Digicall Izinga Legal Supplier Application

Company or Firm Information
Registered company, firm or business name
Company or firm registration no
(Cipro registration number)
VAT no
(if registered for VAT)
Director's information

First NameLast Name
Director's cellphone no
Director's email
Copy of director's ID

Browse Files
10MB max (pdf, doc, docx, jpg, png & rtf accepted) Cancelof
Latest BEE certificate

Upload a File
BEE certificate or Auditor's letter (turnover less than R 5 million pa) Cancelof
Business profile

Upload file(s)
10MB max (pdf, doc, docx & rtf accepted) Cancelof
Area(s) of operation
Photos of offices & facilities

Upload file(s)
20MB max (pdf, zip, jpg, jpeg, png & gif accepted) Cancelof
Head office or practice
Address

Street Address

Street Address Line 2

CityProvince

Zip CodeCountry
Telephone

Area CodePhone Number
Fax

Area CodePhone Number
Office email
Services Information
Please provide us with the following information about your company's services.
Are you currently active in performing services for the insurance industry?
Are you covered for liability flowing from business operations
NOTE

If your company does not have liablility cover, Izinga Access (Pty) Ltd. cannot make use of your services.

Please obtain liability cover for your business operations and reapply.
Cover amount
Amount in rands
Excess amount
Amount in rands
Insurance company
Policy number
Services offered by your organization
Please describe your 'Other' services
NOTE

If your company does not provide LEGAL SERVICES, please DO NOT continue with this application.

For NON-LEGAL services, please apply with our holding company Digicall South Africa (www.digicall.co.za).
Additional notes
e.g. Quotation fees, free delivery & collection, etc.
Should be Empty:

Company or Firm Information

Head office or practice

Services Information