人身保险产品审批和备案管理办法Administrative Measures on Examination, Approval and Filing of Personal Insurance Pro

s for participating products ☆

　　Income distribution and expenses apportionment principles for participating products ☆

　　10. CD or floppy disk containing electronic files of all materials to be submitted

　　11. Other materials specified by CIRC ＃

　　Company document number and company seal

　　Year：

　　Month：

　　Day： Remarks of CIRC

　　Year：

　　Month：

　　Day：

　　Note： 1. Materials marked with＃ are optional；

　　2. If selling has not been started， fill in “selling not started yet” in the column of “Selling date”。 If selling has been started， fill in the date on which selling was started.

　　3. Fill in the number of copies submitted in the column of “number submitted”； if no material is submitted， indicate reasons in the column.

　　4. Item 9 is required only for participating， universal and unit-linked insurance products.

　　Appendix 4：

　　Application Form for Examination and Confirmation of the Qualifications of Responsible Actuary

　　Name Gender Male / female Ethnicity Photo

　　Date of birth Political background Nationality

　　Passport number I.D. Card No.：

　　Academic degree Major

　　Professional qualification Institution granting the professional qualification　Granting date of the professional qualification

　　Current position

　　Office telephone Mobile telephone Fax

　　Mail address and zip code

　　Home address

　　Education background Beginning and ending date University Major Degree

　　Work experience Beginning and ending date Company and department Position

　　Statement of the Proposed Responsible Actuary

　　1. The above information is true； 2. I have no record of criminal penalty； 3. I did not commit any intentional fraudulent act in practicing.

　　Signature：Date： Year：

　　Month：

　　Day：

　　Comment of insurance company We approve ×× to act as our responsible actuary.

　　Official seal

　　Date： Year：

　　Month：

　　Day：

　　Note： If there is no corresponding information， fill in “N/A”。

　　Appendix 5：

　　Application Form for Examination and Confirmation of the Qualifications of Legally Responsible Person

　　Name Gender Male / female Ethnicity Photo

　　Date of birth Political background Nationality

　　Passport number I.D. Card No.：

　　Academic Degree Major

　　Professional qualification Institution granting the professional qualification Granting date of the professional qualification

　　Current position

　　Office telephone Mobile telephone Fax

　　Mail address and zip code

　　Home address

　　Education background Beginning and ending date University Major D

egree

　　Work experience Beginning and ending date Company and department Position

　　Statement of the Proposed Legally Responsible Person　1. The above information is true； 2. I have no record of criminal penalty； 3. I did not commit any intentional fraudulent act in practicing.

　　Signature：

　　Year：

　　Month：

　　Day：

　　Comment of insurance company We approve ×× to act as our legally responsible person.

　　Official seal

　　Year：

　　Month：

　　Day：

　　Note： If there is no corresponding information， fill in “N/A”。

　　Appendix 6：

　　Statement of Responsible Actuary

　　The China Insurance Regulatory Commission：

　　I have performed the duty of actuarial verification of XX product of XX Insurance Company scrupulously. I hereby confirm that the following statements are true：

　　1. The actuarial report for the product is complete；

　　2. The actuarial report for the product complies with the presentation of the clauses；

　　3. The actuarial assumption and method comply with the general actuarial principles and actuarial stipulations of the CIRC；

　　4. The result of calculation is accurate；

　　5. The benefit measurement and calculation methods comply with the general actuarial principles and relevant stipulations of the CIRC. （Applying to a product with benefit measurement and calculation）

　　Responsible Actuary：

　　Year：

　　Month：

　　Day：

　　Note： For a product for filing， the responsible actuary shall issue a statement strictly in accordance with this format. For a product subject to examination and approval， the responsible actuary may refer to this format and issue a statement in accordance with specific features of the product.

　　Appendix 7：

　　Statement of Legally Responsible Person

　　The China Insurance Regulatory Commission：

　　I have performed the duty of legal verification of XX product of XX Insurance Company scrupulously. I hereby confirm that the following statements are true：

　　1. The insurance clauses comply with the Insurance Law of the People‘s Republic of China， other laws， administrative rules and relevant stipulations of the CIRC；

　　2. The insurance clauses do not infringe upon the public interest or to the legitimate rights and interests of the policyholder， the insured and the beneficiary；

　　3. The insurance contract contains all essential elements with accurate wording；

　　4. The product description complies with the presentation of the clauses； its contents are complete and authentic and it complies with relevant stipulations of the CIRC. （Applying to a product with product description）

　　Legally Responsible Person：

　　Year：　　Month：　　Day

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