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1
Information
2
Review Info
3
Payment
NewLife memorial plan
Payment Terms
Monthly
Mode of Payment
Credit/Debit Card
Chosen NewLife Plan
Gold Plan
Cremation then Urn Viewing
₱ 888.00
per month for 5 years
Your uploaded ID
Uploaded ID
Type of ID
Driver's License
ID Number
D01-12-123456
You’ve indicated that you’d upload your ID later.
Government IDs
Tax Identification Number (TIN)
150-483-028-757
Social Security System (SSS)
511-07-6227
Government Service Insurance System (GSIS)
n/a
Personal information
Last Name
Dela Cruz
First Name
Juan
Middle Name
Uy
Prefix
n/a
Suffix
n/a
Date of Birth
December 25, 1983
Place of Birth
Mandaluyong City
Nationality
Filipino
Marital Status
Single
Gender
Male
Cellphone
+63 927-654-3210
Email
juandc@gmail.com
Present Address
2801 Matipid Street, Apple Executive Village,
Barangay San Juan, Antipolo City, Rizal, 1900
Permanent Address
2801 Matipid Street, Apple Executive Village,
Barangay San Juan, Antipolo City, Rizal, 1900
Occupation
Middle management
Name of Employer/Business
MOBINO Inc.
Source of income
Employment
Beneficiaries
You’ve indicated that you’d assign beneficiary later.
Primary Beneficiary 1
Full Name
Ramon Dela Cruz
Date of Birth
November 11, 1960
Relationship
Father
Contact Number
Malea+63 927-012-4567
Complete Address
2801 Matipid Street, Apple Executive Village,
Barangay San Juan, Antipolo City, Rizal, 1900
I have read and agreed with the following:
•
Terms of Plan Contract
•
Health Declaration
Confirmation
Please note that the policy is subject to the condition of “15-day Free-Look Period”. More about this clause on Section 23 Free Look Period in your Terms of Plan Contract.
I declare all information are true and correct.
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