Loan Phone Agreement Form Loan Phone Agreement Form First Name Last Name Claim # Make of Device Apple Samsung Huawei Other Loan Phone Agreement(Required)Please read through the Loan Phone Agreement, and fill in the following fields. A copy of this agreement will be emailed to you. I have read and understood the agreementDo you want insurance on the loan device?(Required)Please note, as referred to in the loan device agreement, a one time fee of R150 will be applicable for insurance on the loan device. Yes No Do you need the loan device before your device is collected for repair / assessment, or can it be sent once we have your device?(Required) Yes, please send it before collection. No, I can wait for the loan device.