1 Details of Premises to be Insured
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- Adam Bennett
- 10 years ago
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Transcription
1 投 通 保 人 姓 名 聯 訊 址 經 絡 電 話 住 Name 投 營 保 業 地 務 of 點 Proposer Mailing Address Contact No. Business 公 眾 責 任 保 險 投 保 書 Public Liability Insurance Proposal Form 宅 手 提 辦 公 室 電 Home Mobile Office 佔 郵 用 地 性 址 質 Address 投 保 人 對 第 三 者 之 人 身 傷 亡 及 財 物 損 失 責 罰 至 ( 起 訖 兩 日 包 括 在 內 ) Occupation HK$ 港 幣 for 每 全 宗 年 any 事 之 故 最 one 高 之 賠 最 Accident 償 高 額 賠 償 額 Death of or Bodily Injury to Third Party & Damage to Third Party Property 投 保 人 資 料 Proposer s Details 保 單 生 效 日 期 由 Situation of Premises 責 任 限 額 投 保 責 任 項 目 Indemnity Required Period of Insurance From To (Both dates inclusive) 在 投 保 範 圍 內 進 行 之 活 動 投 保 地 點 資 料 Amount of Indemnity 機 器 或 其 他 機 械 設 備 之 資 料, 如 有 投 保 地 點 資 料 Details of Premises to be Insured 1 Details of Premises to be Insured Occupancy/Activities being carried out in the Premises 閣 在 投 保 地 點 使 用 或 存 放 之 化 學 品 爆 炸 品 或 帶 有 幅 射 之 物 品 資 料, 如 有 在 下 Details 過 是 去 否 三 在 of 年 申 Machinery, 內 請, 上 閣 述 下 保 是 險 Electrical 否 或 向 續 保 保 險 時 or 公 被 other 司 拒 索 絕 取 撤 回 取 消 或 附 加 特 別 條 款? Mechanical 賠 償? Appliances, if any Details of Chemicals or Explosives or Radioactive Materials used or stored, if any 2 Have you ever been declined, cancelled, refused or imposed special terms when you apply or renew the above mentioned Insurance? 3 Have you make any claims during the past 3 years? 投 保 地 點 的 總 面 積 Floor Area of the Premises 本 人 / 公 本 司 公 申 同 司 請 意 等 投 本 明 保 聲 白 資 明 所 料 及 有 於 上 保 上 述 障 所 範 述 簽 圍 各,, 不 節 本 承 應 人 保 為 / 公 事 本 司 項 人 現,/ 聲 公 條 明 司 款 以 與 及 上 創 細 資 興 則 料 保 概 俱 險 以 屬 有 創 真 限 興 實 公 保 司, 險 立 並 保 約 無 單 之 虛 為 基 報 準 礎 事 情, 並 同 意 根 據 保 單 上 所 載 及 所 批 註 之 條 款, 接 受 該 保 單 投 保 人 簽 署 日 期 ( 日 / 月 / 年 ) 投 保 人 聲 明 Declaration 1. I/We hereby apply for insurance as stated above. I/We hereby declare that the above particulars and answers are true and complete in every respect and that no material facts has been suppressed or withhold. 2. I/We agree that this proposal and declaration and the answers given above shall be the basis of the contract between myself/ourselves and Chong Hing Insurance Company Limited. 3. I/We understand that I shall refer to the policy for details of the insurance coverage, exclusion clauses and terms and conditions. Signature of Proposer Date (dd/mm/yyyy)
2 本 人 選 擇 以 下 列 方 式 繳 交 保 費 現 由 金 創 興 銀 行 戶 口 / 信 用 卡 (Visa 支 或 票 萬 事 ( 抬 達 頭 卡 人 ) 請 直 填 接 轉 賬 創 興 支 保 付 險 保 有 費 限 公 司 ) 付 款 授 權 書 Payment Authorisation I wish to pay my premium by 創 號 碼 發 咭 銀 行 Cash Cheque (payable to Chong Hing Insurance Company Limited) 本 興 人 銀 授 行 權 戶 創 口 興 保 / 險 信 有 用 限 卡 公 持 司 有 從 人 本 姓 人 名 上 述 之 賬 戶 支 取 有 關 保 險 保 單 之 保 費, 包 括 本 人 同 意 續 信 保 的 用 各 卡 期 有 保 效 費 日 期 Direct Debit from Chong Hing Bank Account / Credit Card Account(Visa or Master) Chong Hing Bank Account / Credit Card No Credit Card Issuing Bank Account Holder / Cardholder s Name Credit Card Expiry Date Month/ Year 戶 I hereby authorize Chong Hing Insurance Company Limited, until further written notice from me, to charge my above account for the premium due of this insurance policy, * 簽 口 署 / 信 including 必 用 須 咭 與 持 創 有 payment(s) 興 人 銀 簽 行 署 戶 口 for / 信 日 期 ( 日 / 月 / 年 ) the 用 咭 subsequent 簽 署 相 同 years upon my acceptance on renewal of this insurance policy. * 我 Account 保 Holder/Cardholder s Signature Date (dd/mm/yyyy) Any 們 建 議 閣 下 將 有 關 的 資 料 作 記 錄 ( 包 括 信 件 副 本 ), 以 備 日 後 作 參 考 之 用 為 確 保 閣 下 的 利 益, 閣 下 應 如 實 呈 報 所 有 有 關 資 料, 否 則 此 保 單 將 可 能 無 法 提 供 閣 下 所 需 的 Signature should correspond the specimen signature of your Bank/Credit Card Account policy have copies protection, 障, other any 甚 together. of 至 doubt letters) 可 facts as 能 failure 導 known about 致 for 此 your 保 to what to 單 disclose 無 future you 效 you which reference such should are information disclose, likely of any to affect additional do may not acceptance mean hesitate information that to your ask assessment policy us given. or your will Providing of not insurance the provide insurance correct agent you answers cover with / broker. the you and cover are We making requesting recommend you sure require we must you are and be informed keep may disclosed. even a record invalidate for Should (including your own you the 投 保 人 需 知 Important Notes For Proposer 創 責 人 敬 興 任 資 保 料 險 的 有 安 限 全 僅 公 性 將 司, 為 及 ( 合 避 下 法 免 稱 和 發 相 生 本 關 未 公 的 經 司 目 授 ) 的 權 收 或 明 集 者 白 因 其 意 就 外 而 個 擅 人 並 自 資 將 取 料 採 得 ( 取 私 一 隱 刪 切 除 ) 切 或 條 實 另 例 可 行 ( 行 使 的 用 香 步 個 港 驟 人 法, 例 確 第 保 486 本 情 章 公 況 )( 司 所 持 條 個 例 人 ) 資 料 收 的 集 準 確 持 性 有 本 處 公 理 司 將 使 採 用 取 和 一 / 切 或 切 轉 實 移 可 個 行 人 的 資 步 料 驟 所, 負 確 有 保 的 目 請 的 注 : 意 本 公, 司 如 不 果 時 有 必 不 要 向 收 本 集 公 閣 司 下 的 個 閣 人 下 資 的 料 個 人, 資 並 料 可 能, 因 我 下 們 列 可 各 能 項 無 目 法 提 供 ( 有 所 關 需 目 資 ) 料 而 供 產 本 品 公 或 司 服 使 務 用, 或 無 存 法 儲 處 理 處 閣 理 下 的 轉 要 移 求 披 露 或 共 享 該 等 : 個 1. 士 處 向 與 部 理 閣 就 份 和 下 本 ) 推 評 提 公 之 介 估 供 司 產 閣 後 和 品 下 提 續 / 就 供 或 服 本 和 創 務 公 營 興, 司 銷 關 包 以 及 本 聯 括 創 公 方 但 提 興 司 提 不 供 關 供 限 聯 的 於 廖 維 方 任 創 執 所 何 興 行 提 產 集 / 管 供 品 團 管 理 之 的 理 / 和 產 其 服 已 操 品 他 務 發 作 公 而 出 / 該 司 服 由 等 ( 保 務 閣 產 單 提 下 品 創 出 或 ;/ 興 的 針 服 關 任 對 務 聯 何 閣 ; 方 申 下 ) 請 提 或 出 要 的 本 求 或 公 者 ; 司 其 的 他 商 涉 業 及 合 閣 作 下 夥 伴 任 ( 參 何 閱 索 下 賠 文 相 關 在 的 直 任 接 何 促 目 銷 的 中, 使 包 用 括 及 索 將 賠 其 調 個 查 人 ; 資 料 提 供 予 其 他 人 不 評 為 時 估 客 統 就 閣 戶 計 下 設 或 條 的 計 其 他 款 財 產 目 品 所 務 的 列 需 / 的 求 服 進 任 務 ; 行 何 ; 市 目 場 研 究 核 ; 作 出 法 律 規 則 規 例 對 所 實 持 有 守 的 則 或 與 閣 指 下 引 有 所 關 要 的 求 任 何 披 資 露 料 或 ; 13. 進 遵 開 守 展 上 行 與 述 身 任 何 份 本 任 和 公 何 適 司 目 / 用 業 的 或 務 信 司 直 經 用 法 接 營 管 有 核 有 查 轄 關 的 和 區 的 其 / 其 他 或 法 他 目 債 律 服 務 ; 務 追 收 ; 及 ; 協 助 在 香 港 或 香 港 以 外 其 他 地 方 的 警 方 或 其 他 政 府 或 監 管 機 構 執 法 及 進 行 調 查 ; 1. 個 人 位 資 於 料 香 的 港 轉 或 移 香 : 港 個 以 人 外 資 其 料 他 將 地 予 以 的 保 任 密 何, 創 但 興 在 關 遵 聯 守 方 任 何 本 公 用 司 法 的 律 任 條 何 文 相 的 關 前 聯 提 人 士, 可 任 提 何 供 再 給 保 : 或 2. 金 信 與 融 貸 就 機 資 構 料, 機 以 和 構 及 或 / 就 或 ( 此 創 在 方 興 出 面 關 現 而 聯 拖 言 方 欠 向, 提 還 本 閣 供 款 公 下 司 的 同 任 和 情 意 何 況 / 將 產 下 或 閣 品 創 ) 下 興 追 / 的 關 討 服 資 聯 欠 務 料 款 而 轉 提 公 由 移 供 司 閣 至 行 ; 香 政 港, 針 境 技 對 外 術 閣 ; 下 或 提 其 出 他 的 服 或 務 ( 者 包 其 括 他 險 直 公 涉 接 司 及 促 閣 銷 下 索 服 的 賠 務 任 調 ) 並 何 查 對 公 索 個 司 賠 人 相 資 閣 關 料 下 的 負 之 任 有 何 保 險 人 密 經 士 義 紀 ( 包 務 括 的 行 私 任 業 家 何 協 偵 代 會 探 理 或 ); 聯 承 會 包 商 基 或 金 第 管 三 理 方 公 ; 司 如 欲 在 本 了 香 公 解 港 司 或 權 香 利 港 或 為 以 業 促 外 務 銷 的 目 他 任 何 地 使 實 方 用 的 際 閣 任 或 下 何 建 的 議 政 的 府 人 部 承 資 門 讓 料 或 人 的 其 政 他 受 策 讓 適, 當 方 請 的 參 參 政 閱 府 與 下 或 者 文 或 監 管 次 在 機 參 直 關 與 接 者 促 ; 銷 及 閣 在 下 直 的 接 個 促 人 銷 資 中 料 使 將 用 僅 及 為 將 其 上 個 文 人 中 資 規 料 定 提 的 供 一 予 個 其 或 他 多 人 個 士 有 關 目 的 而 被 轉 移 中 使 用 及 將 其 個 人 資 料 提 供 予 其 他 人 士 部 份 本 1. 公 使 司 用 有 本 意 公 : 司 不 時 持 有 的 閣 下 的 姓 名 聯 絡 資 料 產 品 及 服 務 的 組 合 資 料 交 易 模 式 及 行 為 財 政 背 景 及 人 口 統 計 數 據 以 進 行 直 接 促 銷 ; 1. 閣 下 必 須 在 其 知 悉 範 圍 內 提 供 所 有 有 關 會 影 響 保 險 公 司 於 接 納 或 釐 定 此 保 單 條 文 的 資 料, 如 對 應 透 露 的 資 料 有 任 何 疑 問, 請 即 向 本 公 司 或 閣 下 的 保 險 代 理 / 經 紀 查 詢 2. 收 集 個 人 資 料 聲 明 月 年
3 產 b) a) 品 保 健 就 以 ; 險 康 本 公 服 銀 保 司 務 行 健, 及 創 產 公 興 醫 品 積 關 療 將 金 聯 會 或 方 餐 由, 公 飲 本 積 公 金 體 司 計 育 及 合 劃 運 / 作 或 動 品 以 金 及 牌 下 融 會 夥 機 服 員 伴 構 務 服 及 提 務 商 供 證 業 : 券 娛 合 和 樂 作 相 夥 關 健 伴 產 身 可 品 浴 能 及 或 提 服 類 供 務 似 關 ; 的 於 休 下 閒 列 活 類 動 別 的 旅 服 遊 務 及 交 產 通 品 而 家 進 居 行 直 服 接 裝 促 銷 教 ( 包 育 括 但 社 不 交 限 網 於 絡 提 供 媒 獎 體 賞 的 產 客 品 戶 及 或 服 會 務 員 及 或 高 優 級 惠 消 計 費 劃 類 ): 4. c) a) b) d) 提 任 第 向 除 供 何 本 三 由 上 創 公 方 本 文 興 司 金 公 關 或 融 司 2. 聯 機 促 所 方 構 銷 列 ; 以 上 之 述 所 服 列 務 機 及 構 產 提 品 之 供 外 本 支, 公 援 本 司 的 公 及 第 司 / 三 亦 或 方 有 創 獎 意 興 賞 將 關 上 聯 客 文 方 戶 的 1. 或 商 會 段 業 員 部 合 或 份 作 優 所 夥 惠 述 伴 計 的 或 劃 資 合 提 料 作 供 提 品 者 供 牌 ; 予 夥 上 伴 文 ; 予 品 在 使 中 用 使 閣 用 下, 的 而 個 本 人 公 資 司 料 為 作 此 目 上 的 文 須 所 獲 述 得 的 目 客 的 戶 或 書 提 面 供 同 意 予 上 ( 包 文 括 所 表 述 示 的 不 人 反 士 對 之 ) 前, 本 公 司 須 獲 得 閣 下 書 面 3. 同 段 意 部, 份 及 所 只 述 在 的 獲 全 得 部 閣 或 下 任 的 何 書 人 面 士 同, 意 以 後 供 方 該 可 等 使 人 用 士 閣 在 下 促 的 銷 個 該 人 等 資 服 料 務 及 提 產 其 日 他 後 人 可 士 作 撤 任 回 何 閣 推 下 廣 給 予 及 促 本 公 銷 司 用 有 途 關 使 用 閣 下 的 個 人 資 料 及 提 供 予 其 他 人 士 作 任 何 促 銷 用 途 的 同 意 供 本 閣 日 公 下 後 司 如 的 所 欲 直 持 的 撤 接 個 查 回 促 人 閱 銷 閣 資 和 下 活 料 更 動 給 的 正 中 予 : 種 本 根 類 公 據 司 條 的 例 同, 意 閣, 請 下 發 有 信 權 至 查 下 明 文 本 公 司 個 人 是 否 持 的 有 查 閣 閱 下 和 的 更 個 正 人 資 部 料 份, 所 獲 取 列 的 該 資 地 料 址 的 通 副 知 本, 公 以 司 及 本 更 公 正 司 任 會 何 在 不 不 準 收 確 取 的 任 資 何 料 費 用 閣 的 下 情 還 況 可 下 以 確 要 保 求 不 本 會 公 將 司 閣 告 下 知 納 閣 下 入 香 創 個 查 港 興 人 閱 保 資 和 中 險 料 環 更 有 保 德 正 限 輔 護 的 公 道 主 要 司 中 求 任 二, 十 或 四 有 號 關 創 獲 興 取 銀 政 策 行 中 心 常 五 規 樓 及 本 公 司 所 持 的 資 料 種 類 的 資 料, 均 應 以 書 面 形 式 發 送 至 : 本 電 公 話 司 :852 可 能 會 3768 向 閣 下 9288 收 取 合 / 傳 理 真 的 熱 費 線 用 :, 852 以 抵 銷 3768 本 公 9292 司 為 執 / 行 電 閣 郵 下 :[email protected] Personal ( 如 本 中 文 Information 本 與 英 文 本 Collection 在 文 義 上 有 Statement 岐 異 者, 概 以 英 文 本 為 準 ) 的 資 料 查 閱 要 求 而 引 致 的 行 政 和 實 際 費 用 processing, lawful practicable Chong Hing use Insurance and/or Company transfer of Limited personal (referred data under to hereinafter the Personal as the Data Company ) (Privacy) Ordinance recognises (Cap.486) its responsibilities ( PDPO ). Personal in relation data to the will collection, be collected holding, Please and relevant steps to purposes ensure security and all of practicable the personal steps data will and be to taken avoid to unauthorised ensure that personal or accidental data held access, by the erasure Company or other is accurate. use. The Company will only take for services note you that need if or you process do not your provide request. us with your personal data, we may not be able to provide the information, products or all 1. Purpose: shared our offering, by From providing for time purposes to time and ( Purposes ), marketing it is necessary to you for including: the products/services Company to collect of your the Company, personal data other which companies may be of used, the Liu stored, Chong processed, Hing Group transferred, ( our affiliates ) disclosed or such processing providing business products/services; partners subsequent and evaluating (see services Use any and applications to you, provision including or of requests personal but not made data limited in by to direct you administering for marketing products/services the below), policies offered and issued; administering, by the Company maintaining, and our managing affiliates; and operating or 4. Company evaluating designing conducting purposes and/or products/services your market our in financial connection affiliates, research needs; including with for statistical customers; any investigation claims made other by of purposes; claims; or against or otherwise involving you in respect of any products/services provided by the investigations matching making disclosure any data as held required which relates by any applicable you from law, time rules, to time regulations, for any of codes the purposes of practice listed or guidelines herein; 12. carrying complying conducting out by with identity other police the services laws and/or other of any credit government connection applicable checks and/or with jurisdiction; regulatory the debt operation collection; authorities of the in Hong Kong or elsewhere; or to assist in law enforcement purposes, 13. Transfer 1. other of purposes personal directly data: Personal relating to data any will of the be kept above. confidential but, subject to the business; provisions and association your 2. of our or federation, affiliates, any fund person management associated company with the or Company, financial any institution reinsurance Hong company, Kong or claims elsewhere of any investigation applicable and this law, company, regard may be your provided consent broker, to: products/services to industry 3. data person agent, outside contractor (including of provided Hong or private Kong; by third the investigators) party Company who provides and/or in connection our administrative, affiliates; with any technology claims made by or against or otherwise involving you in respect of any the transfer of Company s and/or any credit our government actual reference affiliates or proposed agencies department Hong assignee, Kong or, in or the other transferee, elsewhere event appropriate of default, participant who governmental debt has or collection a sub-participant duty of or confidentiality agencies; regulatory of or our authority other rights to the services or same; in business; Hong (including Kong and or direct elsewhere. marketing services) to the Company
4 For marketing. Transfer our policy of your on personal using your data personal will only data be made for marketing for one or purposes, more of please the Purposes see the specified section below above. Use and provision of personal data in direct 1. Use The data 2. use Company and your provision name, intends of contact personal to: details, data products in direct and marketing: products conduct held by direct the Company marketing from (including time to time but not for limited direct services marketing; to portfolio providing information, reward, loyalty transaction privileges pattern programmes) and behaviour, in relation financial to background the following and classes demographic activities, a) b) insurance, products and travel and banking, services and services transportation, that provident on the health, Company, fund wellness household, or scheme, our and affiliates, apparel, medical, financial our education, food services, co-branding securities social beverage, partners networking, and sporting and related our media activities products business and and high-end partners and membership, services; consumer may offer: entertainment, products; spa and similar relaxation of c) b) 3. a) d) the any the business of above our affiliates; financial products partners institutions; and or co-branding services may partners be provided of the by Company the Company and/or and/or: 4. persons indication third addition party reward, to marketing loyalty the or privileges above products programme and services, providers the supporting Company affiliates the also Company intends providing to or provide the any products of the above data and described listed services entities set in 1. out above in 2. to above; Before described of no objection) 3. above for for that use purpose; by them in marketing those products and services, and the Company requires your written consent all or (which any of includes the after having using obtained your personal such written data for consent, the purposes may and providing provide to your the personal transferees data set for out any above, promotional the Company or marketing must obtain purpose. your written consent, and only an You If shall, you may wish to future withdraw withdraw your your consent, please to the inform use us and provision writing to of the your address personal the data section for direct on Access marketing. Access of without and correction charge to of you, personal ensure data: you Under are the not PDPO, included you in have future the direct right marketing to ascertain activities. whether the Company and correction holds your of personal personal data, data. to obtain The Company Requests should the data, be for addressed and access to correct and in writing correction any data to: or that for is information inaccurate. regarding You may also policies request and the practices Company and to kinds inform of data you of held the by type the of Company personal data held by it. a copy Data 5/F., Chong Chong Privacy Hing Hing Insurance Officer Bank Company Centre, 24 Limited Des Voeux Central, Hong Kong 3. A 本 reasonable 公 司 致 力 發 展 fee 及 改 may 良 產 be 品 charged 的 質 素, to 務 求 offset 滿 足 閣 the 下 個 人 保 險 上 之 administrative 需 要 作 為 本 公 and 司 的 actual 寶 貴 客 costs 戶, 我 incurred 們 會 時 刻 in 為 complying 閣 下 提 供 新 with 產 品 及 your 服 務 data 之 最 access 新 消 息 requests. 倘 若 閣 下 日 後 不 希 望 * 此 保 單 收 keep please Our 提 到 供 此 Company 的 you 等 write 保 資 險 informed 料, and 必 is 請 須 committed tell 來 在 信 of 本 us. 通 公 new 知 司 本 確 products 公 to 定 司 接 developing 納 投 and 保 後 services, products 才 能 正 when 式 生 to 效 meet they your become personal available. insurance If you requirements. do not want to As receive you are this a valued information customer either of our now Company, or in the we future, will Hotline : / Direct Fax : / [email protected] Company s 代 理 印 分 日 行 代 號 公 司 專 職 用 註 期 Remarks 保 員 險 號 代 碼 理 登 記 轉 號 介 碼 職 員 號 碼 FOR Branch Staff Date Insurance Referrer 章 The liability of the Company does not commence until this proposal has been accepted by the Company. Agent s Stamp OFFICE USE ONLY Code No. Agent Reg. No.: Staff No.:
5 使 用 個 人 資 料 USE OF PERSONAL DATA 個 人 資 料 私 穩 條 例 新 增 的 VIA 條 訂 條 例 部 份 已 於 2013 年 4 月 1 日 起 生 效 就 針 對 使 用 個 人 資 料 作 直 接 促 銷 用 途 加 人 控 制 性 要 求 根 據 新 修 訂 的 條 例, 本 公 司 需 獲 取 閣 下 同 意 才 可 繼 續 使 用 所 收 集 的 個 人 資 料 用 作 直 接 促 銷 活 動 本 公 司 在 此 通 知 閣 下 本 公 司 可 能 使 用 閣 下 的 聯 絡 資 料 個 人 基 本 資 料 及 保 單 資 料, 通 過 書 信 電 郵 電 話 或 流 動 短 訊 與 閣 下 聯 絡, 提 供 金 融 及 保 險 產 品 本 公 司 亦 可 能 提 供 閣 下 的 聯 繫 資 料 閣 下 的 聯 繫 資 料 個 人 基 本 資 料 及 保 單 資 料 給 本 公 司 的 關 連 公 司, 關 連 公 司 可 以 以 書 信 電 郵 或 流 動 短 訊 與 閣 下 聯 絡, 提 供 金 融 及 保 險 產 品 的 直 接 促 銷 通 訊 若 閣 下 不 欲 接 收 有 關 直 接 促 銷 通 訊, 請 在 以 下 回 條 的 方 格 內 填 上 及 填 妥 有 關 資 料 並 盡 快 以 傳 真 或 郵 遞 方 式 送 回 本 公 司 辦 理 如 有 任 何 問 題, 歡 迎 向 本 公 司 查 詢 熱 線 電 話 : / 電 郵 :[email protected] The new Part VI A under the Personal Data (Privacy) (Amendment) Ordinance 2012 is taking effect from 1 April According to these new legislative requirements, we are required to procure your consent for continuing to use your personal data collected in direct marketing activities. We hereby inform you that we may use your contact details, demographic information and policy details to contact you with direct marketing communications regarding financial and insurance products by mail, telephone or mobile message and we may also provide your contact details, demographic information and policy details to our related companies who may send you direct marketing communications regarding financial and insurance products by mail, , telephone or mobile message. Please tick the box and provide relevant information below and returning the reply slip to us as soon as possible either by mail or fax if you do not consent to receive such direct marketing communications. Please feel free to contact us if you have any question at(hotline: / [email protected]) 回 條 REPLY SLIP ( 傳 真 熱 線 Fax Direct : ) 請 在 以 下 方 格 內 填 上 去 確 認 選 擇 Please to confirm your selection 本 人 反 對 接 收 貴 公 司 的 直 接 促 銷 通 訊 I do not consent to receive marketing communication from the Company. 本 人 反 對 接 收 貴 公 司 關 連 公 司 的 直 接 促 銷 通 訊 I do not consent to receive marketing communication from the related companies of the Company. 如 閣 下 遞 交 此 聲 明 書 而 沒 有 在 以 上 方 格 內 以 顯 示 閣 下 的 選 擇, 即 代 表 閣 下 並 不 拒 絶 接 收 任 何 形 式 的 直 銷 推 廣 If you return this form without ticking the above box it means that you do not wish to opt-out from any form of direct marketing of the Company and/or its related companies. 投 保 人 姓 名 Insured Name 客 戶 編 號 Client Code 保 單 編 號 Policy No. 聯 絡 號 碼 Contact No. 電 郵 地 址 Address 投 保 人 簽 署 Insured s Signature 日 期 Date Chong Hing Insurance Co Ltd 創 興 保 險 有 限 公 司 CHI-PICS
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