EXCESS PAYMENT FORM
Step 1
Please choose your preferred payment method
PAYMENT METHOD
1: Online Credit/Debit Card payment
2: EFT
3: Cash Deposit
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Next
Step 2
Enter your address/shipment details and a few personal contact details
Claim Number (provided on your Insrap EXCESS Invoice)
*
Company Name
*
ADDRESS DETAILS
Type of Address
SELECT
Business Premises
Office Park
Private House
Gated Suburb
Farm/Plot
Resort/Game Reserve
Hotel
Embassy/Consulate
Shopping Center
Chain Store
University
Mine
Government Building
Power Station
Trust Area
Township
Town
Suburb
Postal Code
Building Name
Street Address
*
CONTACT DETAILS
Full Name
*
Cell Number
*
Work Number
Email Address
*
example@example.com
Special Instructions:
Anything else you'd like to add?
SUBMIT AND MAKE PAYMENT
Should be Empty: