Step 1: Personal Details:

Initials*

Name*

Surname*

Email*

ID Number

Contact Number*

Step 2: Product Choice:

Please tick all the products that you require:


 Solar & Heat Pump Cover

From R8,50 per R1 000 of cover


 Home Owners Excess

From R20 per month


 Contents

From R20 per month


 All Risk

From R20 per month


 Spare Wheel

From R40 per month


 Vehicle Hire

From R40 per month


 Bicycle Theft Cover

From R13 per month


 GeyserSure

From R30 per month


 Geyser Replacement

From R55 per month


 Credit Shortfall

From R50 per month


 Deposit Protector

From R100 per month


 3 in 1

R155 per month

Step 3: Vehicle Details:

Make*

Model*

Year*

Disclaimer

For Commercial Policies, please contact X’S Sure directly on 086 001 4180. 30 day waiting period applies to all products.