UIF Simplicity Unemployment Benefit Registration Form First Name Last Name Maiden Name (If Applicable) Address City Postal Code Country Identity Number Current Occupation Email Home Number Work Number Mobile Number First Name Last Name Email Address Contact Number Relation to you Employer 1 Start Date End Date Employer 2 Start Date End Date Employer 3 Start Date End Date Employer 4 Start Date End Date Employer 5 Start Date End Date Have you claimed from the UIF before? If so, in which year and what kind of UIF claim was it? How long have you been contributing to the UIF? What is your current monthly gross salary before deductions? How did you come to hear about us? Through a friend Google Bing Facebook Instagram Hospital UIF Simplicity agent Bernice van der Berg Other If you selected other, please specify. Send
