Submitted Cases (NB, AS, CL)
Congratulations on your submitted NB cases! To help you with issuance, kindly fill out this form.

For Amendments and Claims, log details for timely follow ups and resolution.
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Team *
Transaction Type (e.g. NB, Reinstatement, Amendment, etc.) *
Date Submitted *
Agent’s Code (e.g. 70012345) *
Agent’s Name (e.g. Carl Benson Olivar) *
Application or Policy Number (e.g. RF1234567, Editable Form) *
Product (e.g. PAA, Elite 5, PruMil) *
Initial Payment Method if NB (e.g. Cash, Credit Card, Online Transfer, OTC)
Recurring Payment Method if NB (e.g. Cash, Credit Card, ADA)
APE if NB (put NA if not applicable) *
Policyowner (e.g. Hazel Manuel) *
Life Insured (e.g. Ruffa May Lomat) *
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