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change of agent(cs)

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270 views

change of agent(cs)

Uploaded by

win.jc.every.week
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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AIA

Request to Change Servicing Agent


Together, we go green!
申請更改服務營業員
Contact your Financial Planner to submit policy service requests digitally through iChange.
我們為環境保護盡一分力！
聯絡您的財務策劃顧問透過iChange電子方式遞交保單服務申請！

Policy Number Name of Insured Name of Owner


保單號碼 受保人姓名 持有人姓名

Agent Name Agent Code 營業員號碼 Agent’s Tel. No


營業員姓名 Area / Agency Code 區域 / 營業員組別編號 營業員聯絡電話 O2392048

To : AIA (the "Company") 致：友邦（以下一律稱“貴公司”）


Due to the reason stated below, I (Owner's / Assignee's / Trustee's Name)__________________________________________request* for your
above-named agent to provide services to me for the purposes of the insurance policy issued by you and referred to above.
I acknowledge and confirm that this request will take effect only upon written confirmation by the Company.
Reason for change of servicing agent: ___________________________________________________________________________________
由於下列原因，本人 _____________________________________（權益人 / 受讓人 / 信託人姓名_要求上述之營業員為本人就以上由貴公司繕發
的保單提供服務*。本人確認有關要求將於貴公司發出書面認可通知書後始生效。
更改服務營業員之原因：______________________________________________________________________________________________
Change AIA Vitality membership servicing financial planner of the above policy (Apply for membership of the policy owner only)
同時更改上述保單「AIA健康程式」會籍財務策劃顧問（只適用於保單持有人之會籍）
I / We understand that after the Company has completed this request for changing servicing agent, the production agent and / or previous
servicing agent no longer has the right to access the information of the abovementioned policy and provide any related service.
本人 / 我們明白在貴公司完成處理這次更改服務營業員申請後，原有之核保營業員及 / 或前服務營業員將不能再查閱本人上述保單的資料，並就
上述保單為本人提供服務。

PERSONAL DATA COLLECTION AND USE


I / We confirm that I / we have read and understood the AIA Personal Information Collection Statement (“AIA PIC”).
I / We declare and agree that any personal data and other information relating to me / us or my / our policy(ies) or investments
contained in this application or collected, obtained, compiled or held by the Company by any means from time to time may be
collected and utilized in accordance with the AIA PIC. I / We acknowledge and consent to the transfer of my / our personal data
outside of Hong Kong (for policies issued in Hong Kong) or Macau (for policies issued in Macau), as the case may be, for the
purposes and to the types of transferee as set out in the AIA PIC.
The updated version of AIA PIC is available for download from its website: www.aia.com.hk, and is made available upon request.
個人資料收集及使用
本人 / 我們確認本人 / 我們已閱讀及明白AIA個人資料收集聲明（「 AIA個人資料收集聲明」）。本人 / 我們聲明及
同意在本申請所載或貴公司不時以任何方法收集所得、編製或持有的任何個人資料及關於本人 / 我們或本人 / 我們的
保單或投資的其他資料，可根據AIA個人資料收集聲明收集及使用。本人 / 我們知悉及同意就AIA個人資料收集聲明
所述目的視乎情况轉讓本人 / 我們的個人資料至香港（如保單在香港繕發）或澳門（如保單在澳門繕發）境外予AIA
個人資料收集聲明所載的資料承讓人。
AIA個人資料收集聲明的最新版本可於以下網址下載：www.aia.com.hk，及可向貴公司索取。
Personal Information Protection Law of The People’s Republic of China (“China PIPL”)
A Privacy Addendum in compliance with the China PIPL is available at: www.aia.com.hk (Privacy Statement), and is made available upon
request. It is applicable to you if you are located in Mainland China.
中華人民共和國個人信息保護法（「個人信息保護法」）
遵照個人信息保護法的私隱附錄可於以下網站下載：www.aia.com.hk（私隱權保護政策）。您亦可向我們索取。如您位於中國內地，此私隱
附錄則適用於您。
I have read and understood the Privacy Addendum and agree that the AIA group of companies can process my personal information as set out
in the Privacy Addendum.
我已閱讀及明白私隱附錄，並同意友邦保險集團可按照私隱附錄處理我的個人信息。

On On
Signature of Owner / Trustee 於 MM月/DD日/YYYY年 Signature of Assignee (if applicable) 於 MM月/DD日/YYYY年
持有人 / 信託人簽名 受讓人簽名（如適用）

On
Signature of Agent 於 MM月/DD日/YYYY年
營業員簽名
* This request is subject to final confirmation by AIA. 此要求將有待本公司確認作實。
PLEASE SIGN & RETURN IMMEDIATELY BUT NO LATER THAN 14 DAYS 請簽署後即時但不遲於14天內遞交
PLEASE DO NOT SIGN ON BLANK FORM 請勿在空白表格上簽署
“AIA” shall refer to AIA International Limited (Incorporated in Bermuda with limited liability), AIA Company Limited (Incorporated in Hong Kong
with limited liability) or AIA Everest Life Company Limited (Incorporated in Hong Kong with limited liability), as the case may be, depending on the
issuing company of the relevant insurance policies this form / request / correspondence is subject to.
“AIA”指友邦保險(國際)有限公司（於百慕達註冊成立之有限公司），友邦保險有限公司（於香港註冊成立之有限公司）或友邦雋峰人壽有限公司
(於香港註冊成立之有限公司)（視情況而定），具體取決於本表格 / 要求相關保單的簽發公司。
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