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UniHome Safe Application

IMPORTANT NOTES
  1. Under Section 25(5) of the Insurance Act (Chap142), you are required to disclose in this proposal form, fully and faithfully all the facts which you know, or ought to know, otherwise the Policy issued hereby may be void.
  2. Please fill in all sections of this form (IN BLOCK LETTERS), in order to avoid unnecessary delay in the processing of this proposal form.

DECLARATION
I declare that the dwelling is (a) constructed of brick, stone or concrete. (b) not used for trade purpose and (c) occupied by me and under my control.
The information provided above is true and factual. I understand that all facts may be material to the underwriter accepting this risk must be declared. I also understand that no liability shall be accepted by the Company until this Proposal Form is accepted by the underwriter.

Promotion Code:   (if applicable)
PART 1: PROPOSER'S PARTICULARS
Name (in full):
Joint Names (where applicable)
NRIC / FIN / Passport No.: * E.g. S1234567A Nationality:
Gender: Male        Female Marital Status:
Date of Birth:   DD-MM-YYYY    
Postal Address:
Postal Code: *
Unit No. #  -
Block
Street Name *
Building / Estate Name
Country *
Home / Office: Mobile: A confirmation SMS will be sent to this number
 
E-mail: * Occupation /
Profession:
PART 2: DETAILS OF RISK
Location of Risk
(if different from above):


Name of Mortgage (if any):  If Others, please specify:
Type of Building:   If Others, please specify:
Home to be insured is for : Self-occupied        Rental
PART 3: SUMMARY OF INSURANCE COVERAGE
Coverage of Plan:

I want to take up 3-Year Special Premium        I want to take up 5-Year Special Premium
Period of Insurance:

From       DD-MM-YYYY    To      *   DD-MM-YYYY     (both dates inclusive)

 

>> For More Information

Please e-mail us at e-personal@sg.cntaiping.com or call the following personnel:

  Andrew Lee at (65) 6389 6148
 

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