Endorsement Form – Donewell Life Company Limited

Name of Branch (*)

Name(*)

Policy Number (*)

ID Type (*)

ID Number (*)

Address (*)

Staff Number (*)

Email (*)

Phone Number (*)

MoMo Number (*)

Increase in Premium

Current Premium (*)

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Effective From (*)

Change of Beneficiary (ies) - Add or Delete

Name	Age	Relationship	Percentage(%)	Address

Effective From (*)

Change of Trustee (*)

Change of Address (if any)

New Address (*)

Effective From (*)

Change of Retirement Age

Current Age (*)

New Age (*)

Effective From (*)

Change of Name

New Name (*)

Effective From (*)

(PLEASE ATTACH PHOTOCOPY OF EITHER AFFIDAVIT OR MARRIAGE CERTIFICATE)

Date (*)

Attach Supporting Documents (Use CTRL key & click to select multiple files. Accepted Format: doc|docx|pdf|jpg|png)

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Requirements

ID Card