Quality Funeral Support Plan Policy

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Quality Diaspora Funeral Support Plan

Application Form

Step 1: Personal Details

Step 2: Policy Details

Step 3: Health Information

Step 4: Nominated Lives

For more nominees, QLAC staff may contact the applicant after submission.

Step 5: Beneficiary & Trustee

Step 6: Declaration

I declare that to the best of my knowledge and belief all the above statements are true and shall form the basis of the contract between me and Quality Life Assurance Company.