R10 000R20 000R30 000

R80R120R170

R7 000 R165

R10 000 R165

R10 000 R180R10 000R20 000

R90R140

R10 000 R150

0819

I HEREBY INSTRUCT THE SOUTH AFRICAN SOCIAL SECURITY AGENCY (SASSA) TO DEDUCT MONTHLY THE ABOVE PREMIUM FROM MY GRANT AND REMIT TO MULTISURE CORPORATION (PTY) LTD AND/OR KGA LIFE.”

I UNDERSTAND THAT I AM STILL UNDER OBLIGATION TO INSTRUCT SASSA TO AFFECT THE DEDUCTION. THIS MUST BE DONE AT THE SASSA LOCAL OFFICE. I ALSOUNDERSTAND THAT SASSA DOES NOT MARKET OR ENDORSE ANY FINANCIAL PRODUCTS, AND I CONFIRM THAT I HAVE ENTERED INTO THIS AGREEMENT FOR A FUNERAL POLICY OF MY OWN FREE WILL.”

I UNDERSTAND THAT NON-PAYMENT OF PREMIUMS MAY RESULT IN NO COVER AND THAT MULTISURE CORPORATION AND/OR KGA LIFE CANNOT BE HELD REPSONSIBLE FOR NON-PAYMENT BY SASSA OR ITS AGENT ON MY BEHALF.

Refer paragraph 14a.