Content
AGENCY AGREEMENT
between
Universal Healthcare Services (Pty) Ltd
(Reg. No: 2008/005871/07)
(hereafter referred to as Universal)
and
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Reg. Number / Identity Number: ____________________________________
1
For office use only
Date processed by Universal Healthcare Services: ............................................................................................
Agent’s Details:
Date:
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Agency name:
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Agent name and surname:
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FSB / BR number (if applicable):
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