Proposer (Settlor) Information

Assets to be held in trust

Select all assets that apply and enter the value for each. use the add asset button to add more.

Policy Details

Asset Type Source of Asset Current Asset Value(KES)

Total Value

Purpose of Trust

The trust will cater for the following beneficial needs:

Other, please add details below: -

Beneficiary Information

Guardian Details

Individual Proposer (Settlor)

Upload ID front / Passport
Upload ID Back / Passport
Upload your KRA PIN certificate

Added Guardians

Surname Other Name Phone number

Beneficiary Information

Please provide details of any special instructions for management of this trust below

Please provide details of any special instructions for management of this trust below

I, the person by whom the assurance is to be effected declare that the foregoing answers are true and complete. The statements made in this application and in any other documentation submitted in connection with this application form the basis of the policy applied for and shall constitute all representations made as a basis of the said policy.

I have read and accept ICEA LION's Conditions and Provisions

Application Successful

You have successfully submitted your application

We have received your application. We have sent a notification that includes your policy number to your email address xxxxx@xxx.xxx

We are now processing your account and we will send you a notification within 48 hours when your account setup is complete.

You can now login to our self service portal . Your login details have been sent to your email.

You can manage your ICEA LION Products from the self service portal.

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