Phone Legacy(07) 543 4780 at any time

Online Prepaid Funeral Fund Application Form

A Prepaid Funeral Fund allows you to set aside funds for your funeral. These funds are then held for you until they are required. Funds cannot be withdrawn in your lifetime giving you the peace of mind that they will be available when they are required.


("the Client") of

Street address, P.O. box, company name, c/o


State / Province / Region

hereby apply to settle on Legacy Prepaid Funerals Limited as Trustee the amount of $

and establish with effect from the date of acceptance by the Trustee (the “Commencement Date”) a Client Funeral Trust for the purpose of contributing towardthe payment of my funeral expenses in the event of my death (“my Fund”).

NB: Bank Account Details shown below

Return the Application Form along with a cheque made out to Legacy Prepaid Funeral Limited for the amount of your pre-payment.
Alternatively if you wish to make your payment by direct credit, please check this box on your Application Form and make your payment using the following account details:

Bank Account: Legacy Prepaid Funerals Limited
Number: 02-0466-0283399-000

Please indicate your name with the words
‘Prepaid Fund’ in the fields on the bank’s website.