I hereby declare that the information given overleaf is true and complete and that I have not wilfully withheld any material fact. I authorise you to obtain any information you may require relating to this Proposal, from any of the sources stated overleaf. I agree that if any situation arises before this Proposal is finalised which changes any of the representation made by me in this Proposal, I will promptly notify you accordingly.

This Proposal and any Guarantee issued pursuant to this Proposal shall be subject to this Counter Indemnity and the terms and conditions to which I agree.

In consideration of AXA Insurance Pte Ltd of 8 Shenton Way, #24-01 AXA Tower Singapore 068811 (the Company) agreeing at my request to issue a Letter of Guarantee in favour of the Ministry of Manpower (MOM) for the sum of $5000 (hereinafter called the MOM's Guarantee) guaranteeing the satisfactory performance and observation of the conditions imposed on me by the MOM in the Security Bond executed by me in favour of the MOM and/or to issue a Letter of Guarantee in favour of the Labour Attache (the Labatt), Embassy of the Philippines for the sum of $2,000.00 or $7,000.00(hereinafter called the Labatt Guarantee) (both collectively known as the Guarantees) guaranteeing the satisfactory performance and observance of the conditions imposed on me by the Labatt in the Embassy of the Philippines' Standard Employment Contract for Filipino workers in Singapore executed by me in favour of the Labatt, I hereby agree as follows :  

1. I hereby irrevocably and unconditionally undertake for myself/my heirs executors administrators assigns and successors, as a continuing obligation, to indemnify the Company on demand in full against all claims payments demands actions suits proceedings losses liabilities costs interests and expenses whatsoever which may be taken or made against it or incurred or become payable by it under or in respect of either or both the Guarantees including, without limitation, any legal and other costs on an indemnity basis, charge interest or expense incurred by the Company in connection with either or both the Guarantees of this counter Indemnity. I agree that the Company may in its absolute discretion compromise all claims payments demands actions suits proceedings losses liabilities which may be taken or made against it under either or both the Guarantees. I also agree to accept all receipts vouchers and other evidence of all payments made by the Company or of all liabilities or obligations incurred by it by reason of either or both the Guarantees as conclusive evidence against me and my estate of the fact and extent of my liability herein to the Company.
   
2. I further agree that you will be entitled to impose an interest charge of 9% per annum on any sum of money paid out by you on my behalf in connection with the above Bond whether to the MOM or otherwise and that such interest will be payable on any sum(s) of money paid by you on my behalf in the event that I do not settle the said outstanding payment(s) made on my behalf withing 7 days from the date I am given notice by you of the same.
   
3. My liability hereunder is irrevocable and shall remain in full force or effect until the company's liability under either or both the Guarantees is discharged.

I confirm that the information I have provided is my personal data and, where it is not my personal data, that I have the consent of the owner of such personal data and to provide such information. By providing this information, I understand and give my consent for AXA Insurance Pte Ltd and their respective representatives or agents to:

• Collect, use, store, transfer and/or disclose the information, to or with all such persons(including any member of the AXA Group or any third party service provider, and whether within or outside of Singapore) for the purpose of enabling AXA to provide me with services required of an insurance provider. including the evaluating, processing, administering and/or managing of my or our relationship and policy(ies) with AXA, and for the purposes set out in AXA's Data Use Statement which can be found at http://www.axa.com.sg("Purposes").

• Collect, use, store, transfer and/or disclose personal data about me or us and those whose personal data I or We have provided from sources other than myself or us for the Purposes.

• Contact me or us to share information about products and services from AXA that may be of interest to me or us by post and e-mail and