Noble Funeral application forms

NOBLE FUNERAL UNDERTAKERS
FUNERAL COVER AGREEMENT

Client Full Name: ______________________
ID Number: ____________________________
Contact Number: _______________________
Address: ______________________________

Selected Package: ☐ Bronze ☐ Silver ☐ Gold

Monthly Premium: R__________

START DATE: __________________

TERMS & CONDITIONS:

1. Monthly premiums must be paid on time.
2. Cover becomes active after first payment is received.
3. A waiting period may apply (e.g. 3 months natural death).
4. No claim will be processed if payments are in arrears.
5. Noble Funeral Undertakers will provide services as per selected package.
6. Client must provide correct personal details.
7. Cancellation must be requested in writing.

DECLARATION:

I confirm that the information provided is correct and I agree to the terms.

Client Signature: ______________________
Date: ________________________________