Amendment of Application Form

Amendment of Application

In this form, you and your refer to the person being insured and the applicant or the planholder who is named in the application as the buyer of the pre-need plan, whichever is applicable, while we, us, our and the Company refer to Sun Life of Canada (Philippines), Inc. or Sun Life Financial Plans, Inc. Both are members of the Sun Life Financial group of companies.
This is in connection with the application for (check appropriate box)
1 General Information 1 General Information 1 General Information1 General Information

1 General Information
Life to be insured/Planholder (LastName, FirstName, MiddleName)
Client No.
n/a if not applicable
Application Serial No.
Policy No.
Plan No. ( for Pre-Need)
n/a if not applicable
Advisor
New Business Office

3 Signatures 3 Signatures 3 Signatures 3 Signatures

By signing below, you hereby declare that all declarations by the life to be insured or by the planholder and by the applicant, if the applica- tion includes a waiver of premium benefit, made from the time the application for the life insurance coverage was completed to the date of signing of this Amendment of Application form remain true and correct. You hereby agree that this declaration as to your insurability and the above amendments will form part of the application.
Signature of Applicant/Planholder
Printed Name of Applicant/Planholder
Place of Signing
Date of Signing (day/month/year)

MonthDayYear
Date