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

 

ANNEXURE A TO THE AUTO WORKERS' 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 Auto Workers' 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)