New E - Will App 02042025 website

Name*
Surname*
ID Number*
E-mail :
ex: myname@example.com
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Select Product

E - Will 5000 Single 18 to 65 - R89.90E - Will 5000 Single 65 to 75 - R104.75E - Will 5000 Single 75 - 85 - R121.000E - Will 5000 Family 18 - 65 - R100.000E - Will 5000 Family 65 - 75 R115.00E - Will 10000 Single 18 - 65 - R99.65E - Will 10000 Single 65 - 675 - R122.65E - Will 10000 Family 18 - 65 - R129.00E - Will 10000 Family 65 - 75 - R144.00E - Will 20000 Single 18 - 65 - R111.67E - Will 20000 single 65 - 75 - R141.15E - Will 20000 Family 18 - 65 - R165.00E - Will 20000 Family 65 - 75 - R196.00
Your E - Will includes

The drafting of your E - Will with the help of our consultants. Annual reminder to up date your will. Annual Home Affairs search of deceased estates.

Funeral Assistance

Repatriation of Mortal Remains Repatriation Limited up to R10,000 per policy for SA region
Funeral Management Service
Funeral Concierge

Embedded funeral cover

Shinning Light
Who Do You Bank With*

ABSA Bank - 632005African Bank Limited - 430000Bidvest Bank Limited - 462005Capitec Bank Limited - 470010FNB (First National Bank) - 250655Investec Bank Limited - 580 105Nedbank Limited - 198675SA Post Bank (Post Office) - 460 005Standard Bank of South Africa - 051 001Thyme Bank - 678 910UBank - 431010Old Mutual - 462005
Type Of Account*
Account Number*
Debit Date*

1st7th15th25th31st
14:Terms and conditions
Please check the following boxes to indicate your understanding and agreement:*

I agree to allow E - Will and its affiliates to use my information for marketing purposes and for purposes of managing the products takenMy email address will be added to the Newsletter list
15: E-Signature
By signing (typing your legal name) in the space below, you agree to the collection, use and processing of the personal information you provide to E - Will in this form for the purposes of organization administration and inclusion of your contact information to product providers. By signing, you are also certifying that all information is correct and that you are the person completing this application. You also agree that your information may be accessed and used by E - Will its affiliates and its staff. You understand that the majority of the data requested in this application is necessary for administrative and planning purposes and that the failure to provide this information may prevent your application from being properly processed or the services been supplied.
E-Signature:*
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14:Terms and conditions

15: E-Signature