Advisor’s Report

For any explanation, provide further details on Item No. 16 Remarks or Additional Comments or use additional page.
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1. Did you personally see the life to be insured and/or applicant for this Application? ✔ Yes No Note: Face-to-face interview is required.
2. How did you come to know about the life to be insured? Through Business Personal ✔ Family

3. For how long have you known life to be insured? ✔ Life time Years Just met
4. Who/What is your Source of Sale? (Check one)
Friend/acquaintance Orphan policy owner ✔ Relative of Advisor Upselling Campaign, specify
Cold Call Maturity Recapture Existing Client Others, specify
Walk-in (complete an Advisor’s Confidential Report) Referred Lead No.
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5. Form of Payment 6. Mode of Payment 7. Due Date for First Regular Premium
Bank Transfer Cash Check Single Pay Traditional Plan VUL Plan
Credit Card (For Traditional products only) Yearly Settlement Date ✔ Settlement Date

✔ Validated Deposit Slip

Half-Yearly 1 day before birthday subject 1 day before birthday
to backdating guidelines subject to backdating
✔ Cash Check Quarterly Application sign date or guidelines
if cash deposit of over Php 100,000.00, Monthly for Salary date of Medical Examination
declare source of cash Deduction/Worksite whichever is later
8. Provisional Receipt (P.R.) No. 9. P.R. Date (day/month/year) 10. Amount Paid
4 200.00

11. Is the payment included in the application? Yes No

 
 
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12. Source of Payment from Sun Life Products

Maturity proceeds from Policy/Plan No. Redemption from SLAMCI Account No.
(Submit appropriate form to SLAMCI)
Change over bonus on Policy No. Fund withdrawal from Policy No.
(Submit appropriate form to Policy and Plan Change Section)
Dividend/Endowment payout from Policy No. Others, specify
13. What is the purpose of this application?
✔ Income protection Retirement Estate tax funding ✔ Personal health & Retirement (employer-paid)
(Individual) accident protection
Creditor protection Education Savings/investment Key person insurance Others, specify
14. Special Payment Arrangement - if applicable to this product (Submit appropriate forms)
Advance Payment Option Auto-Charge Arrangement Auto-Debit Arrangement Salary Savings
(not available for VUL) (for premiums only; not available for VUL) (applicable for premiums only)
Employee Marketing (see GISSDAF) Salary Deduction/Worksite (see GISSDAF) Staff Assurance
15. Is the life to be insured an Advisor? ✔ family member of the Advisor? Indicate relationship to Advisor
a Staff? family member of the Staff? Indicate relationship to Staff
Others, specify
16. Remarks or Additional Comments:

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17.
Name of Advisor (Last, First, MI) Code Share NBO/ISO Sunny Level Up Passer
NICANOR, ABEGAIL L. 132692 100 % GRANDIS Yes ✔ No

✔
Yes (Provide details. Share must be a minimum of 10%) No
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18.
Name of Advisor (Last, First, MI) Code
Code Share NBO/ISONBO Sunny Level Up Passer
% % Yes No
Name of Advisor (Last, First, MI) Code Share NBO/ISO Sunny Level Up Passer
% Yes No
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19.
I declare and confirm that:
• I have performed the appropriate know-your-client process in accordance with the anti-money laundering laws and policies of the Company. Should there be
any adverse change in my opinion regarding the integrity or reputation of the life to be insured/applicant, I shall inform the Company’s Money Laundering
Reporting Officer immediately;
• I have explained to the life to be insured/applicant the benefits being applied for in this Application in accordance with the provisions of the insurance con-
tract that will be subsequently issued, if approved by the Company;
• I have asked the life to be insured/applicant if the product to be purchased in this Application is intended to change or replace any existing life insurance
policy/ies and have fully explained to the life to be insured/applicant the disadvantages of changing or replacing any existing life insurance policy/ies;
• I have asked the questions contained in this Application to the life to be insured/applicant or parent and the answers were correctly recorded;
• This Application, report and any accompanying information are complete and true to the best of my personal knowledge and belief.
20. Signature of Advisor who conducted the interview and verified the signatures 21. NBO/ISO 21. Date of Signing (day/month/year)
X GRADIS 09 SEP 2020

SRAR.03.19
Sun Life of Canada (Philippines), Inc.
*SRAR.03.19* Page 9 Serial No. SR02175107