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Es Representative; 1. disclosed his/her full names and designation? 2. His/her contact details? 3. Disclosed his/her fit and proper status YES NO B. ADVICE Has the intermediary disclosed the following information to you; 1. The name and type of policy? 2. The premium? 3. Type, extent and limitation of the benefits? 4. The waiting period? 5. The registered name and address of the insurer? 6. Commission and remuneration payable to the intermediary? 7. 30 days cooling off period 8. The claims n.

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