Join Lithemba Funeral Cover

Main Member Details

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First Name

Last Name

Email

ID Number

Phone/Mobile

Address

Street Address

Suburb

Town/City

Province

Postal Code

Country

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Policy Information

Plan

Family Plan Option

Single member with children Plan Option

Single Plan Option

Traditional Plan Option

Payment Method

Inception date

Cover Amount

R

Available cover amounts can be found at - https://dthat.work/lfc-plans

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Premium

R

Beneficiary Details

First Name

Last Name

Beneficiary Email

ID Number

Phone/Mobile

Gender

Relationship with main policyholder e.g. Mother, Father, Cousin, etc.

Address

Street Address

Suburb

Town/City

Province

Postal Code

Country

Dependant Details

Names	ID Number	Gender	Relationship

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Main Member Details

Policy Information

Beneficiary Details

Dependant Details