- Luthando Undertaker

Luthando Undertaker

+447404456382
+27849654963
[email protected]

Facebook Twitter Youtube

Location:

1703 Mcubakazi T/ship, Butterworth 4960, Eastern Cape

Write us:

[email protected]
[email protected]

Home
Services
Deliveries Tracker
Obituaries
Gallery
Contact us
Membership
- Download Form
- Online Form

Home
Services
Deliveries Tracker
Obituaries
Gallery
Contact us
Membership
- Download Form
- Online Form

LUTHANDO UNDERTAKERS MEMBERSHIP APPLICATION FORM

BASICS

Policy No: *

Funeral Plans *Basic PlanTombstone PlusTwo G Star PlanThree G Star PlanFive G Star PlanCatering PlanAdmin and Legal Plan

Total Premium Plan (R) *

POLICY HOLDER'S DETAILS

Title

Initials *

Firstname *

Lastname *

Other Name

Date of Birth

Nationality

ID Number *

Passport Number

Street Address

City

State/Province

Country

Contact Number

SPOUSE DETAILS

Title

Initials *

Firstname

Lastname

Other Name

Date of Birth

Nationality

ID Number

Passport Number

Title

Street Address

City

State/Province

Country

Contact Number

NEXT OF KIN DETAILS

Title

Initials

Firstname

Other Name

Lastname

Date of Birth

Nationality

ID Number

Passport Number

Street Address

City

State/Province

Country

Contact Number

DEPENDENTS/EXTENDED FAMILY MEMBERS’ DETAILS

Name

Relationship

Date of Birth

Residence

ID Number or Passport Number

Name

Relationship

Date of Birth

Residence

ID Number or Passport Number

Name

Relationship

Date of Birth

ID Number or Passport Number

Residence

Name

Relationship

Date of Birth

Residence

ID Number or Passport Number

Name

Relationship

Date of Birth

ID Number or Passport Number

Residence

Name

Relationship

Date of Birth

Residence

ID Number or Passport Number

Name

Relationship

Date of Birth

Residence

ID Number or Passport Number

Name

Relationship

Date of Birth

Residence

ID Number or Passport Number

Name

Relationship

Date of Birth

Residence

ID Number or Passport Number

STOP ORDER DETAILS

Bank Name

Bank Society

Branch Code

Account Type

Account No.

Preferred dates of direct order

Amount

PRICIPAL POLICY BENEFICIARY DETAILS

Title

Initials *

Firstame

Other Name

Lastname

Date of Birth

ID Number

Passport Number

Contact Number

Email Address

STOP ORDER DETAILS

Any extra service would you like us to refer you for?Single willMirror wills (couples)Property protection trust willsPowers of attorney

Title

First Name

Middle Name

Last Name

Consent *

Yes, I agree with the information I have filled above and that is accurate and true to the best of my knowledge

LUTHANDO UNDERTAKERS

Luthando Undertakers team offers universal services. We pledge to make each funeral services a respectful, fulfilling experience that meets the unique needs of each family. We also pledge to provide a safe, comfortable services and facilities convenient service meeting our service users’ needs.

Facebook Twitter Youtube

SERVICES

Casket Sales
Flowers & Gifts
Fumigation & Cleaning Services
Live Streaming
Grief & Healing Services

CONTACT US

1703 Mcubakazi T/ship, Butterworth 4960, Eastern Cape +27(84) 965 4963 (SA)
[email protected]
[email protected]
+447404456382

We are proudly working with South African Funeral Practioners Association