L.I.M. FUNERALS

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011 822 2090 | 082 335 9744

PRE PAID PRODUCTS
Silent Private Cremation
OUR PRODUCTS
Full Cremation Service
OUR PRODUCTS
Burial service
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APPLICATION FORM




    I, the undersigned, wish to become a member of the Funeral Scheme, I understand that cover will only apply to my dependents as set out below. I abide by all the rules, regulations and exclusions as set out in my policy document / burial book. I understand that any incorrect ID's, Date of Birth's, wrong information or non information (no Birth Dates) given by me will NULLIFY a claim.



    SPOUSE

    CHILD

    CHILD




    Debit Order - Payers Details

    I, the undersigned, request you to arrange with my bank to collect the premiums payable in terms of a Debit Order. Please note that F.N.B. Savings Account (BOBSAVE) UNITED HELP U PLUS, Afican Bank & Post Office Accounts are not debitable.

    R100.00 ONCE OFF JOINING/ADMIN FEE MUST BE PAID IN CASH WITH APPLICATION.