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Change of Beneficiary
Email
This field is for validation purposes and should be left unchanged.
Name
(Required)
First
Last
I.D No.
(Required)
REG. No.
(Required)
Address
(Required)
Phone (Home)
(Required)
Email
(Required)
Date Of Birth
(Required)
MM slash DD slash YYYY
I am requesting a change of my Beneficiary. I am now nominating:
(Required)
First
Last
Relationship
(Required)
I.D No.
(Required)
Address
(Required)
Phone (Home)
(Required)
Phone (Mobile)
Other
Estate
Consent
(Required)
I consent to the change of beneficiary details above
NB
Please make every effort to fill out this form and return it to the Association’s office as early as possible. This is very important so as to eliminate problems with the payment of the benefit to your designated beneficiary. You can also insert your Email address in the space provided on the form.
