Proposal Form Funeral Cover

    A. Life assured/Main Members Detail

    All fields with * are compulsory (please put n/a where not applicable)



    Send copy of ID to life@sacos.sc

    Proof of residential addres should be submitted (not older than 3 months)

    If different from residential address

    B. Details of Person responsible for payment of premiums



    Proof of residential addres should be submitted (not older than 3 months)

    If different from residential address



    C. Funeral Cover Desired (please tick in the appropriate box)

    FUNERAL COVER LEVEL (Tick appropriate box)

    * Cover commences after a waiting period of 6 calendar months from the entry date for natural death, while accidental death coverage starts immediately

    D. PLEASE GIVE DETAILS OF YOUR FAMILY/OTHER DEPENDANTS YOU WOULD LIKE TO BE ALSO COVERED (IF ANY)

    * The family members who may be added to the plan are as follows: 1 Spouse, Children up to a maximum age of 21 years
    * Children up to a maximum age of 25 if they are full time students registered in a tertiary education.
    * Parents (of the main member) up to a maximum age of 70 years

    Member

    E. BENEFICIARY DETAILS (person(s) or funeral parlour to be paid upon the death of a policy holder)

    Detail

    F. FOR SALES AGENT ONLY

    G. DISCLAIMER

    By ticking the boxes:

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