6% 6.5% 7% 7.5% 8% 8.5% 9% 9.5% 10% 10.5% 11% 11.5% 12% 12.5% 13% 13.5% 14% 14.5% 15% 15.5% 16% 16.5% 17% 17.5% 18% 18.5% 19% 19.

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1 Option form for Sanlam Staff Umbrella Pension and Provident Funds and Group Life Insurance Annexure B Full names Paycode Telephone number Date of permanent appointment (dd/mm/ccyy) For office use only PEAR: TGP: Name and contact number of HR consultant A. Funds (Please mark the applicable option with an "X") 1. Contribution rates = % of TGP: (See Information Guide, points 6.1 and 6.2) 1.1 Member contribution rate (Default) 7,5% Should you not wish to make the default contribution you may select a member contribution rate from the list below. Please note that choosing a member contribution rate lower than the default will, all things equal, result in reduced retirement savings. This could have a negative impact on your financial situation at retirement. I understand the risks involved in making a lower member contribution rate and hereby select the following member contribution rate: 4% 4.5% 5% 5.5% 6% 6.5 % 7% 1.2 Employer contribution rate (Recommended default rate = 10 %) 6% 6.5% 7% 7.5% 8% 8.5% 9% 9.5% 10% 10.5% 11% 11.5% 12% 12.5% 13% 13.5% 14% 14.5% 15% 15.5% 16% 16.5% 17% 17.5% 18% 18.5% 19% 19.5% 20% 2. Investment Options: (See Information Guide, point 16 and Annexure A) Important note: If you fail to make an investment selection, your monthly member and employer contributions will be fully invested in the Lifestage Option which is the fund s default portfolio My monthly contributions must be invested, as follows: (Please note this total must add up to 100%) Market-related Portfolios SIM Aggressive Coronation Managed NUR Balanced Portfolio Allan Gray Global Balanced SIM Moderate Sanlam Absolute Return Portfolio Smooth Bonus and Cash Portfolios Stable Bonus Monthly Bonus Sanlam Cash Total 100% A Glacier investment option is available for members whose monthly contributions to the funds are more than R Please see the Intranet for full details.

2 Lifestage Option I would like to invest my full monthly contribution into the Lifestage option. I understand that by making this decision I cannot choose any of the other investment portfolios available on the investment menu (Please mark your choice with an "X", if applicable). Lifestage option Yes No I would like to invest 100% of my net future contributions in the Lifestage Option 3. Death benefits: (See Information Guide, point 9.1) You qualify for the default assured death benefit of your age category, and you can increase or decrease it. Important: If you are younger than 55 years you can increase by 0.5 or 1 times above your default without proof of good health Any other increases are subject to proof of good health Please indicate the level of cover that you require Please indicate the level of cover that you require (multiple of PEAR) with an "X" This cover can be revised at the next revision date (1 May). B. Group Life Insurance (See Information Guide, point 9.2) My options for cover in terms of the Group Life Insurance are: (Indicate your choice, multiple of annual PEAR, with an "X") 1. On my own life 1x 2 x [Default = 2x] 2. On my spouse s life 0x 1 x Details of spouse: Full names and surname Date of marriage (dd/mm/ccyy) If you are not legally married, proof of registration of your de facto spouse is required. The registration forms are available on the fund s website at pages/default.aspx. You will be required to provide proof of good health of the insured de facto spouse at your own cost. 3. Trauma Cover (See Information Guide, point 14) My option for trauma cover is (Indicate your choice with an X ) Declaration Standard Option Comprehensive Option I hereby declare that my decision was in no way influenced by Sanlam and that I shall not hold Sanlam and the Board responsible for any eventuality, which may arise from this decision. Signed at on this day of 20 Signature of employee

3 To: HUMAN RESOURCES SSUF Forms Sanlam Office Staff Family Insurance (See Information Guide, Point 9.3) Application Form Annexure C Particulars Of Employee (Principal Member) Full names Date of birth (dd/mm/ccyy) Paycode Department/Business unit (Please mark the applicable option with an "X") I wish to become a member of this Insurance Yes No If Yes, please indicate the option you require Option 1 Option 2 Additional Parent cover Current premiums: Option 1 Option 2 Additional parent cover Basic Benefit R8.75 pm R17.50 pm - Parents and Parents-in-law R22.50 per parent per month R45.00 per parent per month R40.00 per parent per month Additional spouses R4.00 per spouse per month R8.00 per spouse per month - Additional family members (You have to be a member to add additional family members) 1. Legal Parents maximum of 4 parents - Maximum age at entry is 79 years. Particulars of parents/step parents/parents-in-law 1.1 Full names and surname Relationship (mother-in-law/mother) 1.2 Full names and surname Relationship (father-in-law/father) 1.3 Full names and surname Relationship (mother-in-law/mother) 1.4 Full names and surname Relationship (father-in-law/father)

4 2. Additional spouses Particulars of spouses 2.1 Full names and surname Relationship (Ex-spouse or 2 nd /3 rd spouse) 2.2 Full names and surname Relationship (Ex-spouse or 2 nd /3 rd spouse) 2.3 Full names and surname Relationship (Ex-spouse or 2 nd /3 rd spouse) I understand the benefits and conditions as explain in writing and confirm that there is no uncertainty in my mind. I hereby declare that my choice was not influenced by Sanlam and that I will not hold Sanlam responsible for any eventuality that may result from my choice. Signed at on this day of 20 Signature of employee Important: If the application form is not completed in full, the persons will not qualify for cover

5 Sanlam Staff Umbrella Pension and Provident Fund Nomination Form Annexure D Please send the completed form to: Fax number: (021) SSUF.enquiries@sanlam.co.za Initials Date of birth (dd/mm/ccyy) Pay number Telephone number address As member of the abovementioned Fund, I hereby revoke all my previous nominations and request the Fund, in the event of my death, to pay the amount which becomes payable by the Fund (or such portion thereof as is specified below) to the *person(s) mentioned below, subject to the provisions of the Rules of the Fund and in accordance with section 37C of the Pension Funds Act. (*Nomination of a legal person, a trust or your estate is NOT allowed.) Name of nominee Date of birth Relationship % of benefit Total allocation 100% Benefits allocated to minor beneficiaries must be paid and manage in a Beneficiary Fund Yes No for them. Motivation or other requests: (Optional) Signed at on 20 Signature of member Note: Please study Point 19 of the Information Guide prior to making your nomination. It contains a brief summary of the provisions of Section 37C of the Pension Funds Act as well as guidelines for nominating beneficiaries.

6 Sanlam Staff Group Life Insurance Nomination form for cover on your own life Annexure E Please send the completed form to: Fax number: (021) SSUF.enquiries@sanlam.co.za Initials Date of birth (dd/mm/ccyy) Pay number Telephone number address As member of the abovementioned insurance, I hereby revoke all my previous nominations and request that in the event of my death, the benefit payable (or such portion thereof as is specified below) be paid to the *person(s) mentioned below, subject to the provisions of the policy of the Insurance. I realise that in certain circumstances for the sake of equity there might not be adhere to my request. (*Nomination of a legal person, a trust or your estate is also allowed.) Name of nominee Date of birth Relationship % of benefit Total allocation 100% Benefits allocated to minor beneficiaries must be paid and manage in a Trust for them. Yes No Motivation or other requests: (Optional) Signed at on 20 Signature of member Notes: (a) Written notice should be given on a similar form if you wish to alter or supplement this nomination in any way. (b) In terms of the conditions of the policy, benefits will be paid to your dependants and/or nominees, depending on the circumstances, at your death. Dependant means your spouse, your children, someone for whom you are (or may become) lawfully responsible for maintenance, as well as someone who actually depends on you for maintenance.

7 Sanlam Staff Group Life Insurance Nomination form for cover on your spouse s life Annexure F Only complete this form if you prefer not to receive the benefit payable at your spouse s death. Please send the completed form to: Chrisna Swart (HRSS) Fax number: (021) Initials Date of birth (dd/mm/ccyy) Pay number Telephone number address As member of the abovementioned insurance, I hereby revoke all my previous nominations and request that in the event of the death of my spouse, the benefit payable (or such portion thereof as is specified below) be paid to the *person(s) mentioned below, subject to the provisions of the policy of the Insurance. I realise that in certain circumstances for the sake of equity there might not be adhere to my request. (*Nomination of a legal person, a trust or your estate is also allowed.) Name of nominee Date of birth Relationship % of benefit Total allocation 100% Benefits allocated to minor beneficiaries must be paid and manage in a Trust for them. Yes No Motivation or other requests: (Optional) Signed at on 20 Signature of member Written notice should be given on a similar form if you wish to change this nomination