter(s) 女兒 - -Brother(s) 兄弟 - -Sister(s) 姐妹 - -SECTION 3: POLITICALLY EXPOSED PERSON INFORMATION 第三章節：參政人員資料 - -Do you or have you, your family member, close relative* or any individual closely associated (social, business, ☐ Yes 是 -professional or otherwise) with you ever held a position in any government, public/civil service, political party, ☐ No 否 -military, tribunal, government-owned corporation or international organization? (Close relative, whether living or -deceased, means parent, stepparent, child, step-child, adopted child, spouse, domestic partner, spouse or domestic -partner of a child, spouse or domestic partner of a step-child, spouse or domestic partner of an adopted child, -sibling, step-sibling or adopted sibling.) -您或您的家人、近親*或與您密切相關（社交、商業、專業或其他）的人是否曾在政府、公共／公務員、 -政黨、軍隊、法院、國有企業或國際機構任職?（當事人的近親， 無論在世或已故， 指生父母、繼父母、 -子女、繼子女、養子女、配偶、同居伴侶、子女的配偶或同居伴侶、繼子女的配偶或同居伴侶，養子女的 - -配偶或同居伴侶、兄弟姊妹、繼兄弟姊妹或養兄弟姐妹。） - -If Yes, please provide details 若是，請提供具體細節： - -Name of Individual Position and Duties Country Relationship Starting Ending - 個人姓名 職銜和職責 國家 關係 Year Year - 結束年 - 起始年 - -V3.202505 P. 2 of 11 - Have you plan to be a politician/ government official/ member of labor union/ uniformed force / judiciary？您是 ☐ Yes 是 -否計畫擔任為政治家／政府官員／工會成員／軍警人員／司法部門成員？ ☐ No 否 -If Yes, please provide details 如是， 請說明詳情：________________________________________ - -If the last 5 years, have you declared or been petitioned into personal or corporate bankruptcy? 在過去5年， 您 ☐ Yes 是 -是否曾宣佈或申請個人破產或公司破產？ ☐ No 否 -If Yes, please provide details 如是， 請說明詳情：________________________________________ - -SECTION 4: THIRD PARTY INFORMATION 第四章節：第三方資料 - -In completing this questionnaire, are you acting on the instructions of a third party? 在完成這份問卷時，您是 ☐ Yes 是 -否按照第三方的指示行事? ☐ No 否 - -If Yes, please provide details -如是，請說明詳情： - -Name of Individual, company, or organization Date of Birth (DD/MM/YYYY) *for an Individual -個人 / 組織 / 公司名稱 出生日期 (日/ 月/ 年) *個人適用 - -Incorporation number *for a corporation / / -註冊商號 *公司適用 -Primary Address Jurisdiction of registration *for a corporation -主要地址 註冊管轄區 *公司適用 - -Principal business or occupation of this individual, company, or organization -個人職業或公司/ 組織的主營業務 - -Relationship of this individual, company, or organization -與申請人關係 - -SECTION 5: TRAVEL AND RESIDENCY 第五章節：旅遊及居住地 - -Travel pattern for the past 2 years 過去兩年的旅遊詳情: - -Country / Cities Duration of Stay and Purpose of Travel -國家 / 城市 Frequency (p.a.) 旅遊的目的 - 逗留時間及頻率 - (Business / Leisure / Others, please specify) - (出差/休閒/其他，請說明) - -V3.202505 P. 3 of 11 - Travel pattern for the next 2 years 未來兩年的旅遊詳情： - -Country / Cities Duration of Stay and Purpose of Travel -國家 / 城市 Frequency (p.a.) 旅遊的目的 - 逗留時間及頻率 - (Business / Leisure / Others, please specify) - (出差/休閒/其他，請說明) - -Do you plan to change your country of residence within the next 2 years? 您是否計畫今後兩年變更居住地？ ☐ Yes 是 -If Yes, please provide Future Residential Address如是，請提供未來居住地址： ☐ No 否 - -_____________________________________________________________________________________________ -Reason & Duration for Change in Residence遷居原因及居住期: - -_____________________________________________________________________________________________ - -Do you plan to return to your current country of residence? 您是否打算回到目前的居住國家? -☐ Yes 是 ☐ No 否 ☐ N.A. 不適用 - - Do you own additional residential properties (vacation home, second home, time share, etc.)? 您是否擁有額外 ☐ Yes 是 - 的住宅物業（度假屋、第二寓所、分時度假房） ☐ No 否 - -If Yes, please provide details如是，請提供具體細節: - -Property Purpose Full Address Amount of time spent there p.a. - 物業用途 完整地址 每年居住的時間 - -Please let us know if you and/or any other individual that you provide information to us are subject* of the EU ☐ Yes 是 -or EEA so that we can take steps to ensure that the relevant laws are complied with where it relates to the ☐ No否 -information that we collect from you and the services that we agree to provide to you 請告訴我們您或是您提 -供個人資料給我們的其他任何人是否為歐盟或歐洲經濟區的個體*，因此我們可以採取措施以確保我們向 -您收集的資料以及我們同意提供的服務遵守相關的法規。 - -*The term "subject" is not defined in the relevant legislation but is commonly understood to refer to a resident of and -anyone with a place of residence in the relevant jurisdiction. 「個體」 一詞沒有相關法律定義， 但一般被理解為相關管 -轄區的居民及任何在該區有居所的人。 - -V3.202505 P. 4 of 11 - SECTION 6: LIFESTYLE 第六章節：生活方式 - -Have you ever been charged with driving conviction? 您是否曾被指控駕駛罪？ ☐ Yes 是 -If Yes, please provide details and dates 如是，請說明詳情和日期： ☐ No 否 - ☐ Yes 是 -Do you have any pending charges, or have you ever been charged with or convicted of any criminal offense, or ☐ No 否 -are you currently on probation, parole or statutory release? 您目前或以往是否曾因任何刑案被檢控或判罪？ -或者您目前是否正處於緩刑、假釋或法定釋放？ ☐ Yes 是 -If Yes, please provide details and dates 如是，請說明詳情和日期: ☐ No 否 -____________________________________________________________________________________________ - -Have you ever used tobacco or nicotine products in any form (including and not limited to cigarettes, cigars, -cigarillos, pipe,chewing tobacco, vapour products, marijuana, nicotine patches/gum, hookah or shisha)? 您是否 -曾經使用過任何形式的煙草或尼古丁產品 (包括但不限於香煙、雪茄、小雪茄、煙斗、咀嚼煙草、大麻、 -尼古丁貼片/口香糖、水煙或電子煙)? -If Yes, please provide details: 如是，請說明詳情: - -Product(s) 產品 Amount(s) and Current 當前/ Past 過去 Date(s) last used上次使用日 - frequency of use 期 (dd/mm/yyyy) - 用量和使用頻率 - -Do you exercise on a regular basis? ☐ Ball games 球類運動 ☐ Gym 健身 ☐ Brisk Walking 健走 -您是否有定期做運動？ ☐ Jogging 慢跑 ☐ Others 其他: _______________________________ - Duration & Frequency 持續時間及頻率： -Do you engage in or intend to ________________________________________________________ -engage in any hobby(s) or activity(s)? -您是否參與或打算參與任何業餘愛 ☐ Reading 閱讀 ☐ Music 音樂 ☐ Gardening 園藝 -好或活動？ -Do you engage in or intend to ☐ Dancing 跳舞 ☐ Others 其他：_______________ -engage in any hazardous activity(s)? -您是否參與或打算參與任何危險活 ☐ Aviation 航空飛行 ☐ Sky Diving 跳傘 ☐ Scuba Diving 潛水 -動？ - ☐ Powerboat racing 賽艇 ☐ Sports car 賽車 ☐ Motorcycle 摩托車 - - ☐ Rock or Mountain climbing 攀岩或登山 - - ☐ Others 其他: - - _________________________________________________________________________ - If Yes, complete relevant Questionnaire. 如有，請完成相關問卷。 - -SECTION 7: MEDICAL ADVISOR / CLINIC / HOSPITAL INFORMATION 第七章節：醫療詳情 - - Name of personal physician, medical clinic, healthcare advisor or hospital consulted私人醫生/醫院名稱： - -Street Address 地址: - -State / Province 州/省: Country / City 國家/城市: Postal Code 郵遞區號: - -Name on file (if different than legal name) 姓名 (如果與法定名稱不同): Date last visited上次訪問日期: - -Reason for last medical consultation 上次就醫的原因: - -Treatment on medication prescribed and results of any tests completed 處方藥物治療和任何測試的結果: - -V3.202505 P. 5 of 11 - If you have no personal physician or health care advisor, please provide details of why you last consulted any medical clinic, -health care advisor or hospital. 如果您沒有私人醫生或醫療保健顧問，請提供您上次諮詢任何醫療診所、醫療保健顧問或 -醫院的詳細原因。 - - Name of personal physician, medical clinic, healthcare advisor or hospital consulted 私人醫生、醫療診所、醫療保健顧問或醫 - 院名稱: - - Street Address 地址: - -State / Province 州/省: Country / City 國家/城市: Postal Code 郵遞區號: - -Name on file (if different than legal name) 姓名（如果與法定名稱不同）: Date last visited上次訪問日期: - -Reason for last medical consultation 最後一次就醫的原因: - -Treatment on medication prescribed and results of any tests completed 處方藥物治療和任何測試的結果: - -SECTION 8: TAX RESIDENCY 第八章節：稅務居住地 - -Country / Jurisdiction of TIN If no TIN available, please enter If Reason B is selected, pls explain why -Tax Residency 稅務編號 the Reason A, B or C^ you are unable to obtain a TIN -國家 / 稅務管轄區 如沒有提供稅務編號, 請填寫理 如選擇理由 B, 請在以下的方框填寫不 - 由 A、B 或 C^ 能提供稅務編號的原因 - - 1) - - 2) - - 3) - -*"TIN" (including "functional equivalent”) 「稅務編號」（包括具有等同功能的識辨編號）: -The term "TIN" means Taxpayer Identification Number or a functional equivalent in the absence of a TIN. A TIN is a unique combination of letters or -numbers assigned by a jurisdiction to an individual or an Entity and used to identify the individual or Entity for the purposes of administering the -tax laws of such jurisdiction. Further details of acceptable TINs can be found at the OECD automatic exchange of information portal. -包含英文字母或數字的組合， 由司法管轄分配給個人或實體， 用以在其稅務管理上作識辨個人或實體之用。更多關於稅務編號的詳情可 -在經濟合作與發展組織的自動交換資料網站找到。 -^If a TIN is unavailable, please provide the appropriate reason A, B or C where indicated below: -如沒有提供稅務編號， 必須填寫合適的理由A,B或C - -Reason A - The country/jurisdiction does not issue TINS to its residents -理由A －居留司法管轄區並沒有向其居民發出稅務編號。 -Reason B - I am unable to obtain a TIN or equivalent number (Please explain why you are unable to obtain a TIN in the below table if -you have selected this reason) -理由B －本人不能取得稅務編號。如選取這一理由， 請解釋不能取得稅務編號的原因。 -Reason C - No TIN is required (Only this reason if the domestic law of the relevant jurisdiction does not require the collection of the -TIN issued by such jurisdiction) -理由 C －本人毋須提供稅務編號。居留司法管轄區的主管機關不需要帳戶持有人披露稅務編號。 - -V3.202505 P. 6 of 11 - The United States of America ("US") Person Self Declaration 美國人士自我聲明 - -For the purposes of this declaration, "US Person" means 在此聲明中，美國人士的意思是： - -(i) any natural person who is a US citizen (including dual or multiple citizenship/passport holders); or任何是美國公民 - - 的自然人（包括雙重或多重公民身份或護照持有者）；或 - -(ii) any natural person who is "US resident alien" (e.g. Green Card Holder, in possession of a US alien registration card as - - a lawful permanent resident issued by the US citizenship and immigration Service); or - - 任何是「美國居住外國人」（例如綠卡持有者，由美國公民及移民服務局簽發可作為合法永久居民的美國外 - - 國人登記卡之持有者）的自然人；或 - -(iii) any natural person who is a lawful US permanent resident for immigration purposes; or - 任何就移民而言是美國合法永久居民的自然人；或 - -(iv) any natural person who meets a "substantial presence test" (e.g. present in the US for at least 183 days in the - - current year); or - 任何符合實際存在測試（例如該年度在美國至少有183日）的自然人；或 - -(v) any natural person who is a tax resident of the US (e.g. dual residency, spouse filing jointly); or - - 任何是美國稅務居民（例如雙重居民身份、配偶聯合報稅）的自然人；或 - -(vi) any natural person who is a US citizen by operation of relevant laws of the US. - 任何是由美國相關法律實施的美國公民的自然人。 - -Based on the above definition, I confirm and declare that (Please check the applicable status): -根據以上定義， 本人確認及作出聲明 (請選擇適當身分): -☐ I am not a US Person本人不是美國人 -☐ I am a US Person本人是美國人 - -SECTION 9: EXISTING AND PENDING INSURANCE COVERAGE 第九章節：現有和申請中的保險 - -Insurance Company Sum Assured (USD) Type of Insurance Pending / Inforce -保險公司 總保額 (美元) 保險類型 待批 / 已生效 - - ☐ Life Insurance人壽保險 ☐ Pending待批 - - ☐ Savings Plan儲蓄計劃 ☐ lnforce已生效 - - ☐ Critical Illness重大疾病 Year issued 投保年度: - ☐ Others 其他_____________ __________ - - ☐ Life Insurance人壽保險 ☐ Pending待批 - - ☐ Savings Plan儲蓄計劃 ☐ lnforce已生效 - - ☐ Critical Illness重大疾病 Year issued 投保年度: - ☐ Others 其他_____________ __________ - - ☐ Life Insurance人壽保險 ☐ Pending待批 - - ☐ Savings Plan儲蓄計劃 ☐ lnforce已生效 - - ☐ Critical Illness重大疾病 Year issued 投保年度: - ☐ Others 其他_____________ __________ - -Ultimate Total Life Insurance coverage intended including inforce and pending applications - -總人壽保險額包括生效及待批之申請： USD 美元: _________________________________ - -Total intended Premium for Savings Plan (pending applications only) - -總儲蓄計劃保費(待批之申請)： USD 美元: ___________________________________ - -Have you ever been declined, postponed, rated or offered reduced sum assured? 是否曾被拒保、延遲承保、加保 ☐ Yes 是 -費或被要求降低保險金額？ ☐ No否 -If Yes, please provide details如是，請說明詳情：________________________________________ - -Is there any intention to replace, revise or use existing insurance to fund current application? ☐ Yes 是 -您是否打算替代、修改或使用現有保險以支付是次保險申請？ ☐ No 否 - -If Yes, please provide details (sum assured/ insurer/ plan type/ year issued) -如是， 請說明詳情（保額／保險公司／保險類型／投保年度）： - -________________________________________________________________________________________________ - -V3.202505 P. 7 of 11 - SECTION 10: EMPLOYMENT DETAILS/ BUSINESS INFORMATION 第十章節：就業詳情／公司資料 - -Employment Status ☐ Employed 就業 ☐ Homemaker 家庭主婦 ☐ Student 學生 -僱傭狀況 ☐ Professional Investor 專業投資者 ☐ Retired 退休 - -Please provide details of all current and previous employment which are relevant to your current wealth. 提供與您目前的財富有 - -關的所有當前和以前的工作的詳細資料。 - -Starting Ending Position & Duties Company (Name, Address and Website) Nature of Business - Year Year 職位與職責 公司 (名稱、地址和網址) 業務性質 - 結束年 -起始年 - -☐ Business Owner 企業擁有人 - Company Name 公司名稱： - -Registered Address 登記地址： - -Business Address (if different from Registered Address) 營業地址（若與登記地址不同）： - -Company Website 公司網址： Nature of Business 業務性質： - -% of Ownership 擁有權比例： Year Established 成立年份 : - -Position and Duties 職位和職責： No. of Employees 員工數量： - -Business Type 企業類型 : - -☐ Corporation (Private/ Public-listed) 公司(私營/上市公司) ☐ Partnership合夥制 ☐ Sole Proprietorship獨資企業 - -Paid-up Capital 實收資本: Total Assets 總資產: Total Liabilities 總負債: - -Turnover (last 3 years) Profit after tax (last 3 years) Business Failure/Bankruptcy -營業額（過去 3 年）: 稅後利潤（過去 3 年）: 企業倒閉 / 破產： - -V3.202505 P. 8 of 11 - SECTION 11: FINANCIAL DECLARATION 第十一章節：財務申報 - - a) PERSONAL INCOME STATEMENT (USD) 個人收入報表(美元) - ☐ Individual 個人 ☐ Joint 聯名 (________%), shared with 與_____________________________ - - EARNED INCOME 薪酬收入 UNEARNED INCOME 非薪酬收入 - - Current Year Last Year Current Year Last Year - 本年度 上年度 本年度 上年度 - -Salary 薪酬 Interest 利息 - -Bonus 花紅 Dividends 股息 - Rentals 租金 -Other -其他 - -Total Earned Income Other -薪酬收入總顗 其他 - - Total Unearned Income - 非薪酬收入總額 - -TOTAL ANNUAL INCOME 年度總收入：_________________________________________________ - -b) PERSONAL BALANCE SHEET (USD}個人資產負債報表（美元） - ☐ Individual 個人 ☐ Joint 聯名 (________%), shared with 與____________________________ - - ASSETS 資產 LIABILITIES 負債 - -Cash and Fixed Deposits Personal Loans -現金與定期存款 個人貸款 - Margin Account -Investments 保證金帳戶 -投資 - Loan Guarantees -Real Estate房地產* 貸款擔保 -(Residential/ Commercial) -( 住宅 / 商業） Mortgages -Net Business Interest 按掲 -淨商業利益 Others - 其他 -Personal Properties and Others -個人財產及其他 Total Liabilities - 總負債 -Total Assets -總資產 - -TOTAL NETWORTH (ASSETS - LIABILITIES) 總資產淨值 (總資產－總負債): ______________________ - -*Real Estate (USD)房地產（美元） Date of Purchase Mortgage Current Value - Purchase Price 按揭 現值 - Address 購買日期 - 地址 購買價格 - -V3.202505 P. 9 of 11 - SECTION 12: SOURCE OF FUNDS/ SOURCE OF WEALTH 第十二章節：資金來源 / 財富來源 - -Premium Payor ☐ Self# 本人# -保費支付人 ☐ 3rd party, please provide Name and Relationship 若不是閣下， 請提供付款人姓名和關係: - __________________________________________________________________________________________ - -Sources of ☐ Employment 個人收入 ☐ Business Earnings 商業收益 ☐ Inheritance 遺產 -Wealth# ☐ Investments 投資 ☐ Others, please specify 其他，請註明:____________________________________ -財富來源# - -Source of ☐ Own Income 個人收入 ☐ Savings 儲蓄 ☐ Premium Financing 保費融資 -Funds ☐ Others, please specify 其他，請註明: _________________________________________________________ -資金來源 - -Premium ☐ Yes 是 ☐ No 否 -Financing If Yes, please provide details 如是，請說明詳情: -保費融資 ___________________________________________________ - -Has all taxes been paid on the funds that you intend to use for premium payment？ ☐ Yes 是 -用來支付保費的資金的相關稅金是否都已支付？ ☐ No 否 -If No, please provide details若答[否] ， 請說明詳情: - -_______________________________________________ - -Have you ever been investigated or committed tax fraud in any jurisdiction(s)？ ☐ Yes 是 -是否曾於任何國家觸犯稅務欺詐或因此而被調査？ ☐ No 否 -If Yes, please provide details如是， 請說明詳情: - -__________________________________________________ - -#Notes: 1. "Self" includes payment by/ through a structure (PIC/Trust) controlled by you. - - 2. "Source of Wealth" refers to the economic activities which have generated your net worth. -＃註: 1. 「本人」包括由自己控管的架構（私人投資公司／信託）支付或透過該架構進行支付。 - - 2.「財富來源」意指為您帶來資產淨值的經濟活動。 - -SECTION 13: BANKING RELATIONSHIPS 第十三章節：銀行關係 - -Name of Bank 銀行名稱 Name of Contact 聯絡人姓名 - -Introducer 介紹人 Type of Account 帳戶類型 Years of Banking 銀行業務年份 -☐ Yes 是 ☐ No 否 Name of Contact 聯絡人姓名 -Name of Bank 銀行名稱 - -Introducer 介紹人 Type of Account 帳戶類型 Years of Banking 銀行業務年份 -☐ Yes 是 ☐ No 否 - -SECTION 14: ACKNOWLEDGEMENT AND AUTHORISATION 第十四章節：確認及授權 - - I acknowledge that the personal information disclosed in this form and any ancillary forms (including medical information) may - be used by my appointed representative as a basis for making submission for life insurance on my life and assessment of - insurability. - 本人確認被委任代表可根據此表格及其他附加表格上披露的個人資料（包括醫療資料）來為本人提交人壽保險申請及 - 評估可保性。 - - I authorize the below contact person to discuss and/or release my personal information including copies of any records for the - purpose of processing my insurance applications. - 本人授權下述聯絡人討論和/或發放本人的個人資料，包括任何記錄的副本，以便處理我的保險申請。 - - Name of Institution 機構名稱: _____________________________________________ - - Name of Contact Person 聯絡人: _____________________________________________ - -V3.202505 P. 10 of 11 - I represent that the information and answers I have provided are complete, correct, and true to the best of my knowledge and -belief. -本人聲稱以上本人提供的資料及回答就本人所知及所信全是完整、正確和屬實。 - -I understand that this duty to disclose all information in good faith extends to all information and facts (medical and financial) -relating to me. -本人明白，本人有責任就關於本人的資料與實情（醫療與財務）作誠實披露。 - -I understand that the recommendations are based on the information furnished to your company (in particular, the information -furnished in the Information Disclosure and Authorization and other ancillary forms) which have been disclosed to your -company by me. -本人明白貴公司提供的建議是根據本人提供給貴公司的資料（尤其於個人資料披露及授權表格和其他附加表格）而作 -出的。 - -In the event there is any omission of material information or incomplete / inaccurate information has been provided, this can -affect: -若本人所提供的資料存在任何重要資料的遺漏或不完整 / 不準確，也可能會影響： - - (a) the results of underwriting in relation to the insurance application; and/ or - 保險申請的相關承保結果，及 / 或 - - (b) the validity of the insurance policy that is subsequently issued - 隨後發出之保單的有效範圍。 - -I understand that I must notify the insurer of any changes in the facts contained in this form (including but not limited to change -in the state of health of any person named in it) before the issue of the policy. Otherwise, it will be assumed that there is no -change to the information provided. -本人明白，本人必須在保單簽發之前，將與此表格有關之事實的更改（包括但不限於此申請表格上列舉之人士的健康 -情況）通知保險公司，否則本人所提供的資料則被定為無任何更改。 - -This questionnaire does not constitute an offer of life insurance coverage, nor is it intended to be a solicitation on behalf of any -life insurance company. -此問卷不構成人壽保險的要約，也無意代表任何人壽保險公司進行招攬。 - -__________________________________________ __________________________________________ -Signature of Client/ Date Name of Client -客戶簽署 / 日期 客戶姓名 - -__________________________________________ __________________________________________ -Signature of Appointed Representative/ Date Name of Appointed Representative -被委任代表簽署 / 日期 被委任代表姓名 - -V3.202505 P. 11 of 11 \ No newline at end of file