OBMFO Member Registration Form

بِسْمِ اللهِ الرَّحْمٰنِ الرَّحِيْمِ

OBMFO Member Registration Form
Principal Applicant

Please complete in CAPITAL letters
Full Name*

First NameMiddle NameLast Name
Date of Birth*

YearMonthDay
Date
Address*

Street Address (including Apt.)

Street Address Line 2

CityProvince

Postal CodeCountry
Phone Number*
E-mail*
Family Information

SPOUSE, and DEPENDENT CHILDREN (under 18 only)
Spouse and dependents
Agreement

MUST READ BEFORE SIGNING

There are four primary expenses associated with funerals: burial plot, excavation and filling of the grave, body preparation and preservation, and transportation costs.
The monthly membership fee for a family, which includes children under the age of 18, is $10. Anyone aged 18 and over must apply separately.

To ensure fairness between younger and older members, an age specific upfront payment must be made. This one-time upfront fee is applicable to both spouses depending on each person's age. Please see the user guide to accurately calculate your monthly fees.

Age of Applicant and Spouse	Upfront Payment
18 to 40	$0
40+	$60 per spouse for each additional year

In the event of a death, after one year of valid membership, OBMFO will grant a Kobor plot to the active member. Other funeral expenses must be paid by surviving family member(s).
If death occurs within a year, the contributed membership fee and the initial payment will be returned to the family member or used to offset additional funeral expenses.
If a member purchases one or more plots, he or she will get an additional credit equal to the cost of the plot(s) when the burial occurs to pay other funeral expenses.
If a member's membership becomes inactive for 90 days due to failing to pay of the monthly fee or cancellation, he or she will not receive any membership benefits and will not be reimbursed for previously paid monthly fees. Any purchased Kobor plots cost will be refunded based on the purchased price. If a member wishes to rejoin, a new membership application must be completed.
A void cheque must accompany the application. Once the application is approved by OBMFO, membership is payable on the 3rd day of each month.
OBMFO reserves the right to amend the above-mentioned Terms and Conditions at any time. Any modification(s) must be approved by the board of directors and disclosed to the members via Annual General Meetings and other means.

Payment Agreement

PRE-AUTHORIZE DEBIT (PAD) AGREEMENT
- I authorize OBMFO to deduct monthly membership fee and upfront payment (if applicable) from my bank account as agreed below. Please debit my bank account (void cheque attached).
- I agree that the debit will be processed to my account on the 3rd day of each month or the next business day.
- I may revoke my authorization at any time however it will be effective after 31 days. To obtain a sample cancellation form, or for more information on my right to cancel a PAD Agreement, I may contact my financial institution or visit www.cdnpay.ca.
- I have certain recourse rights if any debit does not comply with this agreement. For example, I have the right to receive reimbursement for any debit that is not authorized or is not consistent with this PAD Agreement. To obtain more information on my recourse rights, I may contact my financial institution or visit www.cdnpay.ca.
Please specify amount*

$5 monthly (single member)$10 monthly (family)Other
Void Check (image/pdf format)*

Cancelof
Applicant's Signature for Pre-Authorized Debit*
Date*

YearMonthDay
Date
Membership Agreement
- I confirm the information provided is accurate and true. Any intentional dishonesty may lead to application rejection, membership termination, and loss of membership benefits. I commit to adhering to all rules and regulations set by the organization. Non-compliance may result in membership revocation.
Government Issued Photo IDs (with DOB)*

Photo ID with date of birth
Cancelof
Applicant's Signature*
Date*

YearMonthDay
Date
Should be Empty:

بِسْمِ اللهِ الرَّحْمٰنِ الرَّحِيْمِ

Principal Applicant

Family Information

Agreement

Payment Agreement

Membership Agreement