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Get Credit Card Authorisation Form - Cigna New Zealand
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How to fill out the Credit Card Authorisation Form - Cigna New Zealand online
This guide will assist you in completing the Credit Card Authorisation Form for Cigna New Zealand. By following the steps outlined below, you will ensure that all necessary information is correctly submitted.
Follow the steps to complete the form accurately.
- Click the ‘Get Form’ button to obtain the form and open it in the editor.
- In the 'YOUR DETAILS' section, please print your details clearly in capital letters using a pen. Fill in your name, postal address, and telephone numbers for home, work, and mobile.
- Move to the 'PAYMENT DETAILS' section. Select your card type by marking either Visa or MasterCard. Enter your credit card number, the name as it appears on the card, and the card's expiry date. Make sure to enter these details accurately.
- In the 'Payer Reference' field, input your policy number. This will help identify your account for the payment.
- Choose your premium deduction frequency by ticking one of the options — Monthly, Half-yearly, or Yearly. Additionally, specify the Deduction Start Date by selecting a suitable date range or specific day.
- If you prefer a fortnightly deduction, provide the specific day of the week you wish for the payment to be deducted.
- Finally, in the 'DECLARATION' section, indicate your agreement by signing in the designated area. Also, provide the date of signing to validate your authorisation.
- After ensuring all fields are completed accurately, save the completed form, and make sure to download, print, or share it as needed.
Complete your documents online today to ensure a smooth submission process.
To send an email to Cigna, you can use their official email address found on their website. Make sure to include your account details and a clear subject line to expedite their response. Additionally, it is beneficial to ask specific questions related to your concerns or needs. For further guidance on communication, check resources on the US Legal Forms platform.
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