I declare that the information given on this Application Form is true, accurate and complete and that no material fact has been withheld. I understand that failure to disclose a material fact may result in the contract being declared void and that a claim under the policy may not be paid.
A material fact is one which is likely to influence MSV Life in the best assessment and acceptance of this Application Form. If in doubt as to whether a fact is material, then it should be disclosed. I understand that the contract will not be in force until the Application Form has been accepted by MSV Life in writing.
I have received / read a copy of the ‘Information Guide’ of the product for which I am applying and understand its content. The Application Form and the Policy Document shall be the basis of the contract between myself and MSV Life.
I acknowledge and accept that MSV Life may process the personal data that I provide in this Application Form in accordance with the Data Protection Act, 2001 and with the Data Protection Policy of MSV Life (a copy of which is available from MSV Life’s offices, website and Tied Insurance Intermediaries).
I acknowledge that I have a right to request access to and rectification of such data as processed by MSV Life. Any such request must be signed by myself as the Policy Owner to whom the personal data relates.
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