Fransahome for you - Home Saving Plan Application

Fransahome - Home Saving Plan

Gender

Applicant Title

First Name *

Family Name *

Father’s name *

Maiden name *

Date of birth *

Mobile Number *

Language

Cash Value (Capital to be saved) *

Annual Premium (min. $600) *

or Sum Insured (Amount to be insured) *

Annual premium variation (2 to 10%) - Optional

Age At Maturity *

Premium frequency *

Initial Payment

(*) Required fields