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  • ACA Enrollment Checklist Summary

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    Allen Ponce
    21 просмотров1 страница
    This document is an enrollment checklist for an automatic credit card arrangement (ACA). It contains four sections: I) eligibility requirements that must be verified, II) application requirements that must be validated, III) enrollment guidelines that must be discussed, and IV) additional enrollment applicant guidelines that must be discussed. The checklist requires signatures from both the reviewer and applicant to confirm all items were discussed.

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    ACA Enrollment Checklist signed.pdf

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    This document is an enrollment checklist for an automatic credit card arrangement (ACA). It contains four sections: I) eligibility requirements that must be verified, II) application requirements that must be validated, III) enrollment guidelines that must be discussed, and IV) additional enrollment applicant guidelines that must be discussed. The checklist requires signatures from both the reviewer and applicant to confirm all items were discussed.

    Авторское право:

    © All Rights Reserved
    Скачайте в формате PDF, TXT или читайте онлайн в Scribd
    Отметить как неприемлемый контент
    21 просмотров1 страница

    ACA Enrollment Checklist Summary

    Загружено:

    Allen Ponce
    This document is an enrollment checklist for an automatic credit card arrangement (ACA). It contains four sections: I) eligibility requirements that must be verified, II) application requirements that must be validated, III) enrollment guidelines that must be discussed, and IV) additional enrollment applicant guidelines that must be discussed. The checklist requires signatures from both the reviewer and applicant to confirm all items were discussed.

    Авторское право:

    © All Rights Reserved
    Скачайте в формате PDF, TXT или читайте онлайн в Scribd
    Отметить как неприемлемый контент
    из 1

    ACA ENROLLMENT CHECKLIST

    Agent Code Policy Number

    0 0 7 6 0 1 0 7 1 1 0 2 1 9 7 4 7 5 7

    I. Eligibility Requirements Verified (Indicate “Y” for Yes, or “N” for No on the tick boxes. An “N” in the Eligible Column
    and/or a “Y” in the Ineligible Column render the enrollment application invalid.)
    ELIGIBLE INELIGIBLE
    Y Policy is in-force (Status 20 in Lifelines) N Policy is any of the following:
    Is the credit card holder the policy owner or an  Dollar-denominated

    Y immediate family member of the policy owner N  With premium paying period of three (3)
    (i.e., parent, sibling, spouse, or child) years or less
     Single-pay
    Is the credit card either VISA or MasterCard?
    Y N
    Is the credit card active? (A recent purchase was Is the card to be enrolled a debit card?
    Y made within the last year using the credit card) N
    The account has available credit sufficient for the Is the credit card a Diners Club International,
    Y premium payment due. N AMEXCO, or UnionPay?
    The credit card is still valid on the next payment N The ACA is for a top up payment.
    due date.
    Upon enrollment, the credit card will expire before
    Y (The customer must update the records as soon
    as a new credit card is available.) N the next payment due date.

    II. Application Requirements Validated (Put “x” on the tick boxes representing options.)
    POLICY OWNER AUTHORIZED REPRESENTATIVE
    Customer Information Records (Telephone No., Customer Information Records (Telephone No.,
    X Mobile No., Email Address, Mailing Address) X Mobile No., Email Address, Mailing Address)
    Fully accomplished ACA enrollment form Fully accomplished ACA enrollment form
    X (Strictly one form per policy) X (Strictly one form per policy)
    Photocopy of Credit Card to be enrolled
    X Credit Card to be enrolled presented X presented
    One (1) valid Government ID, with photo and One (1) valid Government ID with photo and
    X signature X signature of the representative
    Photocopy of one (1) valid Government ID with
    X photo and signature of the policy owner
    Letter of Authorization

    III. Enrollment Guidelines Discussed


    Applications for change of payment method must be submitted one (1) working
    Submission
    day, at the latest, before the immediate payment due date.
    Notification of Authorization Results The Policy Owner will receive an SMS regarding the successful enrollment.

    IV. Enrollment Applicant Guidelines Discussed


    Immediate family member of the credit card holder is allowed as long as the
    Relationship of the Credit Card Holder relationship is established – parents, siblings, legal spouse, or children
    to the Policy Owner
    Relatives outside the nuclear family, fiancé/e, and agents are not allowed.
    Customer Signature The signature in the form must match that of the signature on the credit card.

    All items above pertaining to the application for enrollment under the auto-charge arrangement for the
    payment of the premium of the indicated policy number have been discussed.

    Signature Signature
    Reviewer John Lawrence A. Raymundo Applicant Allen R. Ponce
    Branch Makati Date July 23, 2020

    ACA Enrollment Checklist v1.0

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