Death Notification

DEATH NOTIFICATION

TO THE ADMINISTRATOR :

BROKSURE ADMINISTRATORS (PTY) LTD

P.O. BOX 16254, VLAEBERG, 8018

Tel: (021) 424 1299

Fax: (021) 424 2039

Email:

FUND DETAILS (to be completed by employer)

Name of fund.………………………………………………………………………………………..…………….………..………

Name of employer.………………………………………………………………Division / branch………………………………

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MEMBER DETAILS (to be completed by employer)

Title.…………(Mr/Mrs/Ms/etc.) Last name. ……….…………………………First names……………………………….

Date of birth ……………………ID no…………………………………..…Income tax no…….…..…..……………………….

Residential address.………………………………………………………………………………………………….………….…

Postal code.………..….…….Contact persons…………………………..Contact numbers………………………………….

Postal address………………………………………………………………….. …………Postal code ……….……………….

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DETAILS OF DEATH (to be completed by employer)

Date of death (dd / mm / yyyy) ……………………………………Last month of contribution ……………………………….

State member’s salary for the 12 month period

immediately preceding death R…………………….

State details of highest average salary earned

by deceased member during any consecutive

five year period whilst a member of the fund : Year Annual salary

……………. R…………………….

TOTAL (5 years) R…………………….

Divide by 5 if for a full 5 years or by lesser

number of years if employed for a period

of less than 5 years AVERAGE R……………………

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AUTHORISATION (to be completed by employer)

We declare that the above information is correct.

Employer’s signature……………………………………….Date……………………………………………………

Options available on death of member

Benefits are payable by the fund following death of the member. The rules of the fund will provide specific detail which must be followed. Different options may apply to different categories of membership. The summary below is intended only to give an overview of the various options which may be available following the death of a member. We recommend that the beneficiary (-ies) consults with a registered financial service provider.

Subject to the rules of the fund, any group life policy or individual life policy on the deceased member’s life, would trigger a death claim against an insurer for an amount and this sum would be used to enhance the death benefit payable by the fund to the beneficiaries.

The trustees are required to identify potential beneficiaries, initially from the beneficiary nomination forms completed by the member and lodged with either the administrator or the employer. All financially dependent beneficiaries of the deceased must be identified by the trustees. Any nominations made by the deceased (who are not financially dependants) may be disregarded by the trustees in arriving at their settlement decision if one or more financially dependent beneficiaries exist. In essence

In terms of section 37C, the trustees should attempt to settlement the death benefit within twelve months of the deceased’s member’s death. During the twelve months, the trustees are required to identify all financially dependent beneficiaries and to identify each beneficiary’s financial need in terms of their dependency on the deceased member. Should there be no financially dependent beneficiary and no nominee (financially independent beneficiary), the death benefit will be paid to the member’s estate and if there is no inventory in respect of the member, then into the Guardian’s Fund.

Option 1 : Annuity

The rules of the fund make provision for benefits on death which will comprise the value in the members individual account plus an amount, if any resulting from a claim in respect of any underwritten benefits. A death claim will be paid in the form of an annuity in terms of the fund’s rules.

Option 2 : Lump sum cash

Should this option be preferable, the beneficiaries must indicate in writing to the trustees and / or administrator that the annuity option is not suitable and that (up to) 100% of the death benefit may be taken as a lump sum cash amount which would be subject to taxation.