Financial Consultant Payment Instruction Worksheet This is NOT a payment receipt and CANNOT
(for internal use and premium for Life Insurance only) be considered as a proof of premium payment.
理財顧問繳費指令工作紙 (只供內部及繳交人壽保單保費使用) 此並非繳費收據，亦不能被視為繳付保費的證據。
Financial Consultant’s Name and Code Contact Phone No.
理財顧問姓名及編號 - 理財顧問電話號碼
Date of payment submission from customer Date of payment submission to Cashier
客戶繳付保費之日期 理財顧問繳付保費之日期
This worksheet is NOT applicable for Lump Sum Top Up Instruction, please submit “Application For Change in Policy / Withdrawal”.
此工作紙不適用於整付額外投資，請遞交「更改保單/提款申請表」。
Payment 付款 Cash/ Cheque No./
Policy No Name of Policyholder Name of Assured Credit Card No. Payment
保單編號 保單持有人姓名 受保人姓名
Currency 現金/支票號碼/ Code *
Amount 金額
貨幣* 繳費代號*
信用咭號碼
Payment Currency 付款貨幣: HKD - 港幣 USD - 美元 RMB - 人民幣 AUD - 澳元^ CAD - 加元^ GBP - 英鎊^
Payment Code 繳費代號:
01 - Initial / Balance Premium 03 - Renewal Premium 05 – Change in Policy 07 – Fee for Medical Report
首期及餘款保費 續保保費 更改保單 醫療報告費用
02 - Revival 04 - Loan Repayment 06 - Charge for Duplicate Policy 08 – Others (please specify):
保單復效 償還貸款 複印保單費用 其他 (請註明):
Notes 備註：* Must input currency & payment code 必須填上付款貨幣及繳費代號 ｜ RMB cheque is applied to RMB products only and RMB TT is applied
to EGC RMB product only 人民幣支票只適用於人民幣產品及人民幣電滙只適用於人民幣雋富多元貨幣計劃 (EGC) | ^ Applicable to EGC Plan only 只適用於
EGC 計劃 | The premium and/or proposal application must be submitted to Cashier Office immediately but not later than 48 hours. 保費及/或人壽保單申請
書必須於即日(但不得超越 48 小時)遞交至繳費處 Version 07/2022
Financial Consultant Payment Instruction Worksheet This is NOT a payment receipt and CANNOT
(for internal use and premium for Life Insurance only) be considered as a proof of premium payment.
理財顧問繳費指令工作紙 (只供內部及繳交人壽保單保費使用) 此並非繳費收據，亦不能被視為繳付保費的證據。
Financial Consultant’s Name and Code Contact Phone No.
理財顧問姓名及編號 - 理財顧問電話號碼
Date of payment submission from customer Date of payment submission to Cashier
客戶繳付保費之日期 理財顧問繳付保費之日期
This worksheet is NOT applicable for Lump Sum Top Up Instruction, please submit “Application For Change in Policy / Withdrawal”.
此工作紙不適用於整付額外投資，請遞交「更改保單/提款申請表」。
Payment 付款 Cash/ Cheque No./
Policy No Name of Policyholder Name of Assured Credit Card No. Payment
保單編號 保單持有人姓名 受保人姓名
Currency 現金/支票號碼/ Code *
Amount 金額 繳費代號*
貨幣*
信用咭號碼
Payment Currency 付款貨幣: HKD - 港幣 USD - 美元 RMB - 人民幣 AUD - 澳元^ CAD - 加元^ GBP - 英鎊^
Payment Code 繳費代號:
01 - Initial / Balance Premium 03 - Renewal Premium 05 – Change in Policy 07 – Fee for Medical Report
首期及餘款保費 續保保費 更改保單 醫療報告費用
02 - Revival 04 - Loan Repayment 06 - Charge for Duplicate Policy 08 – Others (please specify):
保單復效 償還貸款 複印保單費用 其他 (請註明):
Notes 備註：* Must input currency & payment code 必須填上付款貨幣及繳費代號 ｜ RMB cheque is applied to RMB products only and RMB TT is applied
to EGC RMB product only 人民幣支票只適用於人民幣產品及人民幣電滙只適用於人民幣雋富多元貨幣計劃 (EGC) | ^ Applicable to EGC Plan only 只適用於
EGC 計劃 | The premium and/or proposal application must be submitted to Cashier Office immediately but not later than 48 hours. 保費及/或人壽保單申請
書必須於即日(但不得超越 48 小時)遞交至繳費處 Version 07/2022
