太平信用卡付款指示及授权书（1页）.pdf-业务单证-保险资料库

太平信用卡付款指示及授权书（1页）.pdf

redit Card Payment Instruction and Authorization
信用卡付款指示及授权书
(Payment by the Proposer’s Credit Card is recommended.
建议使用投保人之信用卡。
Accept credit card in HK currency only.
只接受港币信用卡户口。)
Visa MasterCard
Credit Card No.
信用卡号码
– – –
Name of Cardholder (Surname / Given Name)
持卡人姓名（姓/名）
Expiry Date (mm/yy)
信用卡到期日（月/年）
Premium 保费金额
Declaration 声明：
1. I hereby authorize China Taiping Insurance
(HK) Company Limited (“the Company”) to debit
the required initial premium from my credit card
account specified herewith for the insurancepolicy.
本人兹授权中国太平保险(香港)有限公司(“贵公司”)从本人所指定之信用卡户口内提取保单应缴之首年保费。