JP4469626B2 - application - Google Patents

Description

  The present invention relates to an application form including a payment form, and more particularly to an application form suitable for use in application for contract continuation accompanying the maturity of various insurances.

  In the past, in various insurance contracts, when the maturity date has expired, the insurance company has sent a notice to the policyholders that suggests the continuation of the contract by presenting the details of the current contract and the new contract with the aim of raising the level of compensation. It has been broken. In order to continue the contract, the consent of the contractor is required, so the contractor applies for consent to the contents of the continuing contract after maturity. Conventionally, the contractor fills in the necessary information on the application form attached to the notice sent from the insurance company, signs it, seals it, and returns it to the insurance company. It is common to confirm the intention.

  However, according to this conventional example, it is necessary to send a new application form to the insurance company and to pay an amount corresponding to the new fee, which is inconvenient as it is a procedure similar to a new contract. In order to eliminate this inconvenience, when applying for a renewal contract, a payment slip for paying a new fee from a convenience store etc. will be sent together with a notice explaining the contract contents, without sending a new application form. , The contractor's act of removing the label affixed to cover the bar code displayed on this payment form is regarded as the consent act similar to the contractor's signature and seal act, and the payment of the new fee as the contract application Handling is done. However, when this label peeling action is used as an indication of consent, there is a problem that the barcode may be transferred to the label attachment surface. An object of the present invention is to solve this problem and to provide an application form with a simple configuration that facilitates an act of indicating an intention to agree to a contract content.

In order to achieve this object, the application form according to claim 1 of the present invention is formed by binding a plurality of sheets on which various kinds of information such as explanatory texts and greetings are written together with a payment slip. off perforation for inside separation with thus provided portions, payment slip is paid information entry section is folded at the folding portion is positioned on the inner surface tatami Marete, opposite to the folded portion The end portion is bound in a closed manner inside the cutting perforation for separation, and a cutting perforation for spread is provided inside the closed binding portion . In addition, it is preferable that the payment information is printed or printed in advance in the payment information entry field.

According to the application form according to the present invention, since the payment slip is folded and closed so as to be separable, the payment slip is separated by breaking the cutting perforation for separation, and then the spread spread The act of breaking the perforated cutting perforation and making it into a spread state can be regarded as an indication of intent to agree to the contract contents of the contractor, and it is folded by closing the payment information entry field of the payment slip inside since it has to, payment information is separated is paid votes, an effect that is in the concealed until it is a two-page spread state.

  DESCRIPTION OF EXEMPLARY EMBODIMENTS Hereinafter, preferred embodiments of the invention will be described with reference to the accompanying drawings. Here, FIG. 1 is a cross-sectional view showing the entire application form, FIG. 2 is a cross-sectional view with the payment slip separated, and FIG. 3 is a plan view showing the payment information display surface side of the payment slip.

  As shown in FIG. 1, the application form 1 includes a notification sheet 2 that also serves as a front cover that displays a greeting, a contract expiration notice, and a contract continuation notice, and a new contract content that ranks up the conventional contract content and compensation. A first explanation sheet 3 displaying an explanation to explain, a second explanation sheet 4 displaying an explanation explaining a procedure method for applying for a renewal contract, and a folding portion with the payment information entry field inside. The payment slip 5 folded in half at the perforation 8 and the insurance company display sheet 6 also serving as the back cover displaying the contact information such as the address and name of the insurance company are overlapped and bound together with the adhesive 7 It is structured in a booklet form.

  In the present embodiment, although not shown in the explanation sheet 3, two contract contents are presented together with explanations of important matters, so that the payment slip 5 has two payments corresponding to the payment of each contract contents. The votes 5a and 5b are configured to be connected up and down via a cutting perforation 9 (see FIG. 3). In addition, although not shown in the explanation sheet 4, with the text “Confirm the contents of the contract, read and understand the explanation of important matters, pay the prescribed insurance premium and apply for the insurance contract.” , "Please agree to the contents of this sentence, please separate the payment slip and pay at the convenience store."

Here, the payment slip 5 is separable by the adhesive 7 at the end opposite to the folding / cutting perforation 8, and can be separated by providing a perforation 10 for separation inside the binding portion. I have to. Further, the inside of the cutting perforation 10 is bound with an adhesive 11 so as to be closed, and further, the cutting perforations 12 and 13 for spread are provided inside the portion bound with the adhesive 11. When the cutting perforations 12 and 13 are broken, they are configured so that they can be spread from a closed two-fold state.

  As can be understood from FIG. 3, each of the payment slips 5 a and 5 b is divided into a head office submission slip 15, a handling store copy 16, and a payment receipt slip 17 by a folding and cutting perforation 8 and a cutting perforation 14. Each has a predetermined entry field, and necessary items are printed in advance. In addition, four barcodes are displayed below the entry field of the headquarters submission slip 15.

  Since this embodiment is configured as described above, when the contractor reads the explanatory text to understand the contract contents and desires to continue the contract, first, as shown in FIG. The perforation 10 is separated by breaking. Next, by breaking each cutting perforation 12 and 13, as shown in FIG. 3, it is in a spread state, select the payment slip 5a or 5b of the contract content desired, and bring it to the convenience store, A predetermined fee is paid. At this time, the contractor's act of breaking the cutting perforations 12 and 13 is regarded as an intention-indicating act of agreeing to the contents of the new contract, and is treated as having been applied for a contract by paying a predetermined fee.

In addition, this invention is not limited to the above-mentioned embodiment, The payment slip 5 may be comprised by one type corresponding to one plan, and even if it comprises several payment slips 5aa and 5b as another sheet | seat. not good.

Sectional drawing which shows the whole application form. Sectional drawing which shows the state which isolate | separated the payment slip. The top view which shows the spread state of a payment slip.

1 Application Form 2 Notification Form 3, 4 Description Form 5 Payment Form 6 Insurance Company Display Form 7, 11 Adhesive 8 Folding and Cutting Perforations 9, 10, 12 , 13 , 14 Perforation 15 Cutting Headquarters Presentation Form 16 Handling Store copy 17 Payment receipt

Claims (1)

A plurality of sheets on which various information such as explanatory texts and greetings are written and a payment slip are bound together, and a cutting perforation for separation is provided inside the binding portion of the payment slip, payment slip is paid information entry section is folded about the fold positioned inside surface portion tatami Marete, binding in the closed shaped end opposite to the folded portion inside the cutting perforation for the separation An application form characterized by being combined and provided with a perforation for cutting in the inside of a closed binding portion .

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