Transcription of BENEFICIARY NOMINATION FORM - Hollard
1 BENEFICIARY NOMINATION form | 120115 | 1 of 1 BENEFICIARY nominationI, the policy owner, hereby cancel all previous BENEFICIARY appointments (if any) in respect of this policy andAppoint the following person/s as BENEFICIARY /ies under this policy:Additional spouse and children NOMINATION for funeral benefit(1 spouse and a maximum of 4 children up to the age of 21 at next birthday)1. The BENEFICIARY has no rights to the policy until written notice of the death of the policy owner2. The rights of a cessionary shall take precedence over the rights of a nominated The BENEFICIARY NOMINATION will come into effect on confirmed receipt of this form by Hollard Life. BENEFICIARY NOMINATION form (To be completed by the policy owner)Policy details Policy no. Tel owner Cell of insured EmailFirst name/sSurnameTel (tick box)First name/sSurnameDate of birthID ChildSignature of policy ownerSignature (policy owner) Date Signature(policy owner) DateSignature(spouse) DateNOTE: Signature of spouse required for policy owners married in community of Property, nominating a BENEFICIARY other than their
