Do-Not-Contact Request Form

Please fill in the mandatory fields marked with asterisk* Salutation: MR MRS MISS MS Name (as in NRIC/ Passport):* ID type (as per HSBC’s record):* ID document Passport Mobile no +65: *   Which service do you wish to opt-out from? * (please tick the options that apply) Phone SMS Please note the following: This Do-Not-Contact request is applicable to both HSBC Bank (Singapore) Limited (the "Bank") and HSBC Insurance (Singapore) Pte Limited ("INSN")(collectively "HSBC")   Kindly allow 30 days from the date of submission for your marketing preference to take effect. Please ensure accuracy of all information submitted in this form. Please re-submit a new Do-Not-Contact request should there be any change (NRIC/Passport/Mobile number) in your previously submitted request.   I hereby authorize HSBC to share my contact details with your agents, delegates and any such person(s) as HSBC may            consider appropriate in connection with the processing of my request not to be contacted for marketing purpose. *   I am aware that the above information is provided to both bank and INSN and I hereby provide my consent to the sharing          of my above information between the Bank and INSN in connection with the processing of my request not to be contacted          by HSBC for marketing purposes. *