| @@ -272,7 +272,8 @@ public class ClientService extends AbstractBaseEntityService<Client, Long, Clien | |||
| + " , phone1 " | |||
| + " , phone2 " | |||
| + " , remarks " | |||
| + " , joinDate " | |||
| + " , created " | |||
| // + " , joinDate " | |||
| + " , caseManagerId " | |||
| + " , consultantId " | |||
| + " FROM client " | |||
| @@ -31,6 +31,7 @@ import com.ffii.lioner.modules.lioner.commonField.service.CommonFieldService; | |||
| import com.ffii.lioner.modules.lioner.entity.ImpEvent; | |||
| import com.ffii.lioner.modules.lioner.pdf.req.UpdatePdfReq; | |||
| import com.ffii.lioner.modules.lioner.service.FileService; | |||
| import com.ffii.lioner.modules.lioner.template.service.TemplateService; | |||
| import com.ffii.lioner.modules.common.SecurityUtils; | |||
| import com.ffii.lioner.modules.common.service.AuditLogService; | |||
| import com.ffii.lioner.modules.master.entity.SubDivision; | |||
| @@ -50,7 +51,6 @@ import com.ffii.core.utils.JsonUtils; | |||
| import com.ffii.core.utils.Params; | |||
| import jakarta.persistence.Table; | |||
| import com.ffii.lioner.modules.lioner.pdf.web.Pdf2Controller; | |||
| @Service | |||
| public class PdfService extends AbstractBaseEntityService<Pdf, Long, PdfRepository> { | |||
| @@ -59,12 +59,15 @@ public class PdfService extends AbstractBaseEntityService<Pdf, Long, PdfReposito | |||
| private AuditLogService auditLogService; | |||
| private FileService fileService; | |||
| private TemplateService templateService; | |||
| private CommonFieldService commonFieldService; | |||
| public PdfService(JdbcDao jdbcDao, PdfRepository repository, AuditLogService auditLogService, FileService fileService, CommonFieldService commonFieldService) { | |||
| public PdfService(JdbcDao jdbcDao, PdfRepository repository, AuditLogService auditLogService, FileService fileService, | |||
| TemplateService templateService, CommonFieldService commonFieldService) { | |||
| super(jdbcDao, repository); | |||
| this.auditLogService = auditLogService; | |||
| this.fileService = fileService; | |||
| this.templateService = templateService; | |||
| this.commonFieldService = commonFieldService; | |||
| } | |||
| @@ -125,7 +128,7 @@ public class PdfService extends AbstractBaseEntityService<Pdf, Long, PdfReposito | |||
| else{ | |||
| instance = new Pdf(); | |||
| } | |||
| System.out.println(req.getTemplateId()); | |||
| BeanUtils.copyProperties(req, instance); | |||
| Map<String, Object> pdf = new HashMap<>(); | |||
| @@ -158,9 +161,6 @@ public class PdfService extends AbstractBaseEntityService<Pdf, Long, PdfReposito | |||
| "Failed to save PDF: " | |||
| + e | |||
| ); | |||
| // e.printStackTrace(); | |||
| // return ResponseEntity.status(HttpStatus.INTERNAL_SERVER_ERROR) | |||
| // .body(Map.of("message", "Failed to save PDF: " + e.getMessage())); | |||
| } | |||
| Object fileIdList = pdf.get("fileIdList"); | |||
| @@ -194,32 +194,28 @@ public class PdfService extends AbstractBaseEntityService<Pdf, Long, PdfReposito | |||
| } | |||
| public byte[] getTemplateForm(Long templateId, Long clientId) { | |||
| // Ensure the template PDF is in src/main/resources/template/pdf | |||
| String filename; | |||
| switch (templateId.intValue()) { | |||
| case 1: | |||
| filename = "IDA.pdf"; | |||
| break; | |||
| case 2: | |||
| filename = "FNA.pdf"; | |||
| break; | |||
| case 3: | |||
| filename = "HSBCFIN.pdf"; | |||
| break; | |||
| default: | |||
| filename = "HSBCFIN.pdf"; | |||
| }; | |||
| ClassPathResource pdfFile = new ClassPathResource(pdf_path + filename); | |||
| // String filename; | |||
| // switch (templateId.intValue()) { | |||
| // case 1: | |||
| // filename = "IDA.pdf"; | |||
| // break; | |||
| // case 2: | |||
| // filename = "FNA.pdf"; | |||
| // break; | |||
| // case 3: | |||
| // filename = "HSBCFIN.pdf"; | |||
| // break; | |||
| // default: | |||
| // filename = "HSBCFIN.pdf"; | |||
| // }; | |||
| // ClassPathResource pdfFile = new ClassPathResource(pdf_path + filename); | |||
| byte[] pdfBytes; | |||
| Map<String, Object> template = templateService.loadTemplate(templateId); | |||
| byte[] pdfBytes = (byte[])template.get("blobValue");; | |||
| // byte[] pdfBytes; | |||
| byte[] modifiedPdfBytes; | |||
| try (InputStream is = pdfFile.getInputStream()) { | |||
| pdfBytes = is.readAllBytes(); | |||
| modifiedPdfBytes = pdfBytes; | |||
| } catch (Exception e) { | |||
| throw new UnprocessableEntityException("Fail to load PDF: " + e); | |||
| } | |||
| byte[] modifiedPdfBytes = pdfBytes; | |||
| try (ByteArrayInputStream inputStream = new ByteArrayInputStream(pdfBytes); | |||
| ByteArrayOutputStream outputStream = new ByteArrayOutputStream()) { | |||
| @@ -295,12 +291,6 @@ public class PdfService extends AbstractBaseEntityService<Pdf, Long, PdfReposito | |||
| // logger.error("Error processing PDF with iText for ID: " + id, e); | |||
| } | |||
| if (!pdfFile.exists()) { | |||
| throw new UnprocessableEntityException("PDF template not found."); | |||
| } | |||
| // try (InputStream is = pdfFile.getInputStream()) { | |||
| // return pdfBytes; | |||
| // } catch (Exception e) { | |||
| @@ -0,0 +1,57 @@ | |||
| package com.ffii.lioner.modules.lioner.template.entity; | |||
| import java.time.LocalDate; | |||
| import java.time.LocalDateTime; | |||
| import com.ffii.core.entity.BaseEntity; | |||
| import jakarta.persistence.Column; | |||
| import jakarta.persistence.Entity; | |||
| import jakarta.persistence.Inheritance; | |||
| import jakarta.persistence.InheritanceType; | |||
| import jakarta.persistence.Table; | |||
| import jakarta.validation.constraints.NotBlank; | |||
| import jakarta.validation.constraints.NotNull; | |||
| @Entity | |||
| @Table(name = "template") | |||
| @Inheritance(strategy=InheritanceType.TABLE_PER_CLASS) | |||
| public class Template extends BaseEntity<Long>{ | |||
| @NotNull | |||
| @Column | |||
| private String name; | |||
| @NotNull | |||
| @Column | |||
| private Long fileId; | |||
| @Column | |||
| private String remarks; | |||
| public String getName() { | |||
| return name; | |||
| } | |||
| public void setName(String name) { | |||
| this.name = name; | |||
| } | |||
| public Long getFileId() { | |||
| return fileId; | |||
| } | |||
| public void setFileId(Long fileId) { | |||
| this.fileId = fileId; | |||
| } | |||
| public String getRemarks() { | |||
| return remarks; | |||
| } | |||
| public void setRemarks(String remarks) { | |||
| this.remarks = remarks; | |||
| } | |||
| } | |||
| @@ -0,0 +1,9 @@ | |||
| package com.ffii.lioner.modules.lioner.template.entity; | |||
| import java.util.List; | |||
| import com.ffii.core.support.AbstractRepository; | |||
| public interface TemplateRepository extends AbstractRepository<Template, Long> { | |||
| } | |||
| @@ -0,0 +1,37 @@ | |||
| package com.ffii.lioner.modules.lioner.template.req; | |||
| public class UpdateTemplateReq { | |||
| private Long id; | |||
| private String name; | |||
| private String remarks; | |||
| public Long getId() { | |||
| return id; | |||
| } | |||
| public void setId(Long id) { | |||
| this.id = id; | |||
| } | |||
| public String getName() { | |||
| return name; | |||
| } | |||
| public void setName(String name) { | |||
| this.name = name; | |||
| } | |||
| public String getRemarks() { | |||
| return remarks; | |||
| } | |||
| public void setRemarks(String remarks) { | |||
| this.remarks = remarks; | |||
| } | |||
| } | |||
| @@ -0,0 +1,228 @@ | |||
| package com.ffii.lioner.modules.lioner.template.service; | |||
| import java.io.ByteArrayInputStream; | |||
| import java.io.File; | |||
| import java.io.FileOutputStream; | |||
| import java.io.IOException; | |||
| import java.io.InputStream; | |||
| import java.time.LocalDate; | |||
| import java.util.ArrayList; | |||
| import java.util.Arrays; | |||
| import java.util.Date; | |||
| import java.util.HashMap; | |||
| import java.util.List; | |||
| import java.util.Map; | |||
| import java.util.stream.Collectors; | |||
| import org.springframework.stereotype.Service; | |||
| import org.springframework.web.multipart.MultipartFile; | |||
| import com.ffii.lioner.modules.lioner.template.entity.Template; | |||
| import com.ffii.lioner.modules.lioner.template.entity.TemplateRepository; | |||
| import com.ffii.lioner.modules.lioner.commonField.entity.CommonField; | |||
| import com.ffii.lioner.modules.lioner.commonField.service.CommonFieldService; | |||
| import com.ffii.lioner.modules.lioner.entity.ImpEvent; | |||
| import com.ffii.lioner.modules.lioner.template.req.UpdateTemplateReq; | |||
| import com.ffii.lioner.modules.lioner.service.FileService; | |||
| import com.ffii.lioner.modules.common.SecurityUtils; | |||
| import com.ffii.lioner.modules.common.service.AuditLogService; | |||
| import com.ffii.lioner.modules.master.entity.SubDivision; | |||
| import com.fasterxml.jackson.databind.ObjectMapper; | |||
| import com.ffii.core.exception.NotFoundException; | |||
| import com.ffii.core.exception.UnprocessableEntityException; | |||
| import com.ffii.core.support.AbstractBaseEntityService; | |||
| import com.ffii.core.support.JdbcDao; | |||
| import com.ffii.core.utils.BeanUtils; | |||
| import com.ffii.core.utils.JsonUtils; | |||
| import com.ffii.core.utils.Params; | |||
| @Service | |||
| public class TemplateService extends AbstractBaseEntityService<Template, Long, TemplateRepository> { | |||
| private String pdf_path = "templates/pdf/"; | |||
| private AuditLogService auditLogService; | |||
| private FileService fileService; | |||
| public TemplateService(JdbcDao jdbcDao, TemplateRepository repository, AuditLogService auditLogService, FileService fileService) { | |||
| super(jdbcDao, repository); | |||
| this.auditLogService = auditLogService; | |||
| this.fileService = fileService; | |||
| } | |||
| public Map<String, Object> saveOrUpdate(String recordJson, MultipartFile file, Boolean newUpload) { | |||
| ObjectMapper objectMapper = new ObjectMapper(); | |||
| UpdateTemplateReq req; | |||
| try { | |||
| req = objectMapper.readValue(recordJson, UpdateTemplateReq.class); | |||
| } catch (Exception e) { | |||
| throw new UnprocessableEntityException("Invalid JSON format"); | |||
| } | |||
| Template instance; | |||
| // List<SubDivision> onUsingIdList = new ArrayList<SubDivision>(); | |||
| if(req.getId()>0){ | |||
| instance = find(req.getId()).get(); | |||
| } | |||
| else{ | |||
| instance = new Template(); | |||
| } | |||
| BeanUtils.copyProperties(req, instance); | |||
| Map<String, Object> template = new HashMap<>(); | |||
| Map<String, Object> response = new HashMap<>(); | |||
| if (newUpload) { | |||
| if (file.isEmpty()) { | |||
| throw new UnprocessableEntityException("No file uploaded."); | |||
| // return ResponseEntity.badRequest().body(Map.of("message", "No file uploaded.")); | |||
| } | |||
| try { | |||
| MultipartFile[] files = new MultipartFile[1]; | |||
| files[0] = file; | |||
| try { | |||
| template = fileService.saveOrUpdate(files, (long) 0, "pdf"); | |||
| } catch (Exception e) { | |||
| System.out.println(e); | |||
| } | |||
| response.put("message", "Template uploaded successfully."); | |||
| // response.put("id", pdfForm.getId().toString()); // Return the ID of the saved PDF | |||
| if (req.getId() > 0) { | |||
| if (fileService.existsById(instance.getFileId())) { | |||
| fileService.deleteFile(instance.getFileId()); // Delete previous record - WIP | |||
| } | |||
| } | |||
| } catch (Exception e) { | |||
| throw new UnprocessableEntityException( | |||
| "Failed to save PDF: " | |||
| + e | |||
| ); | |||
| } | |||
| // Link the new saved PDF to the template | |||
| Object fileIdList = template.get("fileIdList"); | |||
| List<?> list = (List<?>) fileIdList; | |||
| Long fileId = (long) list.get(0); | |||
| instance.setFileId(fileId); | |||
| } | |||
| instance = save(instance); | |||
| response = Map.of( | |||
| "id", instance.getId() | |||
| ); | |||
| return response; | |||
| } | |||
| // Converter -- WIP | |||
| public File convertMultipartFileToFile(MultipartFile multipartFile) throws IOException { | |||
| // Convert MultipartFile to byte array | |||
| byte[] bytes = multipartFile.getBytes(); | |||
| // Create a temporary file | |||
| File file = File.createTempFile("tempFile", multipartFile.getOriginalFilename()); | |||
| // Write byte array to the file | |||
| try (FileOutputStream fos = new FileOutputStream(file)) { | |||
| fos.write(bytes); | |||
| } | |||
| return file; | |||
| } | |||
| public List<Map<String,Object>> list(Map<String, Object> args){ | |||
| StringBuilder sql = new StringBuilder("SELECT" | |||
| + " t.id, " | |||
| + " t.name, " | |||
| + " t.remarks, " | |||
| + " t.fileId, " | |||
| + " t.created, " | |||
| + " t.modified, " | |||
| + " f.filename, " | |||
| + " fb.bytes " | |||
| + " FROM template t " | |||
| + " LEFT JOIN file f ON f.id = t.fileId " | |||
| + " LEFT JOIN file_blob fb ON f.id = fb.fileId " | |||
| + " WHERE t.deleted = FALSE " | |||
| ); | |||
| if (args != null) { | |||
| if (args.containsKey("name")) | |||
| sql.append(" AND t.name LIKE :name "); | |||
| if (args.containsKey("remarks")) | |||
| sql.append(" AND t.remarks LIKE :remarks "); | |||
| if (args.containsKey("createDateFrom")) | |||
| sql.append(" AND t.created >= :createDateFrom "); | |||
| if (args.containsKey("createDateTo")) | |||
| sql.append(" AND t.created <= :createDateTo "); | |||
| } | |||
| sql.append(" ORDER BY t.id desc "); | |||
| return jdbcDao.queryForList(sql.toString(), args); | |||
| } | |||
| public Map<String, Object> loadTemplate(Long id) { | |||
| StringBuilder sql = new StringBuilder("SELECT" | |||
| + " t.id, " | |||
| + " t.name, " | |||
| + " t.remarks, " | |||
| + " f.filename, " | |||
| + " fb.bytes AS blobValue" | |||
| + " FROM template t " | |||
| + " LEFT JOIN file f ON f.id = t.fileId " | |||
| + " LEFT JOIN file_blob fb ON f.id = fb.fileId " | |||
| + " WHERE t.deleted = FALSE " | |||
| + " AND t.id = :id " | |||
| ); | |||
| return jdbcDao.queryForMap(sql.toString(), Map.of("id", id)).orElseThrow(NotFoundException::new); | |||
| } | |||
| public Map<String, Object> loadPDF(Long id) { | |||
| // Pdf pdfInstance = find(id).orElseThrow(NotFoundException::new); | |||
| // byte[] blobBytes = fileService.getfileBlob(pdfInstance.getFileId()); | |||
| StringBuilder sql = new StringBuilder("SELECT" | |||
| + " t.*, " | |||
| + " fb.bytes AS blobValue" | |||
| + " FROM template t " | |||
| + " LEFT JOIN file_blob fb ON t.fileId = fb.fileId " | |||
| + " WHERE t.deleted = FALSE" | |||
| + " AND t.id = :id " | |||
| ); | |||
| // Map<String, Object> result = jdbcDao.queryForMap(sql.toString(), Map.of("id", id)).orElseThrow(NotFoundException::new); | |||
| // result.put("blobValue", new ByteArrayResource(blobBytes)); | |||
| // return result; | |||
| return jdbcDao.queryForMap(sql.toString(), Map.of("id", id)).orElseThrow(NotFoundException::new); | |||
| } | |||
| public Map<String, Object> getPdfBlob(Long id) { | |||
| String sql = "SELECT " + | |||
| " fb.*, " + | |||
| " fb.bytes AS blobValue " + | |||
| " FROM file_blob fb " + | |||
| " WHERE fb.deleted = FALSE " + | |||
| " AND fb.id = :id "; | |||
| return jdbcDao.queryForMap(sql, Map.of("id", id)).orElseThrow(NotFoundException::new); | |||
| } | |||
| public Integer getIdByName(String name) { | |||
| StringBuilder sql = new StringBuilder("SELECT" | |||
| + " e.id " | |||
| + " FROM event e " | |||
| + " WHERE e.deleted = FALSE" | |||
| + " AND e.name = :name " | |||
| ); | |||
| return jdbcDao.queryForInt(sql.toString(), Map.of("name", name)); | |||
| } | |||
| } | |||
| @@ -0,0 +1,96 @@ | |||
| package com.ffii.lioner.modules.lioner.template.web; | |||
| import java.io.IOException; | |||
| import java.nio.file.Files; | |||
| import java.nio.file.Path; | |||
| import java.nio.file.Paths; | |||
| import java.util.HashMap; | |||
| import java.util.List; | |||
| import java.util.Map; | |||
| import java.util.UUID; | |||
| 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.ServletRequestBindingException; | |||
| import org.springframework.web.bind.annotation.CrossOrigin; | |||
| import org.springframework.web.bind.annotation.GetMapping; | |||
| import org.springframework.web.bind.annotation.PathVariable; | |||
| import org.springframework.web.bind.annotation.PostMapping; | |||
| import org.springframework.web.bind.annotation.RequestBody; | |||
| import org.springframework.web.bind.annotation.RequestMapping; | |||
| import org.springframework.web.bind.annotation.RequestParam; | |||
| import org.springframework.web.bind.annotation.RestController; | |||
| import org.springframework.transaction.annotation.Isolation; | |||
| import org.springframework.transaction.annotation.Transactional; | |||
| import org.springframework.web.multipart.MultipartFile; | |||
| import com.ffii.core.response.DataRes; | |||
| import com.ffii.core.response.RecordsRes; | |||
| import com.ffii.core.utils.CriteriaArgsBuilder; | |||
| import jakarta.servlet.http.HttpServletRequest; | |||
| import jakarta.validation.Valid; | |||
| import com.ffii.core.exception.NotFoundException; | |||
| import com.ffii.core.utils.Params; | |||
| import com.ffii.lioner.modules.lioner.template.req.UpdateTemplateReq; | |||
| import com.ffii.lioner.modules.lioner.template.service.TemplateService; | |||
| @RestController | |||
| @RequestMapping("/template") | |||
| @CrossOrigin(origins = "", allowedHeaders = "") | |||
| public class TemplateController { | |||
| private TemplateService templateService; | |||
| public TemplateController(TemplateService templateService) { | |||
| this.templateService = templateService; | |||
| } | |||
| // @GetMapping("/{id}") | |||
| // public List<Map<String, Object>> get(@PathVariable Long id) { | |||
| // return Map.of( | |||
| // Params.DATA, templateService.findByClientId(id).orElseThrow(NotFoundException::new) | |||
| // ); | |||
| // } | |||
| @GetMapping | |||
| public RecordsRes<Map<String, Object>> list(HttpServletRequest request) throws ServletRequestBindingException { | |||
| return new RecordsRes<>(templateService.list( | |||
| CriteriaArgsBuilder.withRequest(request) | |||
| .addStringLike("name") | |||
| .addDate("createDateFrom") | |||
| .addDate("createDateTo") | |||
| .addStringLike("remarks") | |||
| .build())); | |||
| } | |||
| @GetMapping("/{id}") | |||
| public Map<String, Object> get(@PathVariable Long id) { | |||
| return templateService.loadTemplate(id); | |||
| } | |||
| // Endpoint to receive the filled PDF from the frontend | |||
| @Transactional(isolation = Isolation.SERIALIZABLE, rollbackFor = Exception.class, readOnly = false) | |||
| @PostMapping(value = "/save", consumes = MediaType.MULTIPART_FORM_DATA_VALUE) | |||
| public Map<String, Object> saveTemplatePdf(@RequestParam("record") String recordJson, | |||
| @RequestParam("file") MultipartFile file, @RequestParam("newUpload") Boolean newUpload) { | |||
| return Map.of( | |||
| Params.DATA,templateService.saveOrUpdate(recordJson, file, newUpload) | |||
| ); | |||
| } | |||
| // Optional: Endpoint to receive just the form data (e.g., JSON) | |||
| @PostMapping("/saveFormData") | |||
| public ResponseEntity<Map<String, String>> saveFormData(@RequestBody Map<String, Object> formData) { | |||
| System.out.println("Received form data: " + formData); | |||
| Map<String, String> response = new HashMap<>(); | |||
| response.put("message", "Form data received and processed successfully."); | |||
| return ResponseEntity.ok(response); | |||
| } | |||
| } | |||
| @@ -30,7 +30,7 @@ import jakarta.servlet.http.HttpServletRequest; | |||
| import jakarta.validation.Valid; | |||
| @RestController | |||
| @RequestMapping("/template") | |||
| @RequestMapping("/searchTemplate") | |||
| public class SearchCriteriaTemplateController{ | |||
| private final Log logger = LogFactory.getLog(getClass()); | |||
| @@ -0,0 +1,19 @@ | |||
| --liquibase formatted sql | |||
| --changeset kelvin:add template table | |||
| CREATE TABLE `template` ( | |||
| `id` int NOT NULL AUTO_INCREMENT, | |||
| `created` datetime NOT NULL DEFAULT CURRENT_TIMESTAMP, | |||
| `createdBy` int DEFAULT NULL, | |||
| `version` int NOT NULL DEFAULT '0', | |||
| `modified` datetime NOT NULL DEFAULT CURRENT_TIMESTAMP, | |||
| `modifiedBy` int DEFAULT NULL, | |||
| `deleted` tinyint(1) NOT NULL DEFAULT '0', | |||
| `name` VARCHAR(500) NOT NULL, | |||
| `fileId` int(11) NOT NULL, | |||
| `remarks` VARCHAR(600), | |||
| PRIMARY KEY (`id`) | |||
| ) ENGINE=InnoDB DEFAULT CHARSET=utf8; | |||
| @@ -1,438 +0,0 @@ | |||
| FINANCIAL NEEDS ANALYSIS FORM 財務需要分析表格 | |||
| A. PERSONAL INFORMATION 個人資料 | |||
| Name 姓名 Date of Birth 出生日期 ID Card / Passport Number 身分證 / 護照號碼 | |||
| Occupation 職業 Marital Status 婚姻 Education 教育程度 ☐ Primary or below 小學或以下 | |||
| Contact Number 聯絡電話 ☐ Secondary 中學 | |||
| Number of Dependents 受養人數目 Target Retirement Age ☐ Tertiary or above 大專或以上 | |||
| 預計退休年齡 | |||
| How many year(s) have you been buying life insurance? | |||
| 您有多少年購買人壽保險的經驗? | |||
| ☐ Without any experience 沒有任何經驗 ☐ Less than 5 years 少於5年 ☐ 5 years or above 5年或以上 | |||
| Investment Experience (includes but not limited to MPF, mutual funds investment and stock trading experience) | |||
| 投資經驗 (投資經驗包括但不限於強積金、基金投資及股票買賣) | |||
| ☐ < 1 year 年 ☐1-3 years 年 ☐ 4-6 years 年 ☐ 7-10 years 年 ☐ > 10 years 年 | |||
| B. FINANCIAL OBJECTIVES AND NEEDS 財務目標及需要 | |||
| Note: Client must reply question 1 to 3 below. Do not leave any of these questions blank. We cannot recommend any insurance product | |||
| to you and the insurance company will not proceed your application if you do not reply. | |||
| 註:客戶必須回答以下問題1至3。請不要留空任何一條問題。 | |||
| 如您不回答,中介人無法向您建議任何保險產品及保險公司必須拒絕繼續您的申請。 | |||
| B1 What are your objectives of buying insurance product? (tick one or more) | |||
| 客戶選購保險產品的目標為何? (可選多於一項) | |||
| s ☐ A Financial protection against adversities (e.g. death, accident, disability, etc.) | |||
| 為應付不時之需的財務保障 (例如:死亡、意外、殘疾等) | |||
| Additional level of life protection needed 額外人壽保障額 : HKD 港幣 / USD 美元 ______________________________________ | |||
| ☐ B Preparation for health care needs (e.g. critical illness, hospitalization, etc.) | |||
| (please answer the below supplementary question B1a) | |||
| 為醫療需要作準備 (例如:危疾、住院等)(請回答以下附加問題B1a) | |||
| s ☐ C Providing regular income in the future (e.g. retirement income, etc.) | |||
| 為未來提供定期的收入 (例如:退休收入等) | |||
| Additional target saving amount 額外目標儲蓄金額: HKD 港幣 / USD 美元 ___________________________________________ | |||
| Expected time (in years) to achieve the saving amount 預計年期以達成目標金額: _____________________________________ | |||
| s ☐ D Saving up for the future (e.g. child education, retirement, etc.) | |||
| 為未來需要儲蓄 (例如:子女教育,退休等) | |||
| Additional target saving amount 額外目標儲蓄金額: HKD 港幣 / USD 美元 ___________________________________________ | |||
| Expected time (in years) to achieve the saving amount 預計年期以達成目標金額: _____________________________________ | |||
| s ☐ E Investment (please answer the below supplementary question B1b) | |||
| 投資 (請回答以下附加問題B1b) | |||
| Additional target saving amount 額外目標儲蓄金額: HKD 港幣 / USD 美元 ___________________________________________ | |||
| Expected time (in years) to achieve the saving amount 預計年期以達成目標金額: _____________________________________ | |||
| ☐ F Others (e.g. business/ keyman insurance, etc.) Please specify: | |||
| 其他 (例如:商業保險/要員保險等) 請詳述: ___________________________ | |||
| V1. 202502 Page 1 of 7 | |||
| B1a (The Supplementary question to B1 below is applicable only if “B. Preparation for health care needs” is chosen as one of the | |||
| objectives in B1 above) | |||
| (以下附加題目只適用於第一條的答案選擇包括 “為醫療需要作準備” 時) | |||
| What kind of product would you buy to meet your objective of purchasing a medical insurance product indicated above? | |||
| (tick one or more) | |||
| 閣下希望選購那種類的保險以滿足閣下上述購買醫療保險產品的目標? (可選多於一項) | |||
| ☐ Indemnity Insurance that provides reimbursement of inpatient coverage (meet increasing expenses for medical | |||
| and healthcare services) | |||
| 提供實報實銷住院保障的償付性保險 (滿足醫療保健服務費用的增加) | |||
| ☐ Indemnity Insurance that provides reimbursement of outpatient coverage (meet increasing expenses for medical | |||
| and healthcare services) | |||
| 提供實報實銷門診保障的償付性保險 (滿足醫療保健服務費用的增加) | |||
| ☐ Non-indemnity Insurance that provides a fixed daily cash for loss of income during hospitalization | |||
| 提出住院時每日固定現金的非償付性保險 (滿足收入的損失) | |||
| ☐ s Non-indemnity Insurance that provides lump sum cash benefit for future healthcare needs when diagnosed with critical illness | |||
| 當患有危疾時提供一筆過現金保障的非償付性保險 (滿足未來的醫療保健需求) | |||
| Additional level of Critical Illness protection needed 額外危疾保障額: HKD 港幣 / USD 美元 ______________________________ | |||
| B1b (The Supplementary question to B1 below is applicable only if “E. Investment” is chosen as one of the objectives in B1 above) | |||
| (僅當選擇“E. 投資”作為以上問題1的目標之一時,以下的附加問題才適用) | |||
| 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) | |||
| 為滿足閣下上述投資目標, 閣下希望如何管理保險產品的不同的投資選項/ 選擇 (如有)? (請選一項) | |||
| ☐ 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. | |||
| 我想按照自己的決定 (毋須獲授權保險人及/或持牌保險中介人提供任何專業意見的情況)選擇及管理保險產品 | |||
| 項下的不同投資選項/投資選擇(如有),並且願意在保險產品的目標利益/保障期的整個期間作出此決定。 | |||
| ☐ 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. | |||
| 我想按照自己的決定(經獲授權保險人及/或持牌保險中介人提供專業意見的情況)選擇及管理保險產品項下的 | |||
| 不同投資選項/投資選擇(如有),並且願意在保險產品的目標利益/保障期的整個期間作出此決定。 | |||
| (No ILAS product should be introduced or recommended if client choose this option) | |||
| (如客戶選擇此項時,不應向該客戶介紹或建議任何投連壽險產品) | |||
| ☐ I do not want to choose or manage different investment options/investment choices, if available, under an insurance product. | |||
| 我不想選擇或管理保險產品內不同的投資選項/投資選擇(如有)。 | |||
| (No ILAS product should be introduced or recommended if client choose this option) | |||
| (如客戶選擇此項時,不應向該客戶介紹或建議任何投連壽險產品) | |||
| B2 What is your target benefit / protection period/ expected time frame for meeting the target amount for insurance policy? (tick one) | |||
| 客戶投購保單的目標利益/保障期/實現目標金額的預期時間為多久? (請選一項): | |||
| ☐ A <1 year 年 ☐ B 1-5 years 年 ☐ C 6-10 years 年 ☐ D 11-15 years 年 ☐ E 16-20 years 年 | |||
| ☐ F > 20 years 年 | |||
| ☐ G Whole of Life 終身 | |||
| V1. 202502 Page 2 of 7 | |||
| C. FINANCIAL AFFORDABILITY 財務負擔能力 | |||
| 1 Disposable Income 可動用收入* | |||
| s * Monthly Disposable income equals to Monthly Income minus Monthly Expenses | |||
| 每月可動用收入等於每月入減去每月開支 | |||
| C1a What is your average monthly income/gross profit from all sources in the past 24 months? HKD 港幣 / USD 美元 | |||
| • Individual Client: Including salary, bonus, commission, other allowances/ compensations, | |||
| property rental income, interest from bank deposit, interest from fixed income securities and | |||
| dividend from shares, etc. | |||
| • Company Client: Income from all sources including income from liquid asset _____________ / Month 月 | |||
| 1A | |||
| 在過去二十四個月裡,您從所有收入來源所得的每月平均收入? | |||
| • 個人客戶: 包括薪金、花紅、佣金、其他薪酬福利、物業租貸收入、銀行存款利息、債券 | |||
| 利息及股息等 | |||
| s • 公司客戶: 從不同渠道的所有收入包括由流動資產衍生的收入 | |||
| C1b What are your average monthly expenses in the past 24 months? HKD 港幣 / USD 美元 | |||
| • Individual Client: Including living expenses; household expenses; mortgage payments, regular | |||
| payments (such as entertainment expenses, rent, education, dependent expenses, clothing, | |||
| transportation, personal loans, premium of all existing insurance policies, etc.) | |||
| • Company Client: Including all financial outgoings like rent/wage & operational expenses, and _____________ / Month 月 | |||
| insurance premium of the client’s existing insurance policy(ies) | |||
| 1B | |||
| 在過去二十四個月裡,您每月平均開支為? | |||
| • 個人客戶: 包括生活支出、家庭支出、按揭付款、定期付款 (例如娛樂消費、租金、教育、受供養 | |||
| 人的開支、衣服、交通、私人借貸、現有保單之保費 等) | |||
| • 公司客戶: 包括所有財務支出, 例如租金、人工、營運費用及公司所需繳付的保費 | |||
| C1c If there is existing Premium Financing / Policy Loan (if applicable) 如有現有保費融資/保單貸款(如適用): | |||
| (i) What is the monthly interest repayment amount? 每月的保費融資利息還款額 | |||
| (ii) HKD 港幣 / USD 美元 __________________________________________ | |||
| sWhat is the monthly principal repayment amount? 每月的保費融資本金還款額 | |||
| sHKD 港幣 / USD 美元 ___________________________________________ | |||
| s s (iii) | |||
| What is the monthly repayment amount of existing Premium Financing? 每月的現有保費融資還款額 (i) + (ii) | |||
| HKD 港幣 / USD 美元 ___________________________________________ 1C | |||
| C1d What are your average Monthly Net Disposable Income/Net Profit (from audited company accounts) HKD 港幣 / USD 美元 | |||
| from all sources in the past 24 months? | |||
| 過去二十四個月的每月平均 淨收入 / 每年平均純利(經核證之賬目)有多少? | |||
| Note: Monthly Disposable Income [i.e., Answer of Section C 1d] _____________ / Month 月 | |||
| = Average monthly income 1A - Average monthly expenses 1B | |||
| – Monthly repayment amount of existing Premium Financing 1C | |||
| 註: 每月可動用收入 [亦即 C 部分問題 1d 的答案] | |||
| = 每月平均收入1A- 每月平均開支 1B - 每月的現有保費融資還款額 1C | |||
| C1e What percentage of your monthly net 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 (excluding your existing insurance policy(ies)) | |||
| throughout the entire term of the insurance policy? (tick one) | |||
| 在整個保單期內,您能夠及願意繳付的保費 (不包括您現有的其他保單) 佔透過所有收入來源 (包括流動資產收入) 獲得的每月 淨 | |||
| 收入 (即經扣除開支) 的比率為? (請選一項) | |||
| ☐ <10% ☐ 10-20% ☐ 21-30% ☐ 31-40% ☐ 41-50% ☐ >50% | |||
| Note: In general, a reasonable percentage should account for 50% or less of disposable income. If you decide to choose a percentage of | |||
| larger than 50%, you must cautiously take into consideration of and ensure that you have the ability (sufficient funds) to pay the premiums | |||
| as required for the entire premium term, and must prudentially conduct an evaluation to avoid the risk of the purchase of insurance policy | |||
| restricting your financial liquidity. Failure to pay scheduled premiums on time will delay the expected time to achieve the objectives (of | |||
| purchasing insurance policies). In the worst case it may result in termination of the insurance policy(ie), failure in achieving the objectives. | |||
| 註: 一般而言,合理的比率應佔每月可動用收入50%或以下。如閣下決定選擇比率超過50%,閣下必須慎重地考慮及確保有能力 | |||
| (足夠資金) 以支付全期所需的保費,並必須審慎地作出評估以避免因購買保單而限制閣下資金流動性的風險。如未能按時繳付預 | |||
| 定的保費,將會延遲實現(購買保單的)目標的預期時間,在最壞的情況下,或會導致保單終止,無法實現目標。 | |||
| V1. 202502 Page 3 of 7 | |||
| 2 Net Liquid Assets 淨流動資產 | |||
| s What is your approximate current accumulative amount of liquid assets? Please specify type(s) and total HKD 港幣 / USD 美元 | |||
| C2a | |||
| amount: | |||
| 您現時累積的流動資產約有多少? 請註明種類及金額: | |||
| ☐ Cash 現金 ☐ Money market accounts 貨幣市場賬戶 ☐ Money in bank accounts 銀行存款 | |||
| ☐ Bonds and mutual funds 債券及互惠基金 ☐ Actively traded stocks 交投活躍的股票 2A | |||
| ☐ US Treasury Bills 美國國庫債券 ☐ Others 其他 (Please specify: 請詳述: ____________ ) | |||
| Note: Liquid assets are assets which may be easily turned into cash. Real estate, coin collection and artwork | |||
| s are not considered as liquid assets. | |||
| 註: 流動資產是指可以容易變現為現金的資產,物業、錢幣收藏及藝術品均不能被視為流動資產。 | |||
| C2b What are your total liabilities and estimated fiscal expenses? HKD 港幣 / USD 美元 | |||
| • Individual Client: including outstanding mortgage loan; personal loans/debts (such as credit | |||
| cards, car loans etc.); investment financing facilities, final expenses (such as estate duties, | |||
| funeral & associated expenses) and emergency fund | |||
| • Company Client: including but not limited to outstanding loans/debts and emergency fund | |||
| 您的總負債及預算財務支出為多少? 2B | |||
| • 個人客戶: 包括未償還的按揭貸款、貸款 / 債務(例如信用卡、汽車貸款等)、最後的支 | |||
| 出(例如遺產稅、葬禮及有關開支)、緊急款項 sHKD 港幣 / USD 美元 | |||
| • 公司客戶: 包括但不限於未償還的貸款 / 債務及緊急款項 | |||
| C2c If there is existing life insurance (if applicable) 如有現有的人壽保險(如適用): | |||
| What is the outstanding premium(s) of existing life insurance (such as renewal premium) to be paid by | |||
| Liquid Assets? 以流動資產繳付現有人壽保單的保費(例如續期保費) | |||
| C2d If there is existing Premium Financing / Policy Loan (if applicable) s2C | |||
| 如有現有保費融資/保單貸款(如適用): HKD 港幣 / USD 美元 | |||
| What is the outstanding repayment amount of existing premium financing? | |||
| Outstanding Repayment Amount | |||
| s= monthly repayment amount x 12 x remaining repayment tenor 2D | |||
| = HKD / USD _____________________ x 12 x _______________________ | |||
| 剩餘的保費融資/保單貸款還款額 | |||
| sHKD 港幣 / USD 美元 | |||
| s= 每月的現有保費融資還款額 x 12 x 剩餘的現有保費融資還款年期 | |||
| = 港幣 / 美元 _____________________ x 12 x ______________________ | |||
| C2e What are your current accumulative amount of net liquid assets*? | |||
| 您現時累積的 淨流動資產 有多少? | |||
| Note: Net Liquid Assets [i.e., Answer of Section C 2e] | |||
| = Liquid Assets 2A – Total Liabilities 2B – Outstanding Premium to be paid by Liquid Assets 2C | |||
| – Outstanding Repayment Amount of existing Premium Financing 2D | |||
| 註: 淨流動資產 [亦即 C 部分問題 2e 的答案] | |||
| = 流動資產2A - 總負債及預算財務支出2B - 以流動資產繳付現有人壽保單的保費2C | |||
| - 剩餘的保費融資還款額2D | |||
| C2f What percentage of your net liquid assets would you be able to use to pay premium (including your existing insurance policy(ies)) | |||
| throughout the entire term of the insurance policy? (tick one) | |||
| 在整個保單期內,您能夠及願意繳付的保費 (不包括您現有的其他保單) 佔 淨流動資產 的比率為? (請選一項) | |||
| ☐ <10% ☐ 10-20% ☐ 21-30% ☐ 31-40% ☐ 41-50% ☐ >50% | |||
| V1. 202502 Page 4 of 7 | |||
| Note: In general, a reasonable percentage should account for 50% or less of net liquid assets. If you decide to choose a percentage of | |||
| larger than 50%, you must cautiously take into consideration of and ensure that you have the ability (sufficient funds) to pay the premiums | |||
| as required for the entire premium term, and must prudentially conduct an evaluation to avoid the risk of the purchase of insurance policy | |||
| restricting your financial liquidity. Failure to pay scheduled premiums on time will delay the expected time to achieve the objectives (of | |||
| purchasing insurance policies). In the worst case it may result in termination of the insurance policy(ie), failure in achieving the objectives. | |||
| 註: 一般而言,合理的比率應佔淨流動資產50%或以下。如閣下決定選擇比率超過50%,閣下必須慎重地考慮及確保有能力 (足夠 | |||
| 資金) 以支付全期所需的保費,並必須審慎地作出評估以避免因購買保單而限制閣下資金流動性的風險。如未能按時繳付預定的 | |||
| 保費,將會延遲實現(購買保單的)目標的預期時間,在最壞的情況下,或會導致保單終止,無法實現目標。 | |||
| 3 Premium Payment Period 保費支付年期 & Premium Financing for the proposed policy 建議保單的保費融資貸款 | |||
| C3a For how long are you able and willing to contribute to an insurance policy? (tick one) | |||
| 您能夠及願意支付保單的年期為? (請選一項) | |||
| ☐ 2-5 years 年 ☐ 6-10 years 年 ☐ 11-15 years 年 ☐ 16-20 years 年 | |||
| ☐ > 20 years 年 (until target retirement age of __________ ) (直至目標退休年齡 __________ 歲) | |||
| ☐ Whole of Life 終身 (including period after target retirement age of __________ ) (包括目標退休年齡__________歲後的時期) | |||
| ☐ Single Pay 躉繳 (not more than HKD/USD __________ ) (不超過港幣/美元__________ ) | |||
| C3b In considering your ability to make payments, what are your sources of funds? (tick one or more) | |||
| 就客戶繳付保費的能力,請註明您的資金來源 (可選多於一項) | |||
| ☐ Salary 薪酬 ☐ Income 收入 ☐ Savings 儲蓄 ☐ Investments 投資 | |||
| ☐ Policy Replacement* 保單轉保* ☐ Others (Please specify e.g. Investment Property): | |||
| 其他 (請詳述: 例如投資物業): ____________________________________________________ | |||
| *Note: Please refer to the Policy Replacement Questionnaire for the definition of Policy Replacement. | |||
| 註: 有關保單轉保的定義,請參閱保單轉保聲明表。 | |||
| C3c Are you funding or intending to fund this application using premium financing? | |||
| 您是否會或打算以保費融資貸款支付保費? | |||
| ☐ Yes 是 (please answer the below supplementary question C3d) (請回答以下附加問題C3d) | |||
| C3d s ☐ No 否 | |||
| If you are planning to apply for insurance premium financing, please provide the estimated interest HKD 港幣 / USD 美元 | |||
| derived from the premium financing. | |||
| = Principal x Estimated Interest Rate x Estimated Repayment Period | |||
| 如客戶準備申請保費融資, 請提供預計由保費融資衍生的額外利息開支。 | |||
| = 本金 x 預計利率 x預計還款年期 | |||
| Note: If you cannot provide detailed figures for Interest Rate and Repayment period, assumption will be | |||
| applied. | |||
| 註: 如果客戶無法提供利率和還款期的詳細數據,假設將適用。 | |||
| • Average interest rate 2-3% to be used. | |||
| 使用平均利率 2-3%。 | |||
| • Estimated repayment period equals to Maximum Insured Age minus Existing Age. | |||
| 預計還款期等於最大受保年齡減現有年齡。 | |||
| The above is only an estimate. The actual financing interest rate and repayment terms are subject to the | |||
| relevant loaner’s offer, approval, and discretion. The Intermediary does not provide any financing advice | |||
| or services. | |||
| 以上僅為估計值。實際的融資利率和還款期取決於相關貸款人的報價,批核和酌情決定權。中介人不提 | |||
| 供任何融資建議或服務。 | |||
| V1. 202502 Page 5 of 7 | |||
| D. EVALUATION & RECOMMENDATION 評估及建議 | |||
| Recommendation made by Intermediary – to be completed by Intermediary | |||
| 中介人的建議 – 由中介人填寫 | |||
| Based on your answers in Section B and C, the Intermediary concerned has explored the following insurance options available to meet your | |||
| objective(s) and need(s): | |||
| 根據您於 B 及 C 部分的選項,有關中介人曾提供並與您討論下列保險產品的選擇以迎合您選購保險產品的目標及滿足您的需要: | |||
| Important Notes 重要資訊: | |||
| 1. At least 2 insurance options from different insurers should be recommended according to the preferences that the client has chosen in Part B. | |||
| 中介人需按客戶於 B 部分的意向推介至少 2 個不同保險公司的保險選擇。 | |||
| 2. If the recommended insurance option(s) includes investment linked assurance scheme (ILAS) or policies involved investment elements like PPLI, | |||
| variable annuity, IUL, VUL etc, to comply with the regulatory requirements, the Intermediary should introduce an additional insurance option | |||
| which is a participating product with buying objective of ‘Investment’ to the client. | |||
| 倘中介人介紹的保險產品包括投資相連壽險計劃或有投資成份的保單,中介人必須向客戶介紹另一份屬於分紅保險計劃並符合其投資 | |||
| 目標之保險選項,以符合監管要求。 | |||
| Objectives of Buying the Benefit / Protection Payment Term (C3a) Name of Insurance Product(s) selected | |||
| 支付年期 (C3a) 最終選購的產品 | |||
| Product (B1) Period (B2) Product(s) Introduced | |||
| 選購產品的目標(B1) 得益 / 保障年期 (B2) 曾介紹的保險產品 | |||
| Intermediary’s reason for the recommendation | |||
| 中介人建議原因 | |||
| The reason(s) for the Intermediary to introduce the insurance options are as below: | |||
| 中介人建議該保險選擇的原因如下: | |||
| The recommendation(s) was/were suggested with consideration of client’s financial objective, priorities, total protection needs and budgets. | |||
| 此建議考慮到客戶的理財目標、全面保障的需要,其需要重要性及客戶的財務預算而作出。 | |||
| Customer needs to pay the insurance premium at / after target retirement age but he / she declares to have liquid asset and/or other financial | |||
| plan to afford the premium after retirement. | |||
| 客戶於計劃退休年期後仍需繳付保費,但客戶聲明有足夠的流動資產及/或其他理財計劃以繳付退休後的保費。 | |||
| There is a suitability mismatch between the recommendation(s) and client’s objective(s) and need(s) identified in Section B question 1 to 3. The | |||
| reason for the Intermediary to provide such recommendation is: | |||
| 此建議與客戶在上述 B 部分問題 1 至 3 所表示的目標及需要不相符。中介人仍提供此建議的原因是: | |||
| V1. 202502 Page 6 of 7 | |||
| E. DECLARATION 聲明 | |||
| I / We confirm that my / our Intermediary has conducted a Financial Needs Analysis (FNA) for me / us. I / We also confirm that all information and | |||
| documents I / we have provided for the FNA are true, complete and correct. I / We am aware that any incomplete or inaccurate information I / we | |||
| provided may affect the suitability of the recommendations made. | |||
| 本人/我們確認中介人替本人/我們進行了此財務需要分析;本人/我們亦確認本人/我們為此財務需要分析所提供之資料或文件皆為真實、 | |||
| 完整及正確。本人/我們知道倘本人/ 我們提供之資料並不完整或準確,或會影響所獲得的建議的適用性。 | |||
| I / We hereby declare, to the best of my/our knowledge, that the foregoing statements are true and complete and will form part of the basis of | |||
| any contract of life assurance. | |||
| 茲聲明上述乃本人/我們所知之事實和全部,並構成選擇任何壽險合約之基礎。 | |||
| (Applicable if the policy is to be held by trust. 適用於由信託持有之保單) | |||
| I / We hereby confirm that, to the best of my/our knowledge of information obtained from the settlor, that the foregoing statements are true and | |||
| complete and will form part of the basis of any contract of life assurance. | |||
| 茲聲明上述乃本人/我們基於委托人提供之資訊所知之事實和全部,並構成選擇任何壽險合約之基礎。 | |||
| (Applicable if there is any suitability mismatch. 適用於合適性不符之情況 ) | |||
| I / We hereby confirm that my / our Intermediary has explained the mismatch between the recommendation(s) and my / our objective(s) and need(s) | |||
| and I/ we agree with the recommendation. | |||
| 本人/我們確認中介人已向本人/我們解釋建議產品與本人/我們的目標及需要不相符,而本人/我們同意該建議。 | |||
| WARNING: Please read and fill in all the questions in this form carefully. Do not leave any questions blank. Do NOT sign if any questions are | |||
| unanswered and have not been crossed out. | |||
| 警告:請小心細閱及填寫本財務需要分析表格內的所有問題。請不要留空任何問題。如有任何未回答的問題未被刪去,請不要在表格上 | |||
| 簽署。 | |||
| Note: You are required to inform your insurance intermediary and/or the insurance company if there is any substantial change of information | |||
| provided in this form before the policy is issued. | |||
| 註:若財務需要分析表格上填報的資料有重大改變,您在保單未簽發前,必須通知您的保險中介人及/或保險公司。 | |||
| ______________________________ ______________________________ ______________________________ | |||
| Signature of Policyowner | |||
| (Please do not sign on blank form) Name of Policyowner Date: (DD/MM/YYYY) | |||
| 保單持有人簽署 保單持有人姓名 日期:(日/ 月/年) | |||
| (請勿在空白表格上簽署) | |||
| I declare that the above FNA is based on the information provided by Client in order to recommend the plan that best suit his/her needs. | |||
| 本人聲明以上財務需要分析是基於要保人所提供的資料,而作出的建議乃切合其實際需要。 | |||
| ______________________________ ______________________________ ______________________________ | |||
| Signature of Intermediary Name of Intermediary Date: (DD/MM/YYYY) | |||
| 中介人簽署 中介人姓名 日期:(日/ 月/年) | |||
| V1. 202502 Page 7 of 7 | |||
| @@ -1,992 +0,0 @@ | |||
| HSBCFIN | |||
| PICS 2020Jun (CRS) (Nov 2024) | |||
| Financial Needs Analysis (for Policyholder) | |||
| ৌਕცࠅʱؓࣸڌԶҳڭɛ෬ᄳ | |||
| 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. | |||
| ൗ : ሗΫഈৌਕცࠅʱؓࣸڌʫٙהϞਪᕚfνϞО͊Ϋഈٙਪᕚ͊м̘dሗʔࠅίࣸڌɪᖦf | |||
| YOUR PROFILE આٙࡈɛ༟ࣘ Name in Chinese (if any) ʕ˖֑ΤνϞ | |||
| Name in English ߵ˖֑Τ | |||
| Gender й Date of Birth ̈͛˚ಂ | |||
| Marital Status رًۿ Number of dependents બԶቮɛᅰͦ | |||
| Occupation ᔖุ Contact number ᑌഖཥ༑ | |||
| Education Level ԃܓ 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˜̻ѩϗɝԷ : 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༟ᒔಛᕘνቇ͜ | |||
| 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༟ᒔಛϋಂνቇ͜ | |||
| Note: Take the longest tenor if having more than one premium financing facility(ies) | |||
| ൗ : νܵϞεɓධڭ൬ፄ༟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) ৌਕცࠅʱؓࣸڌԶҳڭɛ෬ᄳ 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༟ପfุيe፺࿆ϗᔛʿᖵஔۜѩʔൖݴމਗ༟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˒ʿ࿆̹ఙሪ˒πಛeʹҳݺᚔٰٙୃeවՎʿʝਿږeߕࢫවՎഃ 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˕ʿОՉ˼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. ͍ίҳڭڭఊܸ݊ৰ͉͡ሗ̮આٙОʊʹʚՉ˼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˹ʔࣛʘცԶৌਕڭღԷνjԒ݂dจ̮dಞशഃ | |||
| b) Preparation for health care needs (e.g. critical illness, hospitalization etc) | |||
| މᏐ˹ᔼᐕڭცࠅԷνjΚशdИ৫ഃ | |||
| Critical Illness Κश | |||
| Medical Indemnity ᔼᐕሦᎵ | |||
| Long Term Care ڗಂᚐଣ | |||
| c) Providing regular income in the future (e.g. retirement income etc) | |||
| ͊މԸԶ֛ಂٙϗɝԷνjৗ;ϗɝഃ | |||
| d) Saving up for the future (e.g. child education, retirement etc) | |||
| ͊މԸცࠅЪᎷႅԷνjɿɾԃdৗ;ഃ | |||
| 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) | |||
| ྼމତɪࠑҳ༟ٙͦᅺdტɨҎૐνО၍ଣڭᎈପۜධɨٙʔΝҳ༟፯ධŊҳ༟፯νϞkʵ፯ɓධ | |||
| 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 | |||
| ͉ɛᗴจܲࡈɛӔ֛ˡᐏબᛆڭᎈɛʿŊܵאڭᎈʕʧɛԶОਖ਼ุจԈٙઋر፯ʿ၍ଣڭᎈପۜධɨٙʔΝҳ༟፯ධ | |||
| Ŋҳ༟፯νϞdԨ˲ᗴจίڭᎈପۜٙͦᅺлूŊڭღಂٙࡈಂගЪ̈ϤӔ֛f | |||
| 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 | |||
| ͉ɛᗴจܲࡈɛӔ֛ᐏબᛆڭᎈɛʿŊܵאڭᎈʕʧɛԶਖ਼ุจԈٙઋر፯ʿ၍ଣڭᎈପۜධɨٙʔΝҳ༟፯ධŊҳ༟ | |||
| ፯νϞdԨ˲ᗴจίڭᎈପۜٙͦᅺлूŊڭღಂٙࡈಂගЪ̈ϤӔ֛f | |||
| I do not want to choose or manage different investment options/investment choices, if available, under an insurance product | |||
| ͉ɛʔᗴจ፯א၍ଣڭᎈପۜධɨٙʔΝҳ༟፯ධŊҳ༟፯νϞf | |||
| f) Others Չ˼Please specify ሗႭ | |||
| | |||
| Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓࣸڌԶҳڭɛ෬ᄳ 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) | |||
| νტɨɪࠑਪᕚ 1 ʕ፯މᏐ˹ʔࣛʘცԶৌਕڭღאՉ˼ڭღٙᗫͦᅺЪމ፯ᒅڭᎈପۜٙՉʕɓࡈͦᅺdሗΫഈ˸ɨਪᕚf | |||
| ሗ̥፯ɓධ | |||
| The target life protection amount for the proposed Life Insured in this life insurance application is வ΅ɛྪڭᎈ͡ሗʕٙաڭɛٙ | |||
| ͦ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΅ɛྪڭᎈ͡ሗʕٙաڭɛٙɛྪڭღږᕘ | |||
| [Note: Please conduct this evaluation for vulnerable customer.] | |||
| [ ൗ : ሗމतйᗫᚥٙ˒܄ආБϤ൙П ] | |||
| Evaluation ൙П US$ ߕʩ | |||
| + | |||
| Family protection (e.g. living expenses of dependents, etc.) | |||
| ࢬڭღԷjաԶቮɛٙ͛ݺක˕ഃ | |||
| Liabilities ࠋව | |||
| Assets ༟ପ – | |||
| Existing life insurance coverage, including group insurance benefits, etc. – | |||
| ତϞɛྪڭღܼ̍ྠɛྪڭღഃ | |||
| 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. | |||
| νტɨɪࠑਪᕚ 1 ʕ፯މᏐ˹ᔼᐕڭცࠅ – ΚशЪމ፯ᒅڭᎈପۜٙՉʕɓࡈͦᅺdሗΫഈ˸ɨਪᕚf | |||
| The target critical illness protection amount for the life insured in this life insurance application is வ΅ɛྪڭᎈ͡ሗʕٙաڭɛͦᅺΚ | |||
| 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) | |||
| νტɨɪࠑਪᕚ 1 ʕ፯͊މԸԶ֛ಂٙϗɝi͊މאԸცࠅЪᎷႅiאҳ༟iאՉ˼ৌబᄣ࠽ٙᗫͦᅺЪމ፯ᒅڭᎈପۜ | |||
| ٙՉʕɓࡈͦᅺdሗΫഈ˸ɨਪᕚfሗ̥፯ɓධ | |||
| My target saving amount on ( years) to be addressed by this life insurance application is ͉ɛ ϋீཀ | |||
| 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) | |||
| ტɨٙڭఊͦᅺлूŊڭღಂŊྼତͦᅺږᕘٙཫಂࣛගމkʵ፯ɓධ | |||
| < 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) ৌਕცࠅʱؓࣸڌԶҳڭɛ෬ᄳ 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) | |||
| ტɨঐʿᗴจڭމఊ˕˹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) ʔቇ͜͟፯ᙌᖮЪڭމ൬ᖮ˹˙ό | |||
| If ‘Yes’ is chosen above, please specify the source(s) of funds and provide the following information to facilitate affordability | |||
| assessment: | |||
| νɪࠑഈࣩ፯݊dሗႭ༟ږٙԸ๕ʿԶ˸ɨ༉ઋ˸کп൙Пტɨٙࠋዄঐɢj | |||
| 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;ܝɓϣ̙ٙږᕘ : 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˕ʔୌdሗҁϓ˸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 ሗႭৗ;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;ܝɓϣ̙ٙږᕘνϞ̥ึ͜Ъ൙Пტɨৗ;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 <0dҢࡁਗ਼ίආБࠋዄঐɢ൙Пʘۃტɨٙଋݴਗ༟ପϔಯ͛ݺක˕ٙʔԑᕘf | |||
| Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓࣸڌԶҳڭɛ෬ᄳ 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? މტɨ̙፯εɓධ | |||
| 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˜ʫਗ਼කٙӊ˜ϗɝjUS$ ߕʩ | |||
| Expected one-off amount in a month ཫಂɓࡈ˜ʫ̙ٙɓϣږᕘjUS$ 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˼༟ږԸ๕הٙཫಂɓࡈ˜ʫਗ਼කٙӊ˜ϗɝʿཫಂɓࡈ˜ʫ̙ٙɓϣږᕘਗ਼ʱйॶɝίტɨ̙ٙਗ͜ϗɝʿଋݴਗ | |||
| ༟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. | |||
| νტɨɪࠑਪᕚ 7 ʕ፯̙ਗ͜ϗɝdܼ̍ᑚཇdϗɝഃЪމ༟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) | |||
| ίࡈڭఊಂʫdტɨঐʿᗴจᖮ˹ٙڭ൬ܼ̍ტɨତϞٙՉ˼ڭఊЦீཀהϞϗɝԸ๕ܼ̍ݴਗ༟ପϗɝᐏٙӊ˜̙ਗ͜ϗɝу | |||
| ϔৰක˕ٙˢଟމkʵ፯ɓධ | |||
| < 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. | |||
| νტɨɪࠑਪᕚ 7 ʕ፯ଋݴਗ༟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? | |||
| ίࡈڭఊಂʫdტɨঐʿᗴจᖮ˹ٙڭ൬ܼ̍ტɨତϞٙՉ˼ڭఊЦტɨଋݴਗ༟ପٙˢଟމk | |||
| < 10% | |||
| 10% – 20% | |||
| 21% – 30% | |||
| 31% – 40% | |||
| 41% – 50% | |||
| > 50% | |||
| Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓࣸڌԶҳڭɛ෬ᄳ Page ࠫϣc5/15 | |||
| Please complete by the Licensed Insurance Intermediary if premium financing is selected | |||
| νʵ፯ڭ൬ፄ༟dܵ͟ڭᎈʕʧɛ෬ᄳ | |||
| 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Ͻୋɓࠫٙઆٙৌਕ༟ࣘ | |||
| 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˷ഃΝאഃΝტɨІʉତϞٙৌਕ༟๕Էνଋݴਗ༟ପfˢଟɽ 1dڌ˾ۆϞཀܓ | |||
| ࠬᎈdуνტɨٙවᛆɛڭ൬ፄ༟ಂഐҼࠅۃӋტɨΌᅰᒔ൲ಛdტɨ̙ঐცࠅৗڭʑঐᎵᒔ༈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˒܄ڭۃᎈ͡ሗٙࠋዄঐɢʘ͜dԨʔϓО൲ಛૢಛf௰൲ಛ༉ઋdܼ̍Шʔࠢ | |||
| ൲ಛږᕘd൲ಛϋಂdಛϋлଟʿӊ˜ᒔಛᕘਗ਼՟Ӕ൲ಛዚٙڦ൲ڭוᄲҭϾ֛f | |||
| # 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༟Ͻᅇίʫfܼ̍І༟ڭ൬ٙ΅dڭ൬ፄ༟ಂʫٙཫಂᐼක˕˸ʿί൲ಛ˙ࠅӋۃᎵᒔڭ൬ፄ༟ | |||
| ൲ಛᕘࣛdᆽڭტɨϞԑٙৌ݁༟๕Ꮅᒔ൲ಛږᕘ | |||
| Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓࣸڌԶҳڭɛ෬ᄳ 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): | |||
| ࣬ኽტɨίϤࣸڌԶٙഈࣩdϞᗫʘڭᎈʕʧɛʊၾტɨীሞɨΐٙڭᎈପۜ˸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 ڭఊ࿆ * ڭ൬ * Payment Mode Payment Term Policy Amount/ | |||
| Company insurance product ڭ൬˕˹˙ό * ڭ൬˕˹ϋಂ * | |||
| ڭᎈପۜΤ၈ Ϥڭᎈପۜঐတԑٙͦᅺ by you (if any) Notional | |||
| ڭᎈʮ̡Τ၈ ಀʧୗʿ௰፯ᒅ Amount | |||
| νϞٙପۜ ڭᕘŊ | |||
| ڭఊږᕘŊ | |||
| Τ່ږᕘ * | |||
| ½ Financial protection ½ Introduced ಀʧୗ | |||
| against adversities ½ މIntroduced and | |||
| Ꮠ˹ʔࣛʘცԶৌਕ 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 | |||
| ڭცࠅ – ڗಂᚐଣ | |||
| ½ Providing regular | |||
| income in the future | |||
| ͊މԸԶ֛ಂٙ | |||
| 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˹ʔࣛʘცԶৌਕ 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 | |||
| ڭცࠅ – ڗಂᚐଣ | |||
| ½ Providing regular | |||
| income in the future | |||
| ͊މԸԶ֛ಂٙ | |||
| ϗɝ | |||
| ½ Saving up for the | |||
| future ͊މԸცࠅ | |||
| Ꮇႅ | |||
| ½ Investment ҳ༟ | |||
| ½ Others Չ˼j | |||
| Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓࣸڌԶҳڭɛ෬ᄳ 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 ڭఊ࿆ * ڭ൬ * Payment Mode Payment Term Policy Amount/ | |||
| Company insurance product ڭ൬˕˹˙ό * ڭ൬˕˹ϋಂ * | |||
| ڭᎈପۜΤ၈ Ϥڭᎈପۜঐတԑٙͦᅺ by you (if any) Notional | |||
| ڭᎈʮ̡Τ၈ ಀʧୗʿ௰፯ᒅ Amount | |||
| νϞٙପۜ ڭᕘŊ | |||
| ڭఊږᕘŊ | |||
| Τ່ږᕘ * | |||
| ½ Financial protection ½ Introduced ಀʧୗ | |||
| against adversities ½ މIntroduced and | |||
| Ꮠ˹ʔࣛʘცԶৌਕ 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 | |||
| ڭცࠅ – ڗಂᚐଣ | |||
| ½ Providing regular | |||
| income in the future | |||
| ͊މԸԶ֛ಂٙ | |||
| 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 ෬ᄳνڭᎈପۜ௰፯ᒅ | |||
| Note: Reason for only providing 1 insurance company suggestion, if any. | |||
| ൗjሗႭ̥Զɓڭᎈʮ̡ܔᙄٙࡡΪdνቇ͜ | |||
| Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓࣸڌԶҳڭɛ෬ᄳ 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˒܄ٙৌਕًرdɛྪڭღცࠅdڭᎈλʿᖮ˹ڭ൬ٙঐɢձจᗴdԨί˙ࠦ՟̻ፅd˸တԑ˒܄ۃٙڭᎈ | |||
| ცࠅf | |||
| Others Չ˼ (Please specify ሗ༉ࠑ ): | |||
| Is there any mismatch(s) against client’s preference in such recommendation? ପۜܔᙄ݊щၾ˒܄ცࠅπίࢨk | |||
| No щ | |||
| Yes, the mismatch(s) is/are ݊dࢨٙઋ݊رj | |||
| i. Target protection amount ͦᅺڭღږᕘ | |||
| ii. Target saving amount ͦᅺᎷႅږᕘ | |||
| If yes, reason(s) for recommendation despite the mismatch(s) indicated above ν݊dኋ၍ପۜܔᙄၾɪࠑٙ˒܄ცࠅπίࢨdШʥ | |||
| ್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. | |||
| ˒܄ί݊ϣ͡ሗٙཫၑʕ͊ঐတԑՑΌٙͦᅺڭღږᕘʿŊͦאᅺᎷႅږᕘfܵڭᎈʕʧɛʊูΣ˒܄༆ᙑϤࢨdʥ್ܔᙄϤପ | |||
| ۜٙࡡΪʿᗫࠬᎈ˸ߧܔהᙄٙପۜ͊ঐҁΌတԑ˒܄ٙ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˸Νɓගڭᎈʮ̡ٙڭᎈପۜတԑΌٙͦᅺڭღږᕘʿŊͦאᅺᎷႅږᕘfܵڭᎈʕʧɛʊูΣ˒܄༆ᙑϤࢨdʥ್ܔ | |||
| ᙄϤପۜٙࡡΪʿᗫࠬᎈ˸ߧܔהᙄٙପۜ͊ঐҁΌတԑ˒܄ٙ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༟Ͻᅇίʫνቇ͜f | |||
| Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓࣸڌԶҳڭɛ෬ᄳ 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. | |||
| ͉ɛᆽႩܵڭᎈʕʧɛʊΣ͉ɛ༆ᙑəପۜ̅ɿŊఊੵձڭᎈࠇྌܔᙄࣣd˸ʿʕٙପۜतᓃe൬͜ձϗ൬eࠠࠅԫධe˴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: | |||
| ͉ɛ͉ٝɛה፯ପۜٙᐼڭღږᕘߕމʩ 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. | |||
| ʔቇ͜f͉ɛӚϞɪࠑਪᕚ 1 ʕ፯މᏐ˹ʔࣛʘცԶৌਕڭღאՉ˼ՈϞڭღٙᗫͦᅺЪމ፯ᒅڭᎈପۜٙͦᅺʘɓf | |||
| 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: | |||
| ͉ɛ͉ٝɛה፯ପۜٙཫಂΫజږᕘ̙ঐၾ͉ɛٙͦᅺᎷႅږᕘߕʩ 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. | |||
| ʔቇ͜f͉ɛӚϞɪࠑਪᕚ 1 ʕ፯͊މԸԶ֛ಂٙϗɝd͊މԸცࠅЪᎷႅdҳ༟אՉ˼ՈϞৌబଢ଼ጐᗫͦᅺЪމ፯ᒅڭᎈ | |||
| ପۜٙͦᅺʘɓ͉אɛʊɪࠑਪᕚ 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. | |||
| ͉ɛٝӚϞୌΥ͉ɛცࠅٙɛྪڭᎈପۜಁ˾˙ࣩ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 | |||
| ͉ɛᆽႩཀ̘ 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. | |||
| ʔቇ͜f͉ɛӚϞཀ̘ 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؈Ϥৌਕცࠅʱܼؓ̍ึࣸڌεɓ΅ٙᗳΝڭᎈ͡ሗd͵່֛މཀ̘ 12 ࡈ˜ʫ͡ሗε΅ᗳΝɛྪڭᎈପۜf | |||
| Financial Needs Analysis (for Policyholder) ৌਕცࠅʱؓࣸڌԶҳڭɛ෬ᄳ Page ࠫϣc10/15 | |||
| Information for Affordability and Suitability Assessment ͜ࠋዄঐɢձቇΥ൙Пٙ༟ࣘ | |||
| I, the proposed policyholder, confirm that the information and details of my financial profile provided in this “Insurance – Financial | |||
| Needs Analysis”: | |||
| ͉ɛЪܔމᙄڭఊܵϞɛdᆽႩ͉ɛίڭᎈ Ñ ৌਕცࠅʱؓࣸڌʕԶٙৌਕًر༟ࣘձືj | |||
| (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༐ڦԶdϞᗫ༟ࣘձືఱ͡ሗϤ΅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). | |||
| ݊ԑձ̂ʱٙd䁩ᔮɛྪڭᎈყϞࠢʮ̡䁩ᔮڭᎈ̙˸ኯᔟϞᗫ༟ࣘձື࿁Ϥ΅ڭᎈ͡ሗආБϞᗫࠋዄঐɢձቇΥ൙ | |||
| ПdϾʔึਞϽ͉ɛ̙ঐʊŊਗ਼䁩ᔮڭᎈՉ˼͡ሗಬ༸Σ䁩ᔮڭᎈԶٙОՉ˼ৌ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. | |||
| ᙆѓjሗʃːቡʿ෬ᄳ͉ৌਕცࠅʱؓࣸڌfሗʔࠅव٤ОਪᕚfνϞО͊Ϋഈٙਪᕚ͊м̘dሗʔࠅίࣸڌɪᖦf | |||
| 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) ৌਕცࠅʱؓࣸڌԶҳڭɛ෬ᄳ 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 [email protected] | |||
| 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) ৌbyਕცࠅʱؓheڌaࣸlthԶaҳnڭdɛw෬eᄳllness 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༟ࣘᑊᚃ | |||
| 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) ৌਕცࠅʱؓࣸڌԶҳڭɛ෬ᄳ | |||
| Personal Information Collection Statement (Cont’d) ϗණࡈɛ༟ࣘᑊᚃ | |||
| 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 [email protected] | |||
| 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༟ࣘᑊᚃ | |||
| 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) ৌਕცࠅʱؓࣸڌԶҳڭɛ෬ᄳ Page ࠫϣc15/15 N_PDPO_PICS_Jun2020 | |||
| HSBC Life (International) Limited 滙豐人壽保險(國際)有限公司 | |||
| @@ -1,563 +0,0 @@ | |||
| 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 | |||
| @@ -1 +0,0 @@ | |||