I hereby declare that the above statements and particulars are complete and correct and that no facts have been suppressed or misstated. I agree that this proposal shall form the basis of the contract between the Company and I.

I and my guarantor (if any) agree to indemnify United Overseas Insurance Limited (UOI) against all payment, costs and expenses incur by UOI under the obligation of such Letter of Guarantee to MOM.

I am aware that I can seek advice from a qualified adviser before making a commitment to purchase the product. In the event that I choose not to seek advice from a qualified adviser, I take sole responsibility to ensure that this product is appropriate to my financial needs and insurance objectives.

I also acknowledge by providing personal data relating to a third-party (e.g. information of my dependent, spouse, children, parents and/or employees) I represent and warrant that the consent of that third party has been obtained for the collection, use and disclosure of the personal data for the Purposes stated in UOI’s Privacy Notice. UOI may disclose my/our personal data to its third-party service providers or agents (including lawyers/law firms), which may be sited outside of Singapore, for one or more of the above Purposes, as such third-party service providers or agents, if engaged by UOI, would be processing my/our personal data for UOI for one or more of the above Purposes. This may include disclosure to industry association.