Labour Relations Act, 1995 (Act No. 66 of 1995) Notices Motor Industry Bargaining Council (MIBCO) Motor Industry Provident Fund Collective Agreement Extension to Non-Parties of the Motor Industry Provident Fund Collective Agreement Annexures Annexure A : Application for Registration as a Member

 

ANNEXURE A TO THE MOTOR INDUSTRY PROVIDENT FUND AGREEMENT

APPLICATION FOR REGISTRATION AS A MEMBER

 

Fund No ...................................................................................................

 

Identity No ...............................................................................................

 

Surname ...................................................................................................

 

First names ...............................................................................................

 

Date of birth (year) ..................... (month) ..................... (day) ....................

 

Sex (state male or female) .........................................................................

 

Employed by (employer's name and address)

 

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Occupation

 

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Applicant's private address

 

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Where you employed in the Motor Industry previously?

 

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If the answer is "Yes", state name and address of employer

 

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I, the undersigned, hereby apply to be registered as a member of the Motor Industry Provident Fund and agree to abide by the provisions of the Fund's rules in force from time to time.

 

I nominate as my beneficiary in the event of my death:

 

First names  ............................................................................................

 

(Mr/Mrs/Miss)  .......................................................................................

 

Surname  ...............................................................................................

 

Relationship (state: wife, husband, father, mother, son, daughter, as the case maybe)

 

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Address:

 

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Identity No. of beneficiary (where applicable)

 

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Date: ...........................................................        ........................................................................

(Member's signature)