| Document Date: 2014-04-03 04:25:42
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City Zurich / / Company Assurance Ltd / Zurich Life Insurance (Hong Kong) Zurich Assurance Ltd / Zurich Insurance Group / Zurich Assurance Ltd / Zurich Life Insurance Company Ltd / / Country United Kingdom / Wales / / Event Product Issues / Product Recall / / / IndustryTerm foreign law / bank account proof / bank name / financial products / investigation services / insurance surveys / insurance services / insurance claims / law binding / bank / telecommunications / insurance application / bank address / banking / bank sort code / bank passbook / insurance applications / overseas bank account** / insurance products / bank statement / designated bank account / insurance intermediaries / / Organization Insurance Authority / Hong Kong Federation of Insurers / / / Position contractor / solicitor / Financial Consultant / Personal Data Privacy Officer at the address below / banker / accountant / legal advisors / Officer / / Product Policy Loan/ Dividends / Guaranteed Cash Coupons / / Region East Hong Kong / / Technology data processors / / URL http /
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Request for Policy Loan/ Dividends Withdrawal 保單貸款╱紅利提取申請表 Private & Confidential 私人及保密文件 Name of Policy Owner 保單持有人姓名