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4. (Payment by) (Premium Payment Application Form) 1. (Insured Name) () 0232631130 Siam Commercial Bank Public C Lumping Branch Account no

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How to fill out premium payment application form

01

Start by entering your personal information in the designated fields of the form, such as your full name, address, and contact details.

02

Provide your policy information, including the policy number and the type of insurance policy you hold.

03

Indicate the amount you wish to pay as a premium, along with the payment method you prefer.

04

If applicable, provide any additional information requested, such as previous payment details or changes in policy coverage.

05

Double-check all the information you have provided to ensure accuracy and completeness.

06

Sign and date the application form.

07

Submit the completed form along with the required payment to the designated address or department.

Who needs premium payment application form?

01

Anyone who holds an insurance policy and needs to make premium payments can benefit from a premium payment application form.

02

It is particularly useful for individuals who prefer to make manual payments instead of automatic deductions from their bank accounts.

03

Insurance companies, agents, and financial institutions also require this form to process premium payments from their customers.

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