Disability Appeal Form For South African Local Authorities Pension Fund Members

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REF No 205
Disability Appeal Form
(To be completed by the Claimant)
FOR
SOUTH AFRICAN LOCAL AUTHORITIES PENSION FUND
MEMBERS
NOTE: The completed Disability Appeal Form and supporting documents (refer to Checklist) to be
forwarded to Soma Initiative, P.O Box 2475, Clareinch, 7740
GLA Death, Family Funeral, Disability: Monthly Income and Accidental Hospitalization
Benefits administered by Prosperity Management Africa (Pty) Ltd

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