GA Life Personal Provident Plan

SECTION 1: APPLICANT DETAILS

SECTION 2: CONTRIBUTIONS

SECTION 3: YOUR EMPLOYER’S CONTRIBUTIONS TO BE COMPLETED IF EMPLOYER IS MAKING CONTRIBUTIONS

SECTION 4: DOCUMENTS REQUIRED TO BE ATTACHED TO THIS APPLICATION FORM:

SECTION 5: BENEFICIARIES' DETAILS (TO BE COMPLETED BY APPLICANT)

DECLARATION (TO BE SIGNED BY THE APPLICANT)

I, the undersigned and Applicant, recognise that my circumstances and those of the persons showed above as beneficiaries may change. I undertake to advise the Trustee when any change should be made regarding my nominated beneficiaries. I understand that:

i. this form amounts to an expression of my wishes and that it is not binding on the Trustee.

ii. by opting not to nominate any guardian above for a nominated beneficiary below the age of majority(18 years) then benefits due to the said nominated beneficiary will be retained until they attain age of majority(18 years) and that unless otherwise indicated my benefits from the Scheme will be divided equally among all persons who are nominated as beneficiaries and who survive me and have attained age of majority OTHERWISE to the guardian (on appointment by the High Court of Kenya where necessary.)

On being admitted as a Member to the Scheme, I hereby agree to be bound by the Scheme Trust Deed & Rules together with every person whose claim upon the Scheme is derived from me and with the terms & conditions of all contractual agreements between the Scheme and service provider(s) to the Scheme.

  I accept

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