This is a completed application, submitted . Nothing here is editable, it is a read-only record for NASASA Life administration.
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Welcome to NASASA Life — quality funeral cover for stokvels and burial societies, groups, families and individuals. Explore the cover that suits you and the people close to you before you commit to anything. If you have questions along the way, ask Thuso using the red button at the bottom right of your screen, or contact the NASASA representative who has been helping you. NASASA Life is a product of the National Stokvel Association of South Africa, in partnership with administrator Serenity Life, and underwritten by Assupol Life. We look forward to serving you and your loved ones. Premium Summary
Premium Summary
Every product's premium at a glance, so you can see the hypothetical cost before choosing a plan. Client premiums only, Scheme 001.
Member Plus
Family
Single Member
Cover for your parent, or parents
This is cover for your parent, or parents, up to a maximum of two, at any age, with no upper limit. It's priced per life according to their age band, and it's a separate policy from any other NASASA Life cover you hold, taking out cover here doesn't change your own Member Plus, Individual, or Family cover.
Who are you covering?
Add each parent separately, their premium depends on their own age band and the cover you choose for them.
How would you like to pay?
Choose whichever suits your budget best. Whichever you choose, the cover itself is exactly the same.
TotalR0
Group details
The stokvel or burial society, and the chairperson or authorised representative submitting this application.
Group location
Group admin
This is recorded as the group's named contact for this application. It isn't used to route anything automatically — each member's own dependants and beneficiary go straight into this group's application the moment they save, via the register below, not to this address. Email addresses above are optional and will not hold up this application if left blank.
NASASA Representative Code REQUIRED
If you have reviewed the pricing and are interested in taking this process forward, please indicate the NASASA representative assisting you with this application. They will receive a percentage of the premium you pay.
Type your representative's name, or their code if you already have it. The rest fills in automatically, and the code shows whether they are an agent (AGT) or a community builder (CB). If you got this form yourself, with no representative involved at any point, choose Direct application.
What cover is the group taking?
The group decides once, for every member. Locked below — press Change to switch.
✓ Locked in
Indicative premiumTap a cell above
Beneficiary
Who receives the pay-out when a member dies.
Each member nominates their own beneficiary on their own policy, linked to their place on this group's cover, not one shared person for the whole group. Their beneficiary choice stays between them and NASASA Life.
If the group is the beneficiary, the pay-out goes to the stokvel or burial society's own funds. The group then contributes towards the deceased member's family funeral costs, under its own protocol.
However this is set up, the arrangement is the same: each member pays their portion to the group, and the group pays NASASA Life on all members' behalf, as one combined premium, via the debit order later in this form.
How should the group share the cost?
Members are different ages, so their individual premiums differ too. The group decides how to handle that.
Member register
Just who the main members are — name, ID number, and age (for the premium). Their beneficiary details come next, once this register is locked.
If the chairperson and/or group admin are themselves taking up this cover, add them here too — even though their details were already captured above.
Members added0
Member Plus benefit
One tier and cover amount for every member — each member is still priced on their own age and dependants, but everyone is on the same tier and cover.
* R30 000 and R40 000 cover is not yet on Assupol's confirmed Member Plus rate card. These premiums are an estimate only, pending confirmation from Serenity, do not use them for a final quote yet.
Member register
Just who the main members are — name, ID number, and age (for the premium). Each member's own dependants and beneficiary come next, once this register is locked.
If the chairperson and/or group admin are themselves taking up this cover, add them here too — even though their details were already captured above.
Members added0
Family benefit
One cover amount for every family — each family is still priced on the member's own age, but everyone is on the same cover.
Family register
Just who the main members are — name, ID number, and age (for the premium). Each family's own spouse, children and beneficiary come next, once this register is locked.
If the chairperson and/or group admin are themselves taking up this cover, add them here too — even though their details were already captured above.
Families added0
Member register
Open a member, choose their own cover and fill in their details, dependants and beneficiary, then close their application — this locks in their premium and downloads their own configuration PDF. You'll stay right here, ready to open the next member.
If the chairperson and/or group admin are themselves taking up this cover, add them here too — even though their details were already captured above.
Members added0
Excel is recommended if the group may need to make changes and resubmit this register later.
Member Dependants
Fill a member's dependants and beneficiary in yourself below, right here on this page — or use "Copy and share link" next to their name to copy a personal link you may share with that member, so they can fill in their own details on their own phone. Either way, it's saved straight into this same group application.
Excel is recommended if the group may need to make changes and resubmit this register later.
Who are you covering?
As the policyholder, you can take out this cover on yourself, or on one other adult, paying for their cover yourself.
Funeral cover
Core premiumR0
Your details
Required, so we can copy you on your own submission and you can see for yourself it went through correctly. No email of your own? Use a trusted family member or friend's address instead, or ask them to help you set one up, it only takes a few minutes and is free.
ID number must be exactly 13 digits.
About the adult you are covering
Must be 18 years or older. A child cannot be insured on their own under this plan.
Dependants and extended family
Spouse and children (immediate family)
This does not change your premium, the core cover below already includes one spouse and up to six children. It just builds your record for the application form.
Extended family (optional)
Spouses, children or relatives not already covered above. Their cover cannot be more than your own. Pick an age band and cover for each person, the premium is worked out for you.
Extended family subtotalR0
Beneficiary
First beneficiary
Second beneficiary (backup)
Core premiumR0
Extended familyR0
GroceriesR0
Your monthly premiumR0
Optional: Grocery & Airtime benefit
A R2,500 benefit on top of your funeral cover: R2,000 in groceries and R500 in airtime, paid out alongside the funeral benefit. This is a separate, optional add-on, it does not change your funeral cover amount.
Grocery & Airtime isn't available for the age band you've selected.
✓ Grocery & Airtime added
Upload your documents
We need these to verify who you are, a standard requirement for any insurance application. Photos or scans, .pdf/.jpg/.png, under 5MB each. Make sure all corners are visible with no glare.
How would you like to pay?
Choose how your monthly premium reaches NASASA Life.
No debit order mandate or bank details are needed. Keep your payment reference handy and use it every time, so your payments can be matched to this policy — without it, a payment can't be allocated to your cover.
Debit order mandate
This authorises Serenity Life and Wealth (Pty) Ltd, the administrator, to collect your premium on the date you choose below, and forms part of your policy contract.
If your chosen date falls on a weekend or public holiday, the debit will go through on the next business day. This mandate stays active until your obligations under the policy are met, or you cancel it in writing.
Debit Order Mandate
This is the actual mandate you're signing, filled in from what you've entered above. Check it over, then tick to confirm below.
No separate signature needed here — the one signature you give at the end of this application (Declaration and signature) is applied to this mandate too.
Tick the box above to download your own copy now — it's also included as its own page in your full application PDF, and will carry your signature once you sign at the end of the application.
Signatories for this stokvel / club account
A stokvel or club account needs three people with authority over it to each confirm this account is being committed to this debit order with the group's authority. Every signatory below is bound by the same mandate you'll sign at the end of this application.
Confirm who assisted you
Declaration and signature
This is the final step. Reading and signing below confirms your application. Your signature is captured electronically and placed directly on your application form, this is legally recognised as your signature in South Africa.
Terms & Conditions
Open and read the Terms & Conditions above before you can confirm.
Sign here
Draw your signature below, or upload an image of your signature, then tap Apply Signature.
Tap to sign
Confirm your application
Everything above exists to work out an accurate costing for your cover and to confirm who is being covered. Confirming generates your completed Application, the document that shows exactly who and what is covered, includes your uploaded documents and your debit order mandate, and has space for your policy number once NASASA Life issues it.
Your application is ready, two steps left
1
Save this application for your own records
Choose where on your device to save it. This is your own signed copy, with your ID and proof of bank account already included — you'll attach it to your email in step 2.
✓ Saved
2
Email it to NASASA Life
Save your application first (step 1), then this becomes available.
Send to: compliance@nasasa.co.za
Your email app should now be open, with the address above filled in and your declaration, a link straight to this application, and a full written summary already in the message. Attach the PDF you just saved before sending — it already has your ID and proof of bank account included.
Prefer to compose the email yourself rather than rely on the button below? Copy the address above, open your own email app, and paste in the same declaration and link from the message body. You'll also receive a copy of the button-generated email yourself if you do use it, so you have it for your own records too.
If this cover is part of a stokvel or burial society scheme, you can also share just your cover summary, tier, cover amount, and premium only, nothing about who you've listed, with your group's chairperson.
Ask Thuso
Hello! I'm Thuso, the NASASA Life assistant. I can explain our funeral cover products, the application process, or the Terms & Conditions — I can't give financial advice, but I'm glad to help you understand your options. What would you like to know?
Please don't share ID numbers or bank details in the chat. Premiums are estimates, not quotes.
