Redundancy insurance - Request form

Step 1Do you meet the requirements?

Yes No
Yes No
Yes No
Yes No
Yes No

Step 2Choose your monthly compensation amount

You receive 1'200.- per month

Your monthly installment 55.30.-

(minimum yearly gross salary 105'000.-)

Step 3Fill the form

Mr Madam
ex. 18 11 2016
ex. 079 433 33 33
 Please enter your monthly salary amount
I hereby confirm having read legal information in its entirety and hereby confirm that I accept all points.

Your data is sent encrypted.

Unfortunately we are unable to offer you our redundancy insurance solution.
Call us at 021 620 60 00, our advisors will gladly answer any questions.