更改保单持有人申请书-AvivaHongKong.PDF

更改保單持有人申請書 *DEEASN* Change of Policy Ownership 保單編號 Policy No. 現有保單持有人姓名 Name of Existing Policyholder(s) 受保人姓名Name of Life Assured(s) 重要資料Important Notice 1. 請以正楷填寫此申請書及在適當的空格內加上√ 號。 2. 請勿在空白或尚未填妥的申請書上簽署。 3. 現有及新保單持有人必須在更改的位置簽署作實 。 4. 請於簽署此申請書後30 天內遞交Aviva Life Insurance Company Limited （「Aviva 」）處理。 5. 新保單持有人必須年滿 18 歲或以上。 6. 如閣下未能符合Aviva 的有關規定，Aviva 有權拒絕此申請。 7. 如此保單持有人之轉讓，有可能涉及稅務及/ 或其他影響，請閣下在作出任何申請前自行諮詢獨立法律/ 稅務顧問。 8. 所有現有及新保單持有人之身份證明文件及地址證明核實副本及/ 或實體之所需文件 ，必須經由Aviva 客戶中心職員、保險中介人或任何Aviva 接受的合適證明人認證 。 9. 此申請書需於上述保單之保單持有人及受保人生存期間獲Aviva 收到並存檔，並經Aviva 確認及發出的信函方為有效。 1. Please complete this application in BLOCK LETTERS and tick the appropriate box. 2. Please do not sign on the blank or incomplete application. 3. All amendments should be countersigned by the existing and New Policyholder(s) in full signature. 4. Please sign this application and return to Aviva Life Insurance Company Limited (“Aviva”) within 30 days. 5. New Policyholder(s) must have attained age 18 or over. 6. Aviva reserves the right to reject this application if you fail to fulfill Aviva’s requirements. 7. There may be tax and / or other implications as a result of assigning policy ownership, please consult your own independent legal and/or tax advisors prior to making any request. 8. All identification document(s) and address proof of the existing and New Policyholder(s) and required documents for entity must be certified by Contact Centre Staff of Aviva, Insurance Intermediary or any Suitable Certifier accepted by Aviva. 9. This application is valid when received and recorded by Aviva during the lifetime of both the Policyholder(s) and Life Assured(s) of the Policy stated above, as well as confirmed by letter issued by Aviva. 新保單持有人資料 Details of New Policyholder 英文全名 Full Name in English