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STEP 9: Main Member's Authorisation

I confirm that all the details provided are correct and by submitting this form I acknowledge that I am applying for Membership. I have read the Statutory Notice attached hereto and understand it. Further, I consent to my information being used for the purposes related to the services provided by Legal Expenses Insurance Southern Africa Limited. I also confirm that no financial advice was provided to me nor was needs analysis conducted for me by the Independent Contractor acting on behalf of Legal Expenses Insurance Southern Africa Limited.

By submitting this form I agree to the terms above.

Monthly Premium: R 190.00
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