Name of (proposed) insured
(拟)受保人姓名
HKID/ PRC ID/ Passport Number
香港身分证/中华人民共和国居民身分证/护照号码
Please answer following questions to facilitate residential
underwriting process.
请回答下列所有问题,以办理居住地核保程序。
1. Is the (proposed) insured a Hong Kong Identity
Card Holder? (拟)受保人是否香港身份证持有人? ?
Yes是 ?No 否
2. Which country’s passport does the (proposed)
insured hold? (拟)受保人持有哪个国家的护照?
3. Purpose of the insurance applied. 申请人投保目的。
4 Details of residency on the (proposed) insured: (拟)受保人居住详情:
(a) Country(ies) & City(ies) of residency in recent past 12 months:
过去十二个月居住的国家及城市:
(b) Duration of stay on average in Hong Kong each year and for how many years?
每年平均留港时间及合共多少年?
(c) Intended Country(ies) & City(ies) of residency with
duration in each location in the next 12 months:
未來十二个月打算居住的国家及城市及将会在每个地方逗留之时间:
(d) Intended Country(ies) & City(ies) to visit with duration
in each location in the next 12 months:
未來十二个月打算旅游的国家及城市及将会在每个地方逗留之时间:
5. Does the (proposed) insured have following connection
to Hong Kong?
(拟)受保人有否以下各种与香港之聯繫?
(a) Business interest or property in Hong Kong? 在港拥有任何业务或物业? ?
Yes是 ?No 否
(b) Family member(s) is(are) residing in Hong Kong? 家庭成员在港居住? ?
Yes是 ?No 否
(c) Under any employment contract in Hong Kong? 在港有否签署任何僱佣合约? ?
Yes是 ?No 否
For each answer “Yes”, please give details如是,请详述
*OBJTQUEST*
The Chinese version of this questionnaire is for
reference only. In the event of conflicts between
the Chinese and the English versions, the English version shall
prevail.
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