TAIFA (UMBRELLA) PENSION FUND

REGISTRATION FORM

Data Privacy Disclaimer: The details collected are for official registration and will be handled as per the 2019 Data Protection Act.

PART A: PARTICULARS OF CONTRIBUTOR

Full Name *

Employer *

Gender *

Date of Birth *

Date of Employement *

Marital Status *

ID / Passport Number *

Payroll Number *

Department / Station *

KRA Pin *

Mobile Phone Number *

Postal Address *

Postal Code *

Town *

Email Address *

Part B: NEXT OF KIN’S INFORMATION (MUST BE ABOVE 18 YEARS)

Full Name *

Relationship *

ID Number *

Email Address

Phone Number *

Part C: Beneficiary Nomination

Enter details of your beneficiaries

Full Name *

Relationship *

ID Number

Phone Number

Allocation %

TOTAL ALLOCATION: 0%

Part D: Member Declaration

I certify that the above information is true and correct in every respect to the best of my knowledge. I hereby give consent to the Employer to make monthly deductions from my salary as required by the Scheme rules and remit the same on due dates. I agree to be bound by the Taifa (Umbrella) Pension Fund Scheme Rules & Regulations.