I, the undersignedauthorize the the following IndemnityMrs / Miss /MrsInvictus Point Financial Services to request information on my behalf for my assurance, investment portfolio or retirement benefits from any Life Office.DatePlease provide a detailed description of all policy information such as lives covered, level of cover, date of birth as well as maturity dateUpload SignatureChoose FileNo file chosenDelete uploaded filePolicy holder digital signatureSend Message INTEMEDIARY INFORMATION FSP Name Invictus Point Financial Services FSP Number 53497 Telephone Number 068 493 2123 Email Address info@invictuspointfs.co.za I declare that I have informed the policy holder of the implications of this authority.