Supporter Plan Application Form

Creating a Better Lifestyle for Families

Thank you for choosing SDL Administrative Services (Pty) Ltd.

SDL is a proudly South African company that believes in offering people the opportunity to create a better lifestyle for their families.

We offer our customers affordable financial and non-financial products that give them the peace of mind and security that comes from knowing their families are fully protected in the event of accident or death.

Please click HERE to familiarize yourself with our bundle product on offer.

What’s more, we offer our customers the opportunity, training and support to join our organisation as distributors and fulfil their aspirations by building a prosperous and sustainable business for themselves and their families.

Please click HERE to familiarize yourself with our fantastic compensation plan which affords you the opportunity to have this package without disrupting your household income, and more.

You must be between the ages of 18 to 64 years. You must be a South African citizen.

*Scroll down to supply all requested information.*

First-month registration Fee = R200.00
Every month thereafter = Premium you have selected.

Please note your business opportunity has already been included.

Supporter Plan Package (R160.00)*

Who Referred you to SDL? *

Provide the Marketer(SM) Number in this field: * 🛈

Details Principal Member

Title: *

First Name: *

Surname: *

ID Number: *

Street Address: *

Address Line 2:

City: *

Code:

Phone Number: * 🛈

Email Address: *

Details of Spouse

Title:

First Name:

Surname:

ID Number:

Marital Status:

Details of Eligible Dependant Children

Full Name and Surname:

Student?

Male or Female?

Date of Birth +

Full Name and Surname:

Student?

Male or Female?

Date of Birth +

Full Name and Surname:

Student?

Male or Female?

Date of Birth +

Full Name and Surname:

Student?

Male or Female?

Date of Birth +

Full Name and Surname:

Student?

Male or Female?

Date of Birth +

Designated Beneficiary

Title:

First Name: *

Surname: *

ID Number: * 🛈

Relationship: *

Telephone Number: *

Debit Order Authorisation

Account Holder Name: *

Bank: *

Account Type:

Debit Order Date *

Branch Name: *

Branch Code:

Account Number: *

Inception Date" * +

I / We hereby request, 'instruct' and authorize you / payroll master to draw / deduct from my / our account / salary with the above mentioned bank (or any other bank or branch to which I / We may transfer my / our account) the amounts (as indicated above) or any other variable amount pertaining to this agreement. This being the amounts necessary for the settlement in respect of my / our purchases / agreement. These withdrawals from my / our bank account by you shall be treated as though it has been signed by me / us personally. I / We understand that the withdrawal hereby authorized will be processed by SDL Administrative Services (Pty) Ltd, indicated on my statement as SDLPioneer, and I / we also understand that the details of each withdrawal will be printed on my bank statement. I / We agree to pay any bank charges relating to this debit order instruction. I/ We understand that if the debit order action date falls on a non banking day that the debit order may be actioned on the banking day after the debit order date. This authority may be cancelled by me / us by giving you thirty days notice in writing. I / We understand that I / we shall not be entitled to any refund of amounts which you have withdrawn while this authority was in force if such amounts were legally owing to you. Receipt of this instruction by you shall be regarded as receipt thereof by my / our bank (whichever it is or will be). ASSIGNMENT: I / We acknowledge that the party hereby authorized to effect the drawing (s) against my / our account may not cede or assign any of its rights to any third party without my / our prior written consent. I / We may not delegate any of my / our obligations in terms of this contract authority to any third party without prior consent of the authorized party. I hereby consent that the above banking details can be used to process a debit order.

I hereby consent that the above banking details can be used to process a debit order. *

Principal Member Confirmation

ACKNOWLEDGEMENT
I warrant that I have been provided with all the intermediatery, insurance and benefit details, or any other information as I may have requested. I warrant that all details and facts herein are accurate and properly disclosed, even if completed by the intermediary or representative on my behalf. I understand that the benefits offered are risk benefits only, and that there are no surrender values. Failure to pay my premium in 3 consecutive months will result in premiums lapsing. In the event of any query regarding this policy or any other claim in terms of this policy, I consent to the disclosure of any relevant information to the intermediary or any SDL Administrative Services (Pty) Ltd official for the purpose of resolving the query. I am satisfied that this plan best suits my needs.

I understand and accept the acknowledgement above. *

Would you like us to forward you a copy of your application form? *

Please call me during the indicated time slot to finalise application form. *

Please provide your signature in the block below:

clear

SDL Administrative Services (Pty) Ltd

Tel: 021-939 9107

Fax: 021-911 0993

e-mail: clientservices@sdl.co.za

website: www.sdl.co.za

SDL Administrative services is a

Juristic Representative under FSP 41507

Supporter Plan Application Form

Details Principal Member

Details of Spouse

Details of Eligible Dependant Children

Designated Beneficiary

Debit Order Authorisation

Principal Member Confirmation

ACKNOWLEDGEMENT