SCHEME NAME
Please Select
GMA STAR FUND (TIER 3)
DATE OF EMPLOYMENT
-
Day
-
Month
Year
Date
SECTION 2: PERSONAL DETAILS
NAME
*
First Name
Last Name
GENDER
*
Male
Female
DATE OF BIRTH
*
-
Day
-
Month
Year
Date
PLACE OF BIRTH:
*
EMAIL
*
example@example.com
STAFF ID:
*
PHONE NUMBER:
*
NATIONALITY
*
SOCIAL SECURITY NUMBER:
*
POSTAL ADDRESS:
PHYSICAL / DIGITAL ADDRESS:
OCCUPATION
NATIONAL ID (prefarably Ghana Card)
SECTION 3: BENEFICIARY
BENEFICIARIES (IN EVENT OF MY DEATH, ANY BENEFITS ACCRUING TO ME UNDER THE FUNDSHALL BE PAID TO MY BENEFICIARIES INDICATED BELOW). IF BENEFICIARY IS BELOW 18YEARS , KINDLY FILL THE TRUSTEE COLUMN.
*
NAME OF BENEFICIARY
RELATIONSHIP
% OF BENEFIT
DATE OF BIRTH
CONTACT
1
2
3
4
5
SUM OF BENEFICIARY:
The sum of your beneficiaries is
{sumOf}
. It should add up to 100%.
TRUSTEE'S NAME
RELATIONSHIP
DATE OF BIRTH
CONTACT/ADDRESS
1
2
DECLARATION BY PARTICIPATING EMPLOYEE
I certify that the contents of the membership enrolment form are accurate.
Signature
*
Clear
Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: