创兴更改、取消保单申请书(4页).pdf
已下载:0 次 是否免费: 否 上传时间:2019-01-17
请填妥有关部分,如有遗漏可能延误有关申请。
Please complete all related questions;failure
to do so may result delay in processing your request.
呈递此申请书,并不表示保险公司已更改内容,一切以保险公司收取正本為有效日期。
This submission of this form does not mean the Insurance
Company have modified the content, the effective
date will start on the date when the Insurance Company
received the original document.
请用正楷填写本表格。
Please complete this form in BLOCK LETTERS.
保单号码POLICY NO.: 代理编号AGENT CODE:
保户名称NAME OF INSURED:
本人谨通知 贵司办理以下事宜 (请在适当方格内加“”号)
Please proceed with the followings
(please “” in the appropriate box)
1.保户名称:
Name of Insured:
2.保户通讯地址:
Insured’s Mailing Address:
3.受保地址:
Location of Risks:
4.营业性质:
Trade or Business:
5.保险期限: 由 至 (首尾兩日包括在内)
Period of Insurance: From To (Both Dates Inclusive)
6.保险金额:增加 / 减少 总额更改至:
Please complete all related questions;failure
to do so may result delay in processing your request.
呈递此申请书,并不表示保险公司已更改内容,一切以保险公司收取正本為有效日期。
This submission of this form does not mean the Insurance
Company have modified the content, the effective
date will start on the date when the Insurance Company
received the original document.
请用正楷填写本表格。
Please complete this form in BLOCK LETTERS.
保单号码POLICY NO.: 代理编号AGENT CODE:
保户名称NAME OF INSURED:
本人谨通知 贵司办理以下事宜 (请在适当方格内加“”号)
Please proceed with the followings
(please “” in the appropriate box)
1.保户名称:
Name of Insured:
2.保户通讯地址:
Insured’s Mailing Address:
3.受保地址:
Location of Risks:
4.营业性质:
Trade or Business:
5.保险期限: 由 至 (首尾兩日包括在内)
Period of Insurance: From To (Both Dates Inclusive)
6.保险金额:增加 / 减少 总额更改至: