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R10 000 R20 000 R30 000 R80 R120 R170 R7 000 R165 R10 000 R165 R10 000 R180 R10 000 R20 000 R90 R140 R10 000 R150 0819 I HEREBY INSTRUCT THE SOUTH AFRICAN SOCIAL SECURITY AGENCY (SASSA) TO DEDUCT MONTHLY THE ABOVE PREMIUM FROM MY GRANT AND REMIT TO MULTISURE CORPORATION (PTY) LTD AND/OR KGA LIFE.” I UNDERSTAND THAT I AM STILL UNDER OBLIGATION TO INSTRUCT SASSA TO AFFECT THE DEDUCTION. THIS MUST BE DONE AT THE SASSA LOCAL OFFICE. I ALSO UNDERSTAND THAT SASSA DOES NOT MARKET OR ENDORSE ANY FINANCIAL PRODUCTS, AND I CONFIRM THAT I HAVE ENTERED INTO THIS AGREEMENT FOR A FUNERAL POLICY OF MY OWN FREE WILL.” I UNDERSTAND THAT NON-PAYMENT OF PREMIUMS MAY RESULT IN NO COVER AND THAT MULTISURE CORPORATION AND/OR KGA LIFE CANNOT BE HELD REPSONSIBLE FOR NON-PAYMENT BY SASSA OR ITS AGENT ON MY BEHALF.
