I declare and agree on behalf of myself and any person or persons, firm or corporation, who may have or claim any interest in any insurance on this application, that:

1. I declare that:
   1. I am aware that it is my pre-contractual duty of disclosure that I must exercise reasonable care not to misrepresent i.e. to give false answers/information when answering any questions asked by AIA and that I am to answer fully and accurately/correctly
   2. I have read and understood the contents of this purchase including all warnings and notices therein and I have fully and accurately answered all the questions in this purchase and the other questions asked by AIA, if any, after having fully read and understood the questions.
   3. I am aware that I must inform AIA of any change to the answers given in this purchase if the change occurred after I have submitted the purchase but before the contract is entered into.
   4. I fully understand that my answers and/or statements given in respect of the question asked by AIA, and any other relevant documents completed by me in connection with this purchase and in any medical report or amendments (collectively referred to as “the information”) are relevant to AIA in deciding whether to accept my purchase or not and the rates and terms to be applied
   5. I am aware that if any of my answers or statements or information given by me is not accurate/correct, the policy may be avoided, my claim denied or reduced, the terms of the policy changed or varied, or the Policy terminated.
2. I understand and agree that upon receipt of the policy document from AIA, I am obliged to check and confirm and/or ensure the accuracy and completeness of all information declared and submitted to AIA in relation to my purchase. I also understand that, I will have a 15 day free look period from the date of receipt of the policy from AIA to evaluate the suitability of the plan purchased. In the event that I wish to cancel the said policy document during this period, I may do so by giving AIA written notice of my intention for cancellation.
3. I understand and agree that any personal information collected or held by AIA (whether contained in this purchase or otherwise obtained) may be held, used, and disclosed by AIA to individuals / organization related to and associated with AIA or any selected third party (within or outside of Malaysia, including reinsurance and claims in investigation companies and industry associations/federations) for the purpose of processing this purchase and proving subsequent service for this and other financial products and service and to communicate with me for such purposes. I understand that I have a right to obtain access to and to request correction of any personal information held by AIA concerning me. Such request can be made to any of AIA’s Customer Service Centre.
4. I confirm my understanding on the provisions for nomination and assignment, including the importance of making a nomination and its implications. I have also been advised to nominate a nominee and ensure that the nominee is aware of the life insurance policy that I have purchased.
5. I further confirm that I have been informed of the importance of notifying AIA of any change in the contact details, including address, nominee and/or trustee.