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INTERMEDIARY HOUSE DETAILS

Company Type

PartnershipCCLTD CompanySole proprietorOther

Same as above

Category/ies of insurance associated with your FAIS Licence

Category ACategory B1Category B1 -ACategory B2Category B2 -ACategory CNone of the above

Holder of Professional Indemnity insurance?

YESNO

Did you earn 30% or more of total commission for the previous year from a specific Insurer Product Provider?

YESNO

Do you own 10% or more of issued shares directly/indirectly in any Insurer/Product Provider?

YESNO

Are you an associated company of any Insurer/Product Provider?

YESNO

Does your organisation meet the FAIS operational requirements?

YESNO

Does your organisation comply with FAIS financial soundness requirements?

YESNO

Contact us : advisors@elevate.co.za

All Elevate Life policies are underwritten by Centriq Life Insurance Company Ltd. (“Centriq”), a licensed life insurer and authorised financial services provider (FSP 7370).