PRINCIPAL MEMBER DETAILS TITLE: MARITAL STATUS: GENDER: FIRST NAME(S): SURNAME: MAIDEN NAME: I.D NUMBER: BIRTH DATE: PHYSICAL ADDRESS: POSTAL CODE: CELL NO: SECTION 2: SPOUSE'S DETAILS: TEL NO.: (please provide us with information of your life partner or spouse) FIRST NAME(S): SURNAME: MAIDEN NAME: I.D NUMBER: BIRTH DATE: SECTION 3: CHILDREN'S DETAILS: (please provide us with information of your children aged below 22) FIRST NAME(S) SURNAME: I.D NUMBER: RELATION: CHILD 1.
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How to fill out the Simanawe Application Form - Prospercare Benefit Solutions online
Filling out the Simanawe Application Form for Prospercare Benefit Solutions can be a straightforward process when you know what to do. This guide will provide you with step-by-step instructions to help you complete the form online with ease.
Follow the steps to successfully complete your application form.
- Click ‘Get Form’ button to obtain the form and open it in the document editor.
- Review the optional plan section at the start of the form. Choose a plan from the available options such as Bronze Plan, Silver Plan, or Gold Plan by selecting the appropriate checkbox.
- Complete Section 1: Principal Member Details by filling in your title, marital status, gender, first name(s), surname, maiden name, I.D number, birth date, physical address, postal code, and cell number.
- In Section 2: Spouse's Details, provide similar information for your life partner or spouse, including their first name(s), surname, maiden name, I.D number, and birth date.
- Fill out Section 3: Children's Details with information for each child aged below 22, which includes their first name(s), surname, I.D number, and their relation to you.
- Complete Section 4: Optional Extended Family by providing details of extended family dependents, including their first name(s), surname, I.D number, relation to you, and the plan selected.
- In Section 5: Selection of Beneficiary, enter the surname, first names, I.D number, and relation to you for the beneficiary. Note that the beneficiary will not be covered under the funeral plan unless included in Section 2 or 3.
- Move to Section 6: Benefit Selection and choose the appropriate benefit from the plans available for each category, ensuring the selected premium suits your eligibility.
- In Section 7: Payment Method, indicate your preferred payment option, such as EasyPay.
- Fill out Section 8: Debit Order Authorisation, providing your account details for monthly premium deductions. Ensure the account holder's name, bank name, account type, and branch code are accurately filled out.
- Review all entered information for completeness and accuracy. After confirming that all details are correct, proceed to save changes, download, print, or share the completed form.
Start completing your application form online today for seamless processing.
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