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Domestic Maid Insurance [ For Agents Please Login ]

Employer's Particulars

Salutation : *
Name of Employer : *
NRIC : *	(SxxxxxxxA)
E-mail : *
Address : *

Country : *
Postal : *
Contact Person :
Phone No. : *
Fax No. :
SB Transmission Ref No. : *

Maid's Particulars

Name of Maid : *
Date of Birth : *	(dd-mm-yyyy)
Nationality : *
Passport No. : *
Work Permit No. : *
Effective date : *	(dd-mm-yyyy) ( For renewal case, please follow work permit expiry )

Plan Selection

Bond & Insurance Plan A

Bond & Insurance Plan B

Bond & Insurance Plan C

Bond & Insurance Plan D

Bond , Insurance & Reimbursement of Indemnity Plan A

Bond , Insurance & Reimbursement of Indemnity Plan B

Bond , Insurance & Reimbursement of Indemnity Plan C

Bond , Insurance & Reimbursement of Indemnity Plan D

Please contact us for Information on 1 year plans

I certify that I have read and agree to the Terms and Conditions from InsureAsia.com
I certify that I have read and agree to the PDPA from InsureAsia.com

ERGO, its group companies and/or business partners may contact me/us to share information about products and services from ERGO by post, e-mail and
Telephone Text Message

Notification
Please check MOM's Work Permit Online (WPOL) for successful bond transmission before arranging for your maid's arrival to
Singapore / renewal of your maid's work permit.

Authorized Agent of:

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