太平信用卡付款指示及授权书(1页).pdf
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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。
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。