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Please provide the below details. Our Relationship Manager will contact you shortly to make an appointment for a professional Financial Needs Analysis.
 
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Financial Needs Analysis:
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Which items below you are interested in (note: you may choose more than one item):
Savings & Life Protection Health / Accident Protection
Retirement Planning & Life Protection Children Education & Life Protection
Estate Planning & Life Protection Others
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Note: Personal data supplied by you on this form is intended to be used for this appointment only and will not be updated to your prevailing record by us.
 
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We will contact you shortly for a Financial Needs Analysis arrangement (provided that your contact number is valid).
 
Note: The life assurance plans are life insurance products and are not bank deposits. They are underwritten by Prudential Hong Kong Limited (a member of Prudential plc group) ("Prudential") and distributed by Standard Chartered Bank (Hong Kong) Limited ("Standard Chartered"). Some of these plans may have a savings element and are not an alternative to ordinary savings or time deposits. Part of the premium pays for the insurance and related costs.

If you are not happy with your policy, you have a right to cancel it within the cooling off period and obtain a refund of any premiums paid, less any withdrawals (if applicable), provided that no claim has been made under the policy. A written notice signed by you should be received directly by the Prudential’s Hong Kong Principal Office at 25th Floor, One Exchange Square, Central, Hong Kong within the cooling off period (that is, within 21 days after the delivery of the policy or issue of a notice (informing you or your representative about the availability of the policy and expiry date of the cooling off period), whichever is the earlier). After the expiration of the cooling off period, if you cancel the policy before the end of the term, the projected total cash value (if applicable) may be less than the total premium you have paid. You should check with Prudential if you have any doubt regarding your cooling-off right.
 
Standard Chartered is an insurance agent of Prudential.
 
As the issuer of the life assurance plans, Prudential will be responsible for all protection and claims issues. Prudential is not an associate or subsidiary company of Standard Chartered. This material is not a contract of insurance. Please refer to the policy for full terms and conditions. Standard Chartered does not accept any responsibilities regarding any statements provided by Prudential or any discrepancies or omissions in the contract of insurance nor shall Standard Chartered be held liable in any manner whatsoever in relation to your contract of insurance.
 
This material is intended to be distributed in Hong Kong only and shall not be construed as an offer to sell or solicitation to buy or provision of any insurance product outside Hong Kong. Prudential and Standard Chartered do not offer or sell any insurance product in any jurisdictions outside Hong Kong in which such offering or sale of the insurance product is illegal under the laws of such jurisdictions. This material does not constitute a contract of insurance or an offer, invitations or recommendation to any person to enter into any contract of insurance or any transaction described therein or any similar transaction.
 
Whether to apply for insurance coverage is your own individual decision. For Prudential’s life assurance plan policy provisions, details and risk disclosure please refer to relevant plan’s product leaflet/offering document and specimen policy.
 
In respect of an eligible dispute arising between Standard Chartered and the client out of the selling process or processing of the related transaction, Standard Chartered is required to enter into a Financial Dispute Resolution Scheme process with the client; however any dispute over the contractual terms of the product should be resolved between directly Prudential and the client.
 
I have read and fully agreed the details and relevant notes of this appointment.
 
 
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