The
orange boxes
are required fields.
Title
Select
Mr
Mrs
Miss
Ms
Dr
Prof
* Required
First Name
* Required
Surname
* Required
Date of Birth
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
January
February
March
April
May
June
July
August
September
October
November
December
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
Year
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
* Day Required
* Month Required
* Year Required
* You must be at least 18 years old to request a quote
Day-Time Contact Number
(Format: 0#########)
* Required
* Incorrect format
E-mail
* Required
* Please enter a valid email address
Daytime Postal Code or Suburb
* Select a suburb/city from the list that appears as you type
Occupation
Occupation
Director – Admin
Director – Manual / Mechanical
Director – People and Admin
Driver
General Administrator
Machine Worker
Manager – Admin
Manager – Industrial
Manager – People
Manual – Engineering
Manual – Industrial
Manual – Office
Miner
Other – Administrative Work
Other – Manual Work
Other – Supervisory Work
Professional – Doctor
Professional – Engineering
Professional – Finance
Professional – Medical Specialist
Professional – Pilot
Sales – Sale Consultant
Sales – Sales Manager
Technical Occupation
* Required
Gender
Male
Female
* Required
Highest Education
Education
No Matric
Matric
Matric plus 1 or 2 Year Diploma
3 or 4 Year Technical or College Diploma
University Undergrad Degree
Future Professional
4 Year Degree
Post Grad
Not Available
* Required
Household Income
Income (per month)
0 - 5000
5001 - 10000
10001 - 15000
15001 - 20000
20001 - 22500
22501 - 25000
25001 - 32000
32001 - 41666
41667 - 55000
55001 - 67500
67501 - 80000
80001 - upwards
* Required
Which branch is nearest to you?
Select Branch
Johannesburg
Durban
Cape Town
Bloemfontein
* Required
Are you a business owner?
Select Status
Yes
No
* Required
Do you own property?
Select Property Ownership
No
Yes - One Residence
Yes - Multiple Residential Properties
Yes - Residential and Commercial
Yes - Commercial Properties
* Required
If you proceed with the trust structure,
would you require that a Life policy is put in place to cover certain costs and expenses of the trust in the event of your death?
Select
Yes - To Secure Business Assets
Yes - To Secure Property
Not Sure - On Advice
* Required
What is your estimated Net Asset worth?
(This is required to assist the Trust attorneys in determining which structures are best to be used.)
Select Asset Worth
Less than R 2 million
R 2 million to 4 Million
R 4 million to R 6 million
Greater than R 6 million
* Required