Selling of Investment-Linked Assurance Scheme Products

Enclosure Annex Product Name and Type: [e.g. ABC ILAS Policy] and Insurer: [name] You should carefully consider the information in this statement and the product documents (including the Principal Brochure, Product Key Facts Statement, and the Illustration Document). Although you may pay nothing to the intermediary who distributes this ILAS policy to you, the intermediary will, in effect, receive remuneration which may be borne out of the charges you pay as illustrated below. If you do not understand the information below, please do not sign the confirmation and do not purchase the ILAS policy. REMUNERATION RECEIVABLE BY [NAME OF AI] IN DISTRIBUTING [NAME OF ILAS PRODUCT] TO YOU Regular/ Single premium: [Regular/ Single] premium (Delete as appropriate) Premium contribution period: (for regular premium plan) [●] year(s) (in terms of number of years) (1) Monetary benefits (i) Specific disclosure [●] (Where the AI and/or any of its associates receives monetary benefits from the insurance company (directly or indirectly) for distributing this ILAS product: Disclose the monetary benefits that are receivable by it and/or any of its associates in actual amounts (unless otherwise stated) in the following manner. For the avoidance of doubt, the specific disclosure should be made on a transaction basis.) Upfront [name of the remuneration] receivable: [Currency] [●] Ongoing [name of the remuneration] receivable: [Currency] [●] [or: [y] % of the [z]1 ] to be received [each month/year] after first policy year Premium amount for first policy year: [Currency] [●] If the policy is held for the full term of the policy, total premium amount for policy: [Currency] [●] (if no maturity date, assume upto age 100, which should be stated in this statement) (If the AI considers it would be more beneficial for the customer to understand, the AI can disclose the monetary benefits receivable by it and/or any of its associates as a percentage of the relevant amount in the following manner: Upfront [name of remuneration]receivable: [x] % of the premium amount for the first policy year Ongoing [name of remuneration] receivable: [y] % of the [z] 1 to be received [each month/year] after the first policy year

1 1 AI should explain in this statement what is referred to in [z], for example, premium amount of [the first year/that year/that month], account value, etc.

2 Premium amount for first policy year: [Currency] [●] If the policy is held for the full term of the policy, total premium amount for policy: [Currency] [●] (if no maturity date, assume upto age 100, which should be stated in this statement)) (ii) Generic disclosure [●] (Where the monetary benefits received by the AI and/or any of its associates are not quantifiable prior to or at the point of sale: Disclose the existence and nature of such monetary benefits.) (2) Non-monetary benefits [●] (Where the AI and/or any of its associates receives from the insurance company non￾monetary benefits for distributing this product: Disclose the existence and nature of such non-monetary benefits.) (3) The insurance company of this ILAS product is: [ ] affiliated with [Name of AI] [ ] not affiliated with [Name of AI] (AI should tick the appropriate box above.) You confirm that you have read and understood all of the information above. Signature of the applicant: _______________________________ Name of the applicant: _______________________________ Date: _______________________________

3 Instructions to AIs when preparing this statement:  “Remuneration” refers to all monetary benefits and/or non-monetary benefits actually paid or payable by the ILAS insurance company to the AI and/or any of its associates in connection with the distribution of this ILAS product. These are benefits paid by the ILAS insurance company to intermediary in the form of monetary benefits such as commissions and other monetary/non-monetary benefits such as overrides, expense allowance, subsidies, referral fees, training subsidy, customer support subsidy, salary, other monetary/non-monetary support and services from the insurance company, etc.  On specific disclosure for monetary benefits –  For the avoidance of doubt, the specific disclosure should be made on a transaction basis.  If the AI considers it would be more beneficial for the customer to understand, the AI can disclose the monetary benefits receivable as a percentage of the relevant amount as shown in the template. In that case, the percentage of the relevant amount to be disclosed should be rounded up to the nearest whole percentage point.  This statement should be provided to the client before each new or top-up application for ILAS policy. The AI should not accept the ILAS policy application if this statement has not been properly signed by the client.  This statement should be visually reader-friendly so that the client can easily read it. Information should be presented in a font that is easy to read and highly legible. The font size adopted should also be reasonably legible taking into account the language used.