Milele Trust Form 2 | ICEA LION Group

Proposer (Settlor) Information

Male Female

Upload ID front / Passport

Upload ID back

Upload your KRA PIN certificate

Assets to be held in trust

Select all assets that apply and enter the value for each. use the add asset button to add more.

Policy Details

Asset Type

Property (including rent income)

Bank / Savings account

Life / Annuity Policy

Total Value

Source of Asset

Retirement Benefits

Salary / Savings

Group Life Benefits

Current Asset Value (KES)

1,100,000

500,000

1,130,000

2,730,000

Purpose of Trust

The trust will cater for the following beneficial needs:

Other, please add details below: -

Proposer (Settlor) Information

Male Female

Upload ID front / Passport / Birth Cert

Upload ID back

Upload your KRA PIN certificate

The trust should be closed when the fund value of the fund gets to zero or when the beneficiary attains the age of

Or on the following date

or after attainment of such condition as described below: -

Added Beneficiary

Surname

Kamau

Total Value

Other names

John Doe

Kevin Doe

Proportion of benefits (%)

40%

30%

100%

*The total proportion of benefits allocated to beneficiaries must add up to 100%

Guardian Details Individual Proposer (Settlor)

Male Female

Upload ID front / Passport / Birth Cert

Upload ID back

Upload your KRA PIN certificate

Added Guardians

Surname

Kamau

Other names

John Doe

Kevin Doe

Phone number

+254 722 321 456

100%

ADDITIONAL INSTRUCTIONS

Please provide details of any special instructions for management of this trust below

I, the person by whom the assurance is to be effected declare that the foregoing answers are true and complete.

The statements made in this application and in any other documentation submitted in connection with this application form the basis of the policy applied for and shall constitute all representations made as a basis of the said policy.

I have read and accept ICEA LION's Conditions and Provisions