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GLOBALHEALTH ASIA GROUP APPLICATION FORM Important Notice: Statement pursuant to Sectionof The Insurance Act (Capor any subsequent amendments thereof): You are to disclose in this Application Form, fully a
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Company

AIG Asia Pacific Insurance Pte. Ltd. / Mastercard / Singapore Deposit Insurance Corporation / /

Country

Singapore / /

/

Facility

Direct Billing Facility / Ltd. AIG Building / /

IndustryTerm

insurance product / insurance objectives / direct bill paying services / insurance intermediary / online records / /

Organization

Credit Card / /

Person

Corner / Code / /

Position

qualified advisor / Producer / advisors / No Producer / /

URL

www.AIG.com.sg / www.globalhealthasia.com / www.sdic.org.sg / http /