
I agree that a monthly premium may be added to my account and I undertake to pay the premium when due as long as I remain a member of Koopkrag or till the age of 70. For this I will receive the following benefit from Koopkrag Limited on condition that the premium is fully paid. At death Koopkrag Limited will pay the insured amount to my next of kin or to the executor of my estate at the registered offices of Koopkrag Limited, provided that if there is a balance outstanding on the Koopkrag account at the time of death, Koopkrag will be entitled to set it off against the insured amount and any surplus will be paid to the executor of the estate. The insured amount is determined with reference to the table set out below.
It is a condition of any payment made by me that:
The life cover for a premium of R5.05 per month equals one unit and is determined as follows:
| Age of member/spouse as on date of death | < 30 | 30-39 | 40-49 | 50-59 | 60-69 | 70+ |
| Amount in Rand per unit | R12000 | R10000 | R7000 | R4000 | R2000 | R1000 |
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