ED ("OBRA PA") INSURANCE ENROLVENT FORM, CREDIT ADVA\ + eas att:ted tothe oon soleton orm °° nae FF cette] enon roe] TREGSTERED FAMILY MEMBER AGE (2-70 senor Lv se NEXT OF KIN pureose oF toma] TYPE OF LOAN -_— ausivess aDoness e cath of Brrower ‘Nera in reeves ath benef of Gr S00, “(Cash benefit nat applet oan above GHS 100000 T & ecu if nortsintret repaid te Advars Death of Ore (1 Regstere Fory Meer ‘rower reeves GHS 00 uson death fore (Fay Member ‘(ht appabete oar above Gx 109.020) ‘thet oppeabiete Agr toon) Hosptaiaton of torroner ey 15:30 nghte= 1 mont aninstaiment upto a matimum of GMS SCO far Agro ons = GS 100) ‘Sriaonents=2 mont os ints ment a oa mama of GHS 1000 (erage lars = GHS 250) 1230 nes =3 months lon insta mene 0 # maxium of GHS 1500 oragro ans «GES 200) 10: This Benefit oul ess depending on manthy repayment /instalment amount *iNotopplccbe to loan above Gx 100.220) Teta Parl ropere Destruction Not fr Agree lons) wh ‘for Paral Destruction the nur sal inpect the eve of loss end poy the value of iessor the oustanding loan amaunt + - “(Cash benefit rat applicable to loans above GHS 100,000) # [ Sanature /Thumbornt Date | cerity that the information have given i correct, and that my insured family memler and aren good heath “Sigature -Thumprnk Advans Official