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Register Please complete and submit this form to receive your refunds

We typically process your application within 24 hours and you will receive a confirmation email.

Please have the following details ready:

  • Full name of the life insured
  • Policy owner(s) and signature(s)
  • Policy provider
  • Policy number
  • Bank account details to receive refunds
Registration Form
  • Personal Details
  • Policy Details
  • Bank Details
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Your Details (Life Insured)