If you are a Rebosa Member and have an PPRA query that requires our intervention, kindly access and complete the form below in order for us to assist you.  To avoid delays, kindly complete all the required fields on the form and upload all relevant documentation relating to your query.  It is important to note that you must already have completed an PPRA online query and received a query reference number from the PPRA in order for us to assist.  Please quote the PPRA online query reference number in the form below.

PLEASE NOTE: Supporting documents need to be uploaded with each query. Queries without supporting documents will be considered incomplete.

    I confirm that I am a Rebosa Member*

    Your query is in respect of a Principal / Agent / Intern*

    First Name*

    Last Name*

    Name of Firm*

    Email Address*

    Office Number*

    Cellphone Number*

    PPRA Reference Number (7 digits)*

    Valid FFC?

    Date of FFC Payment*

    Your PPRA Online Query Number*

    Are you compliant with the PPRA?*

    Submitted Audit Report?*

    Your Query*


    Supporting documents

    These are mandatory documents required to be uploaded with this enquiry form. We accept .pdf, .doc, .docx, and .jpg files only.

    Application Form

    Letter of Appointment

    Certified ID


    Contact Us

    We're not around right now. But you can send us an email and we'll get back to you, asap.

    Not readable? Change text. captcha txt

    Start typing and press Enter to search

    Share This