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MyLifeIncome Application Form

 

For a limited time only, get attractive cashback on your application.*

 

Capital guaranteed. 

On death, your family gets the premiums back & potentially more.

From retirement, receive lifetime annual cash benefits. 

 

 

 * If you have note received your personal quotation yet, please get your personal quote and promo here. Cashback is payable after the free-look period as passed.

 

 

Apply for Aviva's MyLifeIncome
Premium Term

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Premium Amount(*)
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This is the premium amount that you will invest into this plan each year over the premium term.

Annual income to start in:
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About You
Name as in NRIC(*)
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NRIC Number
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Date of Birth
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Gender
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Resident Status
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Country of Birth
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Nationality
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Marital Status(*)
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Upload Picture of NRIC - Front(*)
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Upload Picture of NRIC - Back(*)
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About Your Employment
Occupation(*)
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Nature of Work(*)
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Name of Employer(*)
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Employer's Address(*)
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Annual Income S$(*)
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Contact Details
Email(*)
Please specify your email address.

Handphone No.(*)
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Health & Lifestyle
Have you ever filed any claims or have you had an application, reinstatement or renewal of a Life, Critical Illness, Health, Accident or Disability policy deferred, declined or accepted with special terms?(*)

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In the last 12 months preceding the date of this application, have you been residing in Singapore for more than 183 days?(*)

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In the last 12 months, have you spent more than 30 days outside of your current country of residence (excluding holiday or leisure)?(*)

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In the next 12 months, do you plan to spend more than 30 days outside of your current country of residence (excluding holiday or leisure)?(*)

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Do you currently engage in or do you have definite plans to engage in any of the following (due to occupation or recreation/hobby): Scuba diving, mountain or rock climbing (excluding artificial wall climbing), private flying, parachuting or sky diving, motor sports (car, bike and boat), demolition, bomb disposal, naval diving and other extreme or hazardous activities?(*)

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Please provide details as you have indicated "Yes" to one of the above questions.(*)
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Source of Funds
Source of Funds to Pay Premiums(*)

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Please specify other source of funds
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How did you accumulate your wealth?(*)

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Please specify other source of wealth
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Declarations
I confirm that I am solely a tax resident of Singapore and do not have a foreign tax residency. My Singapore TIN is my NRIC or FIN.
I am not a Politically Exposed Person (PEP).
I confirm that I am the payor as well as the proposer for this plan.
I am not currently applying for any other Life Insurance policies and I do not intend to replace any of my existing policies with this policy.
Declarations(*)
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Where did you hear about us?
Where did you hear about us?

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Apply