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Intermediary Registration Form

(Leisure Vehicle Insurance - Sales)
MUST BE COMPLETED AND SIGNED BY THE INTERMEDIARY, PLEASE COMPLETE ALL SECTIONS IN BLOCK LETTERS

COMPANY

INTERMEDIARY DETAILS

Spouse
Child
Child
Child
Child

BANK DETAILS

CARA-SURE INTERMEDIARY
CONDITIONS AND LIMITATIONS

PLEASE MAKE SURE THAT YOU READ EACH ITEM BELOW AND WE ACCEPT THAT YOU HAVE READ AND UNDERSTOOD THE CONTENTS WHEN THIS DOCUMENT IS SUBMITTED
  • I understand that if I am not FAIS Compliant, I may NOT under NO circumstances whatsoever provide any ADVISE to any person/s on behalf of or regarding the CaraSure product.
    If you are NOT FAIS Compliant, you may ONLY provide INFORMATION and NO ADVISE. (“Information” regarding CaraSure product ONLY)
  • Only once I am Registered with CaraSure, received the necessary Training as provided by CaraSure and accepted as an Intermediary with CaraSure as well as being FAIS Complaint, may I provide ADVISE to a client.
  • I undertake that any Information/Advise I give to a client will be honest, without misrepresenting CaraSure or the Insurance Industry.
  • I further understand that I will NOT receive ANY commission from Natsure (Pty) Ltd/CaraSure if I am not FAIS Complaint and Registered with the FSCA (Formerly ‘FSB’).