::.Welcome to Goldlink Insurance.::

We Have added the following new products:
  *School Safety policy.
  *Travel & Tours Insurance.
* Hospitality Plus Insurance.
  *A re-branded auto Insurance
more

UNITISED UNI-DOWMENT POLICY :::

PROPOSAL FORM FOR LIFE ASSURANCE
UNITISED UNI-DOWMENTS/UNITISED FLEXI-DOWMENTS

1. LIFE TO BE ASSURED
FULL NAME
MAIDEN NAME (if a married woman)
MARITAL STATUS
POSTAL ADDRESS
(for our correspondences)
Residential
Office
EXACT OCCUPATION
PLACE AND DATE OF BIRTH
TYPE OF POLICY

2. DETAILS OF ASSURANCE: UNITISED UNI-DOWMENTS
FREQUENCY OF PREMIUM
AMOUNT OF PREMIUM
*MATURITY YEAR (55th or 60th Year)
COMMENCEMENT DATE

DOUBLE SUM ASSURED OPTION YES NO

HOME KEEPING EXPENSES OPTION YES NO

DO YOU WANT TO PAY PREMIUM THROUGH YOUR BANK BY
DIRECT DEBIT? YES NO

(*Please note that the sum assured is the total premium payable from inception to maturity (55 years) while Estimated Maturity Units EMU is as shown on Projection Tables)

3. DETAILS OF ASSURANCE: UNITISED FLEX--DOWMENTS
NUMBER OF LINES @ =N=100/Month/Line
TERMS OF LINES 5 YEARS
TERMS OF LINES 10 YEARS
TERMS OF LINES 15 YEARS
TERMS OF LINES 20 YEARS
TERMS OF LINES 25 YEARS
TOTAL

DO YOU WISH TO PAY LESS FREQUENTLY THAN MONTHLY?

DO YOU WISH TO PAY PREMIUM THROUGH YOUR BANK BY DIRECT DEBIT?
YES NO

4. OTHER ASSURANCES ON LIFE TO BE ASSURED WITH THIS OR OTHER COMPANIES

SUM ASSURED

ACCIDENTAL DEATH BENEFIT

NAME OF COMPANY

HAS ANY PROPOSAL ON YOUR LIFE BEEN:

(a) Accepted on special terms? YES NO

(b) Postponed? YES NO

If yes, please give name of Insurance Company

5. (a) Name and Address of your Medical Attendant

(b) Name and Address of any Doctor consulted in the past
and reason for consultation

6. (a) Do you travel in non-scheduled private flights

(b) What sports do you engage in?

BENEFICIARY:	Full Name	Age	Relationship	Address
Primary
Contingent
EXCEPT AS OTHERWISE DIRECTED (A) the proceeds are to be divided equally among all person who are named as primary Beneficiary and who survive the assured, but if non survive, equally among all persons who are named as Contingent Beneficiary and who survive assured, and (B) the right to change the beneficiary is reserved

If the person proposing is NOT the life to be Assured, details of the PROPOSER to whom the Policy will be granted.

FULL NAMES

ADDRESS

OCCUPATION

RELATIONSHIP TO LIFE TO BE ASSURED

DEPOSIT MADE WITH THIS PROPOSAL

DECLARATION:

**GET YOUR QUOTES NOW