Absolute Assignment for Value

In this form, you and your refer to the policy owner while we, us, our and the Company refer to Sun Life of Canada (Philippines), Inc., a
member of the Sun Life Financial group of companies.

PRINT clearly. Use BLACK ink.

1 General Information
Policy Owner (Last Name, First Name, M.I.)

Life Insured (Last Name, First Name, M.I.) (Complete if the life insured is not the policy owner)

Policy Number(s)

2 Absolute Assignment
For value received, you hereby request the Company to effect the absolute and unconditional transfer, other than as security,
of all rights, title and interest in the policy to the assignee named below:
For Individual
Assignee (Last Name, First Name, M.I.) Relationship to the life insured
Father Mother Others, specify

Birthplace (City/Province and Country) Bithdate (day/month/year) Age Religion

Citizenship/s Country/ies of Legal Residence other than the Philippines

ID Presented ID No. ID Expiry Date TIN

SSS No. or GSIS No. Explain if there is no TIN, SSS or GSIS No.

Permanent Residence Address (no., street, municipality/city, province, country, zip code) P.O. Box is not acceptable

Present Residence Address (no., street, municipality/city, province, country, zip code) P.O. Box is not acceptable

Home Phone Work Phone Mobile Phone E-mail Address

(country code, area code & tel. no.) (country code, area code & tel. no.) (country code & mobile no.)

For Institution
Assignee (Complete Company/Business Name) Relationship to the life insured
Employer Others, specify
Country of Incorporation or Business Registration Type of Business
Sole Partnership Corporation Others, specify
Proprietorship
TIN Contact Person Designation

Business Address (building, street, municipality/city, province, country, zip code) P.O. Box is not acceptable

Business Phone (country code, area code & tel no.) E-mail Address

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3 Acknowledgement and Agreement

Changes to Material Facts or Personal Information

By affixing your signature below, you acknowledge and agree that you shall notify the Company in writing and provide the required details
or documents within thirty (30) days for any changes in your personal/material information which results in the Company being subject to
tax reporting and withholding requirements under local and/or foreign laws applicable to you or your property. There is a change in your
personal/material information if there is a change in your contact number(s), place of residence, citizenship, or other circumstance as defined
under applicable laws.

Data Privacy
By signing below, you consent, as well as affirm that you are authorized to give consent on behalf of the assignee and/or beneficiary,
for the collection, processing, use, storage and destruction of personal and sensitive personal information and any information related
to you and your assignee and/or beneficiary in relation to the subject insurance policy as well as its sharing, transfer and/or disclosure
to any of the Company’s branches, subsidiaries, affiliates, advisors and representatives, industry associations and third parties such as
but not limited to outsourced service providers, external auditors, and local and foreign regulatory authorities in relation to any matter
including but not limited to those involving anti-money laundering and tax monitoring, review and reporting, statistical and risk analy-
sis, provision of any products, service, or offers made through mail/email/fax/SMS/telephone, customer satisfaction surveys; compliance
with court and other lawful orders and requirements. You and your assignee and/or beneficiary hold the Company free and harmless
from any liability that may arise from any transfer, disclosure, processing, collection, use, storage or destruction of said information.

This section must be signed by you and all of your irrevocable beneficiaries, if any.

The witness should be a disinterested person and his/her address should be provided.

Signature of Policy Owner Printed Name

X
Signature of Witness Printed Name
X
Address of Witness (no., street, municipality/city, province, country, zip code)

Place of Signing Date of Signing (day/month/year)

Signature of Irrevocable Beneficiary, if any Printed Name Place and Date of Signing (day/month/year)
X
Signature of Irrevocable Beneficiary, if any Printed Name Place and Date of Signing (day/month/year)

X
Signature of Irrevocable Beneficiary, if any Printed Name Place and Date of Signing (day/month/year)
X
Signature of Witness Printed Name
X
Address of Witness (no., street, municipality/city, province, country, zip code)

Place of Signing Date of Signing (day/month/year)

4 For Company Use Only

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