Transcription of Bar Code SEE INSTRUCTIONS OVERLEAF TYPE OF …
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Bar Code SEE INSTRUCTIONS OVERLEAF TYPE OF …
81/99567 Bar CodePension Fund (GEPF) National TreasuryGovernment EmployeesSEE INSTRUCTIONS OVERLEAFPage 1 of 4 ALL PAGES OF THIS FORM MUST BE COMPLETED IN ORDER FOR THIS FORM TO BE VALIDAND THE RELEVANT PARTIES MUST INITIAL THIS PAGEC ommissionerof Oaths InitialApplicant'sInitialTYPE OF TRANSACTION (Select only one type) - PENSION FOR: SPOUSE OR ORPHAN(S)A) PARTICULARS OF DECEASED (Compulsory)B) PARTICULARS OF PERSON APPLYING FOR PENSION (Compulsory) 4. date of marriageC C Y Y M M D D5. Marital type:A. ReligionB. Customary UnionC. CivilD. Life Partner3. Maiden name1. date of birthC C Y Y M M D D2. Income tax ) PARTICULARS OF SPOUSE/LIFE PARTNER (Only needed for spouse's pension applications)7. Residential addressC O D EC O D E6. Postal address5. E-mail address3.
Applicant's Initial Commissioner of Oaths Initial Z143 7.a) Surname 7.b) Date of birth 7.c) Firstname 7.d) Other initials 7.e) Child of: Contributing Member Pensioner Spouse 7.f) Orphan: Yes No
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