POLICY INFORMATION

Full Name of Owner NRIC/Passport No.

Policy Number
ADVICE (Applicable to Customer who is serviced by a Manulife Representative for an investment-linked policy transaction)
Please note that it is mandatory to complete this section for the following transactions only:
Increase Premium of Basic Plan
Commencement of RSP
Increase RSP Amount
It is important to seek advice from your Manulife Representative before submitting this Application. Your Manulife Representative can
provide suitable recommendations to you, taking into account your financial objectives, financial situation and particular needs.
I/We met my/our Manulife Representative and:
DID obtain advice from my/our Manulife Representative before submitting this Application; OR
DID obtain advice from my/our Manulife Representative BUT the transaction I/We have chosen is not a transaction recommended
by my/our Manulife Representative; OR
notified my/our Manulife Representative that I/We do not want any advice.
Please note:


I/We DID NOT meet my/our Manulife Representative before submitting this Application.
I/We now wish to be referred to a Manulife Representative for advice before I/we submit this Application.
I/We do not wish to be referred to a Manulife Representative for advice before I/we submit this Application.
Please complete Sections 2C to E, of this Form, which relate to your Customer Knowledge Assessment.
Kindly note that the Company will NOT be able to process your Application if Sections 2C to E are not completed.
1.
possess the required knowledge or experience in such products. In order for us to make an assessment, please ensure that the
following are completed:
Section 2C - Customer Knowledge Assessment (CKA)
Section 2D - Your CKA Outcome
Section 2E - Your Acknowledgement and Decision
Any inaccurate or incomplete information provided can affect the outcome of the assessment and the suitability of the advice or recommendations
made (if any).
2. Where the policy is under Trust, Sections 2C to F must be completed by:
Any Trustee who is not the Owner OR all Beneficiaries 18 years old and above for Section 49L trust under the Insurance Act.
All Trustees of the policy under Section 73 of the Conveyancing & Law of Property Act.
If there is more than one Trustee or Beneficiary, please attach the complete set of Section 2C to F for each additional Trustee
or Beneficiary.
Manulife (Singapore) Pte Ltd. Reg. No. 198002116D Page 1 of 6
Your Application must be submitted with the Manulife Plan Right form(s) and
if you select this Section 2A, you do not have to complete Sections 2C to 2F of the Form. Please proceed to complete Sections 3, 4 and 5.
If you wish to proceed with this Application or make any future transaction in an Investment-Linked policy (ILP), it is important that you
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POLICY DETAILS CHANGE
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And for Corporate Policies
-Enclose photocopies of NRIC/Passport of authorised signatories
-Enclose copy of the latest ACRA business profile extracted not more than 3 months
from submission date
Please remember to...
Countersign any amendments
EEnsure that the appropriate boxes are checked
Note that Submission Cut-off time is 3pm

INTERNAL USE - FOR STAFF

Client No.
Doc ID PA016 PA017 PA021 PA024 PA026 PA030 PA043 PA044 NB108 _____
INTERNAL USE - FOR REPRESENTATIVE
Update is for New Business Client Services
Submitted by Servicing Rep Others _________________(Code)
A. Met Manulife Representative
B. Did not meet Manulife Representative
C. Customer Knowledge Assessment (CKA)
3. Please tick the applicable box(es) and provide details.
Educational Qualifications
1. I have a Diploma or higher qualifications in:
Accountancy Capital Market Financial Engineering
Actuarial Science Commerce Financial Planning
Business/ Economics Computational Finance
Business Administration/ Finance Insurance
Business Management/
Business Studies
Institution: Year of graduation:
2. I have Professional Finance-related Qualifications:
E.g. Associate Financial Planner (AFP), Associate Financial Consultant (AFC), Chartered Financial Analyst (CFA), Association of Chartered
Certified Accountant (ACCA), Diploma in Life Insurance, Diploma in Financial Planning, CMFAS M5/M8/M9.
Qualification: Year of attainment:
Investment Experience
3. I have made at least 6 transactions in Investment-Linked Policies (ILPs) and/or Collective Investment Schemes (CIS) in the
past 3 years. (excluding rollover of funds from maturity proceeds of investments insurance policy and regular savings plans.)
Name of Financial Institution(s):
Work Experience
4. I have a minimum of 3 consecutive years of working experience in the past 10 years in:
(i) the development/structuring/management/sales/trading/research on and analysis of investment products, or
(ii) the provision of training in investment products or
(iii) accountancy, actuarial science, treasury or financial risk management activities or
(iv) the provision of legal advice or legal expertise in the areas listed (i) to (iii) above.
Company(ies):
Designation(s):
Please be informed that if you have ticked at least one category under Section 2C part (3), you have met the passing requirement of CKA.
However, if none of the four categories under Section 2C part (3) apply to you, you have not fulfilled the passing requirement of CKA.
Based on the informaon provided, I understand that I am assessed:
To have knowledge and/or experience in Investment-Linked Policies and/or Collective Investment Scheme products.
(i.e. PASSED CKA)
Not to have knowledge and/or experience in Investment-Linked Policies and/or Collective Investment Scheme products.
(i.e. DID NOT PASS CKA)
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Please note that general support functions such as operations, human resources, corporate services and information technology will not be
considered as relevant experience.
D. Your CKA Outcome
PASSED CKA
I understand that I have passed the CKA and,
I WISH to receive advice offered by my Manulife Representative concerning this Application.
I DO NOT WISH to receive advice offered by my Manulife Representative concerning this Application.
I understand that by choosing not to receive advice:
It is my responsibility to ensure that the transaction I select is suitable for me, and
I will not be able to rely on section 27 of the Financial Advisers Act to file a civil claim in the event of a loss.
I CONFIRM that I wish to proceed to select my transaction without advice.
DID NOT PASS CKA
I understand that I did not pass the CKA and,
I WISH to receive advice offered by my Manulife Representative concerning this Application.
I DO NOT WISH to receive advice offered by my Manulife Representative concerning this Application.
I CONFIRM that I wish to proceed with a transaction that is not recommended by my Manulife Representative even though I am aware
and fully understand that:
I have not passed my CKA;
my Manulife Representative is required to give me advice;
it is my responsibility to ensure the suitability of the transaction I wish to perform;
my request to perform the transaction will be referred to the Companys senior management for consideration which will require
a reasonable amount of time and
I can proceed only if the Companys senior management agrees.
Section 49L (Insurance Act)
Who to sign:
Any Trustee of the policy who is not the Owner OR all Beneficiaries 18 years and above
Trustee can be appointed by the Owner via Nomination of Beneficiary Form 3
Section 73 (Conveyancing & Law of Property Act)
Who to sign:
All Trustee(s) of the Policy
Signature of Trustee/Beneficiary
Name
NRIC
Date of Assessment
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E. Your Acknowledgement on CKA Outcome and Advisory
F. Additional Declaration for Policy under a Trust
CHANGE POLICY DETAILS
1. Increase Premium of Basic Plan to $
For Investment-Linked Policies only (Subject to minimum Sum Insured). Please complete Sections 2C to F if applicable.
2. Decrease Premium of Basic Plan to $
3. Increase Sum Insured of Basic Plan to $
- -- -Please attach the Regular Premium Application Form or Declaration of Insurability Form where applicable as further underwriting is required.
4. Decrease Sum Insured of Basic Plan to $
Please note that for Traditional Policies, a decrease in Sum Insured is considered a partial surrender of the Policy.
1. Commence RSP as at next Policy Anniversary
Amount: $
End Date: Policy Anniversary after age
Frequency: Monthly Quarterly Semi-Annually Annually
For SRS, only Annual mode is available. Please complete Sections 2C to F if applicable.
2. Increase RSP Amount to $
- -- -Please complete Sections 2C to F if applicable.
3. Decrease RSP Amount to $
4. Change RSP End date to Policy Anniversary after age
5. Terminate RSP at the next Premium due date
1. Change Payment Frequency to
Monthly (GIRO only) Quarterly (ManuCare Policies only) Semi-Annually Annually
2. Change Payment Method to
GIRO (Please attach Application for Interbank GIRO form) Cash / Cheque
For GIRO mode, is the Payor the Owner / Assignee / Life Insured?
Yes. The Payor is the Owner/Assignee/Life Insured.
No. The Payor is NOT the Owner/Assignee/Life Insured. Payor's details are as follows.
Payor's Name
Relationship to Owner
Payor's Occupation
Annual Income
Source of Wealth
Source of Funds
Payor's Address
Reason for making payment for Owner
- -- -Please enclose copy of Payor's NRIC/Passport of Evidence of incorporation, ownership & shareholdings(where applicable).
3. Terminate GIRO Facility
4. Commence Premium Holiday for Years Months
If duration is not specified, premium holiday will continue to be in effect as long as the policy is in force.
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A. Change Basic Plan Details
B. Change Recurring Single Premium (RSP) Details
C. Change Payment Arrangement
1. Increase Sum Insured of Rider/Supplementary Benefit to $
Name of Rider/Supplementary Benefit
- -- -Please attach the Regular Premium Application Form or Declaration of Insurability Form where applicable as further underwriting is required.
2. Decrease Sum Insured of Rider/Supplementary Benefit to $
Name of Rider/Supplementary Benefit
3. Add Rider(s)/Supplementary Benefit(s)
Sum Insured $
Sum Insured $
Sum Insured $
- -- -Please attach the Regular Premium Application Form or Declaration of Insurability Form where applicable as further underwriting is required.
4. Delete Rider(s)/Supplementary Benefit(s)
1. Life Replacement Option
2. Keyman Replacement Option
1. New Occupation Title
2. Effective Date of New Occupation
3. Description of Job Duties
Please note that we may request further information for underwriting purposes.
1. Freelook Cancellation of Policy
Reason:
Freelook Cancellation can only be exercised within 14 days from date of receipt of the policy contract by the Owner.
Contract is deemed received within 7 days after date of postage.
For ManuRetire Secure, please refer to your Policy Contract for information on the applicable valuation on your transaction.
2. Convert to Reduced Paid-Up
3. Other Changes
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Depending on the type of Rider/Supplementary Benefits, deletion will be effective at the next monthly anniversary or premium due date.
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D. Change Rider/Supplementary Benefit
E. Change Insured Person
F. Change Occupation Details of Insured
G. Other Policy-Related Changes
DECLARATION & AUTHORISATION
1. I/We understand the contents of this Application and confirm that I/We wish to perform the transaction selected above.
2. I/We/The beneficiaries are not undischarged bankrupt(s). There are currently no pending or threatened bankruptcy proceedings against me/us.
3.
4. I/We agree to provide the Company with information of any change to the Life Insured's health, occupation or engagement of hazardous activities.
5. I/We confirm that the above information is true and correct, and I/We authorise the Company to effect the change(s) requested on my policy(ies).
6. Applicable for submission via Facsimile / Electronic mail (Electronic Services) where permitted by the Company -
7.
8. I/We are aware that this Application will not be effective until it is formally accepted by the Company.

Name
Signature of Owner/Assignee Contact No. Date
Section 49L (Insurance Act) Section 73 (Conveyancing & Law of Property Act)
Who to sign: Who to sign:
Any Trustee of the policy who is not the Owner All Trustee(s) of the Policy
OR all Beneficiaries 18 years and above
Proceeds payable to:
Trustee can be appointed by the Owner via Nomination of Beneficiary Form 3
Trustee(s) for the benefit of the Beneficiary(ies)
Proceeds payable to:
Trustee(s) OR All Beneficiary(ies)
Signature of Trustee/Beneficiary Signature of Trustee/Beneficiary
Name Date Name Date
NRIC No. Contact No. NRIC No. Contact No.
Signature of Trustee/Beneficiary Signature of Trustee/Beneficiary
Name Date Name Date
NRIC No. Contact No. NRIC No. Contact No.
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Save as provided in this form, information provided on the Life Insured's health, occupation and engagement of hazardous activities is complete and remains
accurate.
I/We hereby authorise the Company to carry out the above-mentioned policy transaction(s) on my Policy received viaElectronic Services. I/We acknowledge
that the Company is not responsible for verifying the authencity of the instructions given by me/us or purported to be given by me/us. The Company reserves
the right to withhold or disallow the execution of instructions for verification or other purposes and shall not be liable for any losses incurred in consequence.
The Company retains full authority and discretion to amend the terms and manner of use of the Electronic Services (including terminating the use of such
Electronic Services) at all times. Please note the transmission of instructions via Electronic Services shall be evidenced by the receipt of a successful transmission report(in the case
of facsimile) or message(in the case of electronic mail).
I/We agree to indemnify and hold harmless the Company against any and all losses (whether direct, indirect, special or consequential) suffered by me/us or any
third party arising from or in connection with the Company accepting and acting on my/our instructions (including where relevant, the use of the Electronic
Services) except where such loss is attributable to the Companys gross negligence or willful default.
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If you wish to understand the list of purposes for which your personal data may be used or disclosed, you may refer to
the Statement of Personal Data Protection located at our website (www.manulife.com.sg)
Additional Authorisation for Policy under a Trust
Need Help? Please contact your Financial Representative for further assistance.
Alternatively, you may call our Client Services Officers at 6833 8188 or visit us at 51 Bras Basah Road, #01-02C Manulife
Centre Singapore 189554 during service hours.

Completed? For the following 6 transactions, please send us the original form with relevant documents via MAIL.
OIncrease Sum Insured for Basic Plan OIncrease Premium of Basic Plan
OIncrease Sum Insured for Rider(s)/Supp. Benefit(s) OCommencement of RSP
OAddition of Rider(s)/Supp. Benefit(s) OIncrease RSP Amount

For Other Requests, you may submit this form to us via Email or Fax.

Mail 51 Bras Basah Road #09-00 Manulife Centre Singapore 189554
Email forms@manulife.com Fax 67322714