business shield application form july 2013 - · pdf file1 - 5 n$337.00 6 - 10 n$675.00 11 ......

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Premiums Free Funeral Policy for all employees included Employees 1 - 5 N$337.00 6 - 10 N$675.00 11 - 15 N$917.00 16 - 20 N$1,223.00 21 - 30 N$1,569.00 31 - 40 N$1,940.00 41 - 60 N$2,909.00 61 - 80 N$3,374.00 81 - 100 N$3,585.00 VAT inclusive

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Page 1: Business Shield Application Form July 2013 - · PDF file1 - 5 N$337.00 6 - 10 N$675.00 11 ... Title: Business Shield Application Form_July 2013.indd Created Date: 7/19/2013 9:18:10

PremiumsFree Funeral Policy for all employees included

Employees

1 - 5 N$337.006 - 10 N$675.0011 - 15 N$917.0016 - 20 N$1,223.0021 - 30 N$1,569.0031 - 40 N$1,940.0041 - 60 N$2,909.0061 - 80 N$3,374.0081 - 100 N$3,585.00

VAT inclusive

Page 2: Business Shield Application Form July 2013 - · PDF file1 - 5 N$337.00 6 - 10 N$675.00 11 ... Title: Business Shield Application Form_July 2013.indd Created Date: 7/19/2013 9:18:10

Documents Attached For Internal Use Only

ID Main memberID PayeeID Beneficiary/DependantsBirth Certificates

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