Transfer Agent PAMB to PBTB Agent
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This document is a form for appointing a new servicing agent for an insurance policy or certificate. It contains sections for the policyholder to provide their contact details and signature approving the change. There are also sections for the new servicing agent to provide their details and signature accepting the appointment. The existing agent and quality leader must also sign to agree to the transfer of servicing, commission, or both to the new agent. The policyholder is asked to return the completed form by a specified date so the insurance agency can process the change of servicing agent on the policy.
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Transfer Agent PAMB to PBTB Agent
- 1. Attention : Agency Administration Date : _____________ Level 10, Menara Prudential APPOINTMENT OF NEW SERVICING AGENT Section I is to be completed by policyholder / certificateowner: Policy / Certificate No. : Name of Assured / Participant : Contact No : Signature of Assured / Participant : : Section II is to be completed by new servicing Agent : Agent's Code : Agent's Name : Signature of Agent : Section III is to be completed by existing agent & QL(Please tick whichever applicable) : I am agreeable to the transfer of servicing only. I am agreeable to the transfer of commission only. I am agreeable to the transfer of servicing and commission. Agent's Code : Agent's Name : Signature of Agent : Signature of QL : FOR OFFICE USE ONLY Dear Mr / Ms ______________________________ Please complete section __________________ and return to us before _________________ for further action. Remarks : Checked by : ________________