Get Download Application Form For Authorisation To Appoint Intermediary

Completing the Download Application Form For Authorisation To Appoint Intermediary online is a straightforward process. This guide will walk you through each section of the form, ensuring you provide all necessary information accurately and efficiently.

Follow the steps to effectively complete the application form.

1. Click ‘Get Form’ button to obtain the form and open it in your browser.
2. In the attention section, fill in your name and the date of completion. This ensures clarity about who is submitting the form and when it is submitted.
3. Provide your contact details. Include your full names, surname, ID number, Profmed membership number, email, telephone number, fax number, and cell number in the Member detail section.
4. Acknowledge the understanding of the appointment of the Intermediary. This involves reading and accepting that all previous intermediaries will no longer represent you.
5. Identify the products that the new Intermediary will be responsible for. These may include options like ProPinnacle, ProSecure Plus, ProSecure, ProActive Plus, or ProActive.
6. Enter the Intermediary's details. This includes their name, broker code, ID number, email address, telephone number, and cell number.
7. Specify the change effective date for the appointment of the new Intermediary. This date reflects when the change will officially take place.
8. Complete the signature section. Both you and the new Intermediary must sign and date the form in the designated areas.
9. Save any changes made to the form. Then, download or print the completed form for your records and future reference.

Complete your Download Application Form For Authorisation To Appoint Intermediary online to streamline your appointment process.