To Whom It May Concern
APPOINTMENT AS INSURANCE BROKER
hereby appoint Ample Insurance Brokers as my Insurance Broker to deal with my insurance and/or investment portfolio.
This letter of appointment shall also serve as my authority to insurance companies to furnish
Ample Insurance Brokers with any information relating to my policies that might be required.
Ample Insurance Brokers acknowledges that in the course of rendering services in terms of this appointment
letter that they shall come into possession of information of a confidential nature. The broker shall not,
whether during the course of this agreement or at any time thereafter use or disclose or allow third parties to
use or disclose any of the confidential information except to the extent permitted by the client and /or if it is in
the best interest of the public.