Policyholder Document
Beneficiary Nomination Form
To be completed by the policyholder
Policy Information
Policy number/ID Number is required
Policyholder name is required
Marital Status
Please select marital status
Beneficiary Nominations
I/We hereby cancel all previous beneficiary appointments (if any) in respect of this policy and appoint the following person/s as my new beneficiary/ies.
Total %
0%
Must equal 100%
OR — Entity Beneficiary
Legal Notices
1
The beneficiary has no right to the policy until written notice of the death of the policy owner.
2
The rights of a cessionary shall take precedence over the rights of a nominated beneficiary.
3
The beneficiary nomination will come into effect on confirmed receipt of this form by Ongeza Life (Pty) Ltd.
Policyholder Signature
Location is required
Date is required
Sign with mouse or finger
Spouse Consent (Required — Matrimonial Property Act 88 of 1984)
Spouse name is required
Spouse signs here
This form will be submitted to info@ongezalife.co.za
