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IMPORTANT NOTICE 重要提示

You have to disclose in this Insurance Application 

Form all material facts, which shall form the basis 

of the contract made between CHINA TAIPING INSURANCE (HK)

COMPANY LIMITED (the Company) and you, otherwise 

the policy issued may be void or voidable at the 

option of the Company. If you are in doubt whether a fact is

material, please disclose it this insurance 

Application Form. Please complete this form in 

ENGLISH/CHINESE AND BLOCK LETTERS and tick√the 

appropriate box below.

阁下必须在本保险申请书上填报一切重要有关之事实，因為阁下与中国太平保险(香港)有限公司（本公司）之合约将以这些事实為根据，否则签发之保单将根据本公司的选择而无效或可使无效。如阁下不清楚某一项是否重要，也请将其事实在本保险申请书上说明。请以正楷英文/中文填写此份投保书，并於下列适当之方格填上√号。

(I) Particulars of Proposer 投保人资料 

(Proposer must be aged 18 or above 投保人必须年满18岁或以上）

1. English Name 英文姓名

2. Chinese Name 中文姓名

Surname 姓

Given Name 名

3. Document Type

证件类别

□ HKID Card 香港身份证 

□ Travel Document 港澳通行证 

□ Passport 护照

4. Sex 性别

□ Male 男 

□ Female 女

Document No.