FORM-I FORM OF APPOINTMENT OF BENEFICIARY. I,_________________________________________ AN Insured Member of the___________________________________ Group Saving Linked Insurance Scheme hereby appoint in terms of Rule No.12 headed 'Appointment of Beneficiary' of the Rules governing the scheme may (relationship) ____________________ named_____________________ and whose address is___________ ____________________________________________________________________________________________________________ as the person to be the beneficiary to whom the moneys payable in terms of the Rules of the Scheme shall be paid in the event of my death. Signed at______________ this ___________________ day of _______________ ____. Signature of Insured Member Witnessed by: 1. i) Signature_______________ ii) Name ________________ iii) Address______________ ____________________ 2. I) Signature______________ ii) Name_________________ iii) Address________________ _______________________ ******
