ANNUITY 27

Fixed Monthly Savings Program

1

Personal

2

Next of Kin

3

Savings

4

Bank

5

Review & Pay

Personal Information

Please provide your personal details

Full Name *

Full name is required

Date of Birth *

Date of birth is required

Phone Number *

Phone number is required

Email Address *

Valid email address is required

Place of Work *

Place of work is required

Next of Kin Details

Provide your next of kin's information

Next of Kin Name *

Next of kin name is required

Next of Kin Contact *

Next of kin contact is required

Savings Details

Tell us about your savings plan

Preferred Fixed Monthly Savings (UGX) *

Monthly savings amount is required

Source of Funds *

Please select a source of funds

Purpose of the Funds *

Purpose of funds is required

Savings Period *

1 Year

2 Years

3 Years

Please select a savings period

Bank Details

Enter your bank account information

Bank Account Number *

Bank account number is required

Bank Account Name *

Bank account name is required

Review & Payment

Review your details and proceed to payment

Personal Information

Name: —

Date of Birth: —

Phone: —

Email: —

Place of Work: —

Next of Kin

Name: —

Contact: —

Savings Details

Monthly Savings: —

Source of Funds: —

Purpose: —

Period: —

Bank Details

Account Number: —

Account Name: —

Membership Registration Fee

UGX 6,000

One-time registration fee • Secure payment