Forms

Please click on one of the links below to view the relevant form.

Proposal Forms

Motor and Goods in Transit Proposal Form

Debit Order Form

Broker fee Consent Form

Claim Forms

Windscreen Claim Form

Third Party Claim Form

Goods in Transit Claim Form

Mechanical Breakdown Claim Form

Motor Accident Claim Form

Motor Theft & Hijack Claim Form

Property Loss Damage Claim Form

Spillage Clean-Up Claim Form

For further information email info@merxum.co.za or phone +27 86 100 6379