Nehawu Online Application Form – Fill Out and Use This PDF

Form # 307

DESIGNATION OF BENEFICIARY

This designation shall only be effective when delivered and filed with NEHAWU SACCO duly executed by an insured member and during the lifetime of the beneficiary designated (PLEASE PRINT).

Member Number: ...........................Date: ........../................./…......

I, ................................................................., being a member of Nehawu SACCO

(FULL NAMES OF MEMBER)

do hereby designate:

I hereby reserve the right to change the beneficiary herein designated. The execution of a subsequent Designation of Beneficiary form shall constitute a change of beneficiary. Payment of proceeds to a designated beneficiary or, if none, to the beneficiary determined by NEHAWU SACCO as entitled to such proceeds under said Contract shall discharge NEHAWU SACCO from any and all liability to the extent of such payment.

Explanation: (English)

The purpose of this form is to instruct your SACCO who to pay your Life and Loans insurance benefits to when you die. Without this form it may take a long time for your SACCO to determine who is legally entitled to receive your insurance benefits after your death. All that is needed is your name, the name and address of your beneficiary, how they are related to you, if at all and your signature that must be witnessed by another person (but not the beneficiary). Your SACCO will keep this form. You may change your beneficiary by submitting anew Designation of Beneficiary form at any time.

Verduidelikende Nota: (AFRIKAANS)

Die doel van hierdie nominaise is om die SACCO instaat te stel om u voordeel aan u genomineerede bevoordellde uit te betaal na u afterwe, en uitbetalings te bespoedig. U mag u genomineerede bevoordeelde te eniger tyd verander deur n andernominasie by u SACCO in te handig. Geliewe sorg te dra dat u genomineerede bevoordeelde nie ook as getue op hierdie nominasie teken nie. Indien u handtekening deur n kruisie verteen woordig worrd moet sodanige kruisie deur n kommissaris van ede gesertifiseer word as synde n kruisie deur u gemaak. Ten einde uitetalings verder te bespoedig word voorgestel dat, indien moontlik eide die werktelefoon-nommer van u bevoordeelde ingevul word in die spasie daarvoor gereserveer.

Inkcazelo: (XHOSA)

Unobangela wale fomu kukuyalela iSACCO yakho ukuba amalungelo e Life ne Loans Insurance akho abhatalwe bani na xa ubhubhile. Ngaphandle kwale fomu iSACCO yakho iyakuthatha ithuba elide ukuqinisekisa ukuba ngubani omakafumane amalungelo e-insurance yakho ngokusemthethweni xa ubhubhile. Nazi izinto ezifunekayo; igama lakho, igama nedilesi lalomntu uza kufumana amalungelo e- insurance yakho xa ubhubhile, nokuba uzalana njani nawe, uze usayine kubekho nengqina elisayinayo kodwa lingabi ngulo mntu uzakufumana amalungelo akho. ISACCO izakugcina le fomu. Ungamtshintsha umntu ozakufumana amalungelo e-insurance yakho nanini uthanda, oko ukwenza ngokungenisa enye ifomu entsha ekwanje ngale.

Incazelo: (ZULU)

Leliphepha lichazela iqembu lakho ukuthi amalungelo e Life ne Loans insurance akho abhadalwe bani uma ufile. Uma leliphepha lingekho iqembu lakho lingathatha isikhathi eside ukuthi bazi ukuthi banikeze bani amalungelo akho ngokusemthethweni. Kufuneka igama lakho, negama lomuntu ozothola amalungelo akho, nomfakazi wakho, kodwa hayi umuntu ozothola amalungelo akho. Iqembu lakho lizoligcina leliphepha. Uma ufuna ukutshintsha umuntu ozokuthola amalungelo akho kuvumelekile, ungagcwalisa elinye iphepha.

The details of my/our account are as follows:

This signed Authority and Mandate refers to our contract as dated as on signature hereof ____________. I / We

hereby authorise you to issue and deliver payment instructions to the bank for collection against my / our abovementioned account at my / our above mentioned bank (or any other bank or branch to which I / We may transfer my / our account) on condition that the sum of such payment instructions will never exceed my / our obligations as agreed to in the Agreement, and commencing on the commencement date and continuing until this Authority and Mandate is terminated by me / us by giving you notice in writing of no less than 20 ordinary working days, and sent by prepaid registered post or delivered to your address indicated above.

The individual payment instructions so authorised to be issued must be issued and delivered as follows

On the _______ day of each and every month commencing on _____________. In the event that the payment

day falls on a Saturday, Sunday or recognized South African public holiday, the payment day will automatically be the very next ordinary business day. Further, if there are insufficient funds in the nominated account to meet the obligation, you are entitled to track my account and re-present the instruction for payment as soon as sufficient funds are available in my account;

I / We understand that the withdrawals hereby authorised will be processed through a computerized system provided by the South African Banks and I also understand that details of each withdrawal will be printed on my bank statement. Each transaction will contain a number, which must be included in the said payment instruction and if provided to you should enable you to identify the Agreement. A payment reference is added to this form before the issuing of any payment instruction. I / We shall not be entitled to any refund of amounts which you have withdrawn while this authority was in force, if such amounts were legally owing to you.

MANDATE

I/We acknowledge that all payment instructions issues by you shall be treated by my/our above mentioned bank as if the instructions had been issued by me/us personally

CANCELLATION

I / We agree that although this Authority and Mandate may be cancelled by me / us, such cancellation will not cancel the Agreement. I / We shall not be entitled to any refund of amounts which you have withdrawn while this authority was in force, if such amounts were legally owing to you.

ASSIGNMENT

I/We acknowledge that this authority may be ceded or assigned to a third party if the agreement is also ceded or assigned to that third party, but in the absence of such assignment of the agreement, this authority and mandate cannot be assigned to any third party

Signed at _________________ on this _________________ day of _________________ 20___

______________________________

SIGNATURE AS USED FOR SIGNING CHEQUES OR CREDIT CARD VOUCHERS