Accept this application. The life insured and policy owner must complete this application. To avoid delays, check that all questions have been answered fully. Please use BLOCK LETTERS. Policy num ber/s Policy type: Wealth Protection Active Sumo FutureWise Other Your duty of disclosure Before entering into a life insurance contract, we must be told anything that each of you as the proposed policy owner and the life to be insured (if a different person to the propo.

How it works
  • Open form

    Open form follow the instructions

  • Easily sign form

    Easily sign the form with your finger

  • Share form

    Send filled & signed form or save

How to fill out the AU Zurich ZU11821 online

Filling out the AU Zurich ZU11821 form is an essential step for individuals seeking non-smoker rates for their insurance policy. This guide will provide you with clear, step-by-step instructions to ensure you complete the form accurately and efficiently.

Follow the steps to complete your application successfully.

  1. Click the ‘Get Form’ button to obtain the AU Zurich ZU11821 form and open it for editing.
  2. Begin by filling in the life insured details. This includes entering the title, surname, given names, date of birth, and address. Make sure to use BLOCK LETTERS for clarity.
  3. Provide your contact details, including work, home, and mobile phone numbers, along with your email address.
  4. In section 2, the smoking history must be completed by the life insured. Answer all relevant questions regarding tobacco use, cessation dates, motivation to stop smoking, and any related medical advice.
  5. In question (i) of section 2, if you answered 'Yes' to any medical conditions or treatments, fill out the table with specific details, dates, and treatment received.
  6. Proceed to the declaration section where both the life insured and policy owner need to acknowledge the duty of disclosure and sign the form. Ensure that the dates are correctly filled in.
  7. Once all sections are complete, review your entries to ensure accuracy. You can then save your changes, download the completed form, print it, or share it as necessary.

Complete your AU Zurich ZU11821 form online today to secure your non-smoker rates!

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.

If you believe that this page should be taken down, please follow our DMCA take down process here.

AU Zurich ZU11821 Form

This form is available in several versions. Select the version you need from the drop-down list below.

Get AU Zurich ZU11821