Declaration:

I hereby declare that the above-mentioned information is true and correct to the best of my knowledge. I also declare that I am the main member on the Lifewize policy.  I hereby request that my Lifewize Funeral Policy be cancelled with immediate effect. I duly understand the consequences of this cancellation, resulting in all of the existing cover on this policy to be cancelled and that all premiums paid over to Lifewize will be forfeited.