DECLARATION

I hereby warrant that all personal information herein are true, correct and updated to the best of my knowledge, freely and voluntarily given to Oriental Assurance Corporation (OAC). I agree and consent that above information be collected, hold, processed, used, transferred, disclosed and recorded, for and on my behalf, for purposes which are relevant and necessary in securing an insurance contract or transacting a business or any activity with OAC. I further authorize OAC, its directors, officers, consultants, employees, personal information comptroller/processor and duly authorized representatives to keep, store, update, use, access, and process the information given to it and to share, transfer, or disclose the information, including this form to OAC, their affiliates, subsidiaries, contractors, partners, agents and representatives, intermediaries, industry associations , and third parties such as but not limited to outsourced service providers, adjusters, salvage buyers, banks, external auditors, and local and foreign regulatory authorities for purposes of marketing or promotional information campaign, provision of any products, services, or offers through mail/email/fax/SMS/telephone or any type of electronic facility, profiling, research, studies/customer satisfaction surveys, statistical and risk analysis, tax monitoring, review, and reporting, compliance with court and other lawful order and requirements, with Anti-Money Laundering Act, Credit Information System Act, and all other regulatory laws, and all other activities consistent with the provisions of the Data Privacy Act and subject to appropriate security safeguards. If purchasing, transacting and/or acting in behalf of other person(s), I hereby warrant that I am duly authorized to perform such acts and that I am duly allowed to give their information to OAC. I hereby bind myself to advise all other persons in whose behalf I have acted, transacted with and/or purchased any product from OAC of all the terms and conditions herein. I also authorize OAC to verify and investigate the information given by me, including submitted documents from whatever source it may consider appropriate. I have the right to access the given information, and I undertake to correct, rectify or supplement information should any information be found to be inaccurate or incomplete. I shall notify OAC in writing of any changes in the information given above. I will hold OAC free and harmless from any liability that may arise as a result of the authorization given above."

AGREEMENT

I acknowledge and agree to the data sharing declaration above.