Prudential Assurance Company Singapore (Pte) Limited (Reg. No.: 199002477Z) Postal Address: Robinson Road P.O. Box 492, Singapore 900942Website: www.prudential.com.sgPart of Prudential Corporation plc Page 1 of 1

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Update your address and contact information now at a click! Log in to PRUaccess at www.prudential.com.sg.

UPDATE OF ADDRESS AND CONTACT DETAILS FORMName of Policyowner *NRIC/Passport No of Policyowner *

New Address:

Blk/House No.

Postal CodeCountry: Singapore

For PO BOX address, please submit proof of ownership.

New Address:

Blk/House No. Unit No.

Street

Postal CodeCountry: Singapore

List the policy numbers:

A. Update of Residential Address (all your correspondences will be sent to this new address)

Tick all the required boxes, fill in the details and sign next to any amendments made.

Date of Birth of Policyowner *

If you wish to receive your correspondences at another address for any of your policies, please complete Update of MailingAddress.

Building

Others, pls. specify

Unit No.

Street

Others, pls. specify

Building

P01112

017

(D D M M Y Y Y Y)

B. Update of Mailing Address (if different from residential address)

* Mandatory field to complete

(1)

(4)

(2) (3)

(5) (6)

-

C. Update of Contact Details

Note: Update of mobile number requires only Policyowner’s signature. This number will be used as OTP (One TimePassword) when Policyowner accesses our secured online portal - PRUaccess at www.prudential.com.sg. Without a validmobile phone number, the Policyowner will not be able to login to PRUaccess and perform any online transactions.

Mobile No

(Country Code)

-

(Area code + Numbers) (Registered Country)

Home No

(Country Code)

-

(Area code + Numbers) (Registered Country)

Office No

(Country Code)

-

(Area code + Numbers) (Registered Country)

Email

By submitting this form, I hereby confirm the information given in this form is correct and up to date.

Signature of Policyowner(s) and Trustee(s) or Assignee

Date (dd/mm/yyyy):

PruCustomer Line: 1800 333 0333 (Local) +65 6333 0333 (Overseas)

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