To: THE CHIEF EXECUTIVE OFFICER

SWAZILAND NATIONAL PROVIDENT FUND Form NPF. 35A. (E)

P.O. BOX 1857
MANZINI

LIDLELANTFONGENI
SWAZILAND NATIONAL PROVIDENT FUND
NOMINATION FOR SURVIVOR’S BENEFIT
Particulars of Member in BLOCK CAPITALS

Surname First Name (s) Year of Birth Identity Number

PIN: ...................................................
Graded Tax: ......................................
Date of Number of Type of
Marital Status Marriage Spouses Marriage
(a) Civil Rites
(b) Swazi Law
and Custom
Employer’s name and Postal Address Employer’s Account No:

A
I hereby nominate the person (s) named below as the only person (s) to receive the amount standing to the credit of my account
in the event of my death and direct that the said amount shall be distributed in the proportions indicated below:

Particulars of persons (s) nominated in BLOCK CAPITALS:

Proportion
Name and Residential Area of Relationship Nominne’s
Name and Residential Area of Nominee Year of Birth or % of
Nominee’s Mother/Father etc to Member PIN. No. Benefit

(a) Name
1. ....................................................................................................................................................... ..................................................................................

2. ....................................................................................................................................................... .................................................................................

3. ....................................................................................................................................................... .................................................................................

4. ....................................................................................................................................................... .................................................................................

(b) Region
1. ....................................................................................................................................................... .................................................................................

2. ....................................................................................................................................................... .................................................................................

3. ....................................................................................................................................................... .................................................................................

4. ....................................................................................................................................................... .................................................................................

(c) Area
1. ....................................................................................................................................................... .................................................................................

2. ....................................................................................................................................................... .................................................................................

3. ....................................................................................................................................................... .................................................................................

4. ....................................................................................................................................................... .................................................................................

* The Year of Birth to be entered in this column is the year of birth or approximate year of the Nominee at the date of completion of this form.

Member’s Signature (or Thumb Print) Name of witness (in BLOCK CAPITALS)

...................................................................................................... ...........................................................................................................

Postal Address: .................................................................................

...................................................................................

Signature of Witness: ........................................................................

Date: ............................................................................................. SWAZILAND NATIONAL PIN: ...........................................................

UNGAGCWALISI NGESISWATI, BUKA NGEMUVA

To: THE CHIEF EXECUTIVE OFFICER
SWAZILAND NATIONAL PROVIDENT FUND Form NPF. 35A. (E)
P.O. BOX 1857
MANZINI

SIKHWAMA SESIVE LIDLELANTFONGENI

KUKHETSA LOYO LOTAKUTSATSA IMALI YEMUFI

Ligama lelilunga nalokuqondzene nalo, akubhalwe NGEMAGAMA LAMAKHULU

Sibongo Ligama lekucala Umnyaka

Inombolo
wekutalwa
Yebuve: ...........................................
Yelipasi: ...........................................
Lusuku Linani Washada Ngamuphi
Sewateka/Watekwa na
Lwemshado Lebafati bakho Umshado
(a) Wesilungu
(b) Wesintfu

Ligama lemchashi nelikheli lakhe Inombolo Yemchashi

A
Ngiyakhetsa ngikhetsa lomuntfu loshiwo kutsi kube nguye kuphela loyokutsi atsatse imali lesegameni lami (ngabo kuphela labayakutsi batsatse imali
lesegameni lami) uma kwenteka ngifa, nekutsike ngiyasho ngitsi lemali iyakwehlukaniswa ngelinani lengilibekile (ngemanani lengiwabekile) langentansi.

Ligama noma emagama aloyo/alabo lengimkhetsile/lengibakhetsile abhalwe NGEMAGAMA LAMAKHULU.

Bahlobane Incenye
Ligama nendzawo yekuhlala Ligama nendzawo yekuhlala Inombolo yebuve Umnyaka yemali
yalokhetsiwe ngani leya kulona
YaMake/Babe walokhetsiwe Yalokhetsiwe Wekutalwa
Nalokhetsiwe lokhetsiwe

(a) Ligama
1. ....................................................................................................................................................... ..................................................................................

2. ....................................................................................................................................................... .................................................................................

3. ....................................................................................................................................................... .................................................................................

4. ....................................................................................................................................................... .................................................................................

(b) Sigodzi
1. ....................................................................................................................................................... .................................................................................

2. ....................................................................................................................................................... .................................................................................

3. ....................................................................................................................................................... .................................................................................

4. ....................................................................................................................................................... .................................................................................

(c) Indzawo
1. ....................................................................................................................................................... .................................................................................

2. ....................................................................................................................................................... .................................................................................

3. ....................................................................................................................................................... .................................................................................

4. ....................................................................................................................................................... .................................................................................

* Umnyaka wekutalwa lekufanele ufakwe kulesikhala, ngumnyaka noma umnyaka losondzele emnyakeni wekutalwa kwalowo lokhetsiwe
mhla kugcwaliswa leliphepha.

Kusayina Lilunga (Nome licindzetele ngesitfupha salo) Ligama lafakazi (Ngemagama Lamakhulu)

...................................................................................................... ............................................................................................................

Likheli : ...............................................................................................

...................................................................................

Kusayina kwafakazi: ...........................................................................

Lilanga: ............................................................................................. Inombolo yebuve (PIN): ......................................................................

(Mhla kugcwaliswa leliphepha)
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