Skip to content
Home
About us
Funeral
Catering
Contact us
010 065 0457
THE BEST OR NOTHING
4590 LINK ROAD EXT 2 ORANGE FARM
Apply now
Step
1
of
5
20%
TYPE OF PLAN
(Required)
Family
Individual
Single parent
Society
1. POLICYHOLDER DETAILS (MAIN LIFE ASSURED)
Names
(Required)
SURNAME
FIRST NAMES
NATIONALITY
(Required)
ID NUMBER
(Required)
EMPLOYEE/MEMBER NUMBER
MARITAL STATUS
EMPLOYER NAME
COUNTRY OF BIRTH
EMAIL ADDRESS
(Required)
DATE OF BIRTH
COUNTRY OF RESIDENCE
(Required)
PHYSICAL OR POSTAL ADDRESS
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
PHONE
(Required)
2. SPOUSE'S DETAILS
Names
SURNAME
FIRST NAMES
ID OR PASSPORT NUMBER
DATE OF BIRTH
3.A BENEFICIARY NOMINATION (COMPULSORY) - PRIMARY BENEFICIARY - COMPULSORY (NOT THE FUNERAL HOME)
Names
(Required)
NAMES
SURNAME
ID NUMBER
(Required)
RELATIONSHIP
(Required)
3.B BENEFICIARY NOMINATION (COMPULSORY) - SECONDARY BENEFICIARY - COMPULSORY FOR SINGLE PLANS
I hereby agree that in the event of my death, I wish to nominate the following person as the beneficiary of this policy, in order to cover the funeral costs up to the value of my chosen cover. I acknowledge and appreciate that I may change my nominated beneficiaries at any time prior to death. Policyholder signature
(Required)
STANDARD COVER SELECTION SUBJECT TO AGE OF MAIN MEMBER
R4 000
R5 000
R6 000
R7 000
R8 000
R9 000
R10 000
R12 500
R13 500
R15 000
CATERING
3 in 1 Plan
UNDER 65 YEARS
Inkomo, Grocery and Catering, R370 (6 People) R530 (10
UNDER 70 YEARS
Inkomo. Grocery and Catering R390 (6 People) R600 (10 People)
UNDER 75 YEARS
Inkomo, Grocery and Catering R420 (6 People) R650 (10 People)
CATERING PLAN
UNDER 65 YEARS
2 Meat, 2 Starch, 1 Veg, 1 Salad ano R240 6 (6 People) R340 (10 People)
UNDER 70 YEARS
2 Meat, 2 Starch, 1 Veg, 1 Salad and R260 (6 People) R370 (10 People)
UNDER 75 YEARS
2 Meat, 2 Starch, 1 Veg, 1 Salad and R280 (6 People) R410 (10 People)
Catering plans include the following: waiters, chefs, mobile kitchen, pots, stoves, and decor using the undertakers, tents and chairs.
SOCIETY PLAN COVER SELECTION MAXIMUM JOINING AGE 74 MAXIMUM COVER CHILDREN UNDER AGE 6 = R10 000
SELECT SOCIETY
Society 1+5
Society 1+9
Society 1+13
Choose amount (Society 1+5)
R5 000
R8 000
R10 000
R12 500
R15 000
Choose amount (Society 1+9)
R5 000
R8 000
R10 000
R12 500
R15 000
Choose amount (Society 1+13)
R5 000
R8 000
R10 000
R12 500
R15 000
Dependents
How many dependents will you want to cover?
(Required)
1
2
3
4
5
6
7
8
9
10
11
12
13
Fill in for 1 Dependant
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
Consent to collect and share information in terms of POPI Act
(Required)
I agree
I, the undersigned, hereby grant explicit consent to the administrator of my funeral policy, Genlife Financial Services FSP 43895 to process specific personal information in the ordinary course of its duties. I acknowledge that the financial services provider and its representatives are takina ALL reasonable steps to ensure my rights to privacy and the protection of my personal information fron unauthorised use, and or access. I declare forthwith that my personal information is being processed lawfully, legitimately and consistently as would be expected for the purpose of serving my best interests as well as for achieving fair and reasonable outcomes as a consumer of financial products. I further permit the sharing of my personal information with third parties (public or private body) as appropriate from time to time to ensure that the FSP is able to carry out its industry imposed legal and compliance related obligations. My consent shall remain in force provided the FSP and its authorised representatives continue to abide by the conditions for lawful processing of personal information as contained in th POPI Act no. 4 of 2013, as may be amended from time to time.
Fill in for 2 Dependants
1
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
2
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
Fill in for 3 Dependants
1
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
2
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
3
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
Fill in for 4 Dependants
1
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
2
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
3
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
4
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
Fill in for 5 Dependants
1
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
2
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
3
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
4
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
5
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
Fill in for 6 Dependants
1
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
2
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
3
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
4
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
5
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
6
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
Fill in for 7 Dependants
1
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
2
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
3
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
4
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
5
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
6
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
7
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
Fill in for 8 Dependants
1
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
2
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
3
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
4
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
5
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
6
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
7
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
8
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
Fill in for 9 Dependants
1
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
2
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
3
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
4
DEPENDANT'S NAMES
Name
Surname
DEPENDANT'S ID NUMBER
RELATIONSHIP
5
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
6
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
7
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
8
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
9
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
Fill in for 10 Dependants
1
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
2
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
3
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
4
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
5
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
6
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
7
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
8
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
9
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
10
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
Fill in for 11 Dependants
1
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
2
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
3
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
4
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
5
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
6
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
7
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
8
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
9
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
10
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
11
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
Fill in for 12 Dependants
1
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
2
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
3
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
4
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
5
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
6
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
7
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
8
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
9
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
10
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
11
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
12
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
Fill in for 13 Dependants
1
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
2
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
3
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
4
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
5
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
6
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
7
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
8
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
9
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
10
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
11
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
12
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
13
DEPENDANT'S NAMES
(Required)
Name
Surname
DEPENDANT'S ID NUMBER
(Required)
RELATIONSHIP
(Required)
Consent to collect and share information in terms of POPI Act
I agree to the privacy policy.
I, the undersigned, hereby grant explicit consent to the administrator of my funeral policy, Genlife Financial Services FSP 43895 to process specific personal information in the ordinary course of its duties. I acknowledge that the financial services provider and its representatives are takina ALL reasonable steps to ensure my rights to privacy and the protection of my personal information fron unauthorised use, and or access. I declare forthwith that my personal information is being processed lawfully, legitimately and consistently as would be expected for the purpose of serving my best interests as well as for achieving fair and reasonable outcomes as a consumer of financial products. I further permit the sharing of my personal information with third parties (public or private body) as appropriate from time to time to ensure that the FSP is able to carry out its industry imposed legal and compliance related obligations. My consent shall remain in force provided the FSP and its authorised representatives continue to abide by the conditions for lawful processing of personal information as contained in th POPI Act no. 4 of 2013, as may be amended from time to time.
Home
About us
Funeral
Catering
Contact us
WhatsApp us
