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TAKAFUL IKHLAS SDN BHD(593075 U)
IKHLAS Point, Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur.
tel: 03-2723 9999 fax: 03-2723 9998 website: www.takaful-ikhlas.com.my
(A subsidiary of Malaysian National Reinsurance Berhad)
CERTIFICATE OF TAKAFUL
JPJA1MX1
Road Transport Act, 1987 ( Malaysia )
Motor Vehicles (Third Party Risks) Rules, 1959 (Malaysia)
Motor Vehicles (Third Party Risks & Compensation) Act (Cap 189) Republic of Singapore
Motor Vehicles (Third Party Risks& Compensation) Rules 1960 (Republic of Singapore)
Motor Vehicles Insurance ( Third Party Risks) Act (Cap 90) Negara Brunei Darulsalam
Certificate No.:ML1000892
1.Index Mark and Vehicle Registration No. PDJ5951
2.Name of Participant MUKHLIS BIN MAT ISA @ YAHYA
3.I/C No. 810120-06-5365
4.Effective date of Commencement of Takaful for the purposes of the Ordinance 07/10/2011
5.Date of Expiry of Takaful 06/10/2012
6. Persons or Classes of Person Entitled to Drive. *
(a) The Participant
(b) Any other person who is driving on the Participant's order or with his permission.
Provided that the person driving is permitted in accordance with the licensing or other laws or regulations to drive the Motor Vehicle or has been so permitted
and is not disqualified by order of a Court of Law or by reason of any enactment or regulation in that behalf from driving the Motor Vehicle.
7. Limitation as to Use. *
Use only for social, domestic and pleasure purposes and for the Policyholder's business.
The Policy does not cover use for hire or reward, racing, pacemaking, reliability trial speed-testing,the carriage of goods other than samples in connection with
any trade or business.
*Limitation rendered inoperative by Section 95 of the Road Transport Act 1987 (Malaysia) or Section 8 of the Motor Vehicles (Third Party Risks and
Commpensation) Act (Cap 189) Republic of Singapore or Section 7 of the Motor Vehicles Insurance (Third Party Risks) Act (Cap 90) Negara Brunei
Darussalam are not included under this heading.
I/WE CERTIFY THAT THIS COVERING NOTE IS ISSUED IN ACCORDANCE WITH THE PROVISIONS OF PART IV OF THE ROAD TRANSPORT ACT,
1987 (MALAYSIA), MOTOR VEHICLES (THIRD PARTY RISKS & COMPENSATION) ACT (CAP 189) REPUBLIC OF SINGAPORE AND THE MOTOR
VEHICLES INSURANCE (THIRD PARTY RISKS) ACT (CAP 90) NEGARA BRUNEI DARUSSALAM
-----------------------------------------------------------
Salinan Asal Telah Ditandatangani
(Original Duly Sign)
TAKAFUL IKHLAS SDN BHD(593075 U)
IKHLAS Point, Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur.
tel:03-2723 9999fax:03-2723 9998website:www.takaful-ikhlas.com.my
(A subsidiary of MNRB Holdings Berhad)
STAMP DUTY PAID
THE SCHEDULE MX1
Peserta :
The Participant :
MUKHLIS BIN MAT ISA @
YAHYA
NRIC :
NRIC :
810120-06-5365
Alamat :
Address :
61, TAMAN PERMAI,
09300 KUALA KETIL,
KEDAH
No Pendaftaran Perniagaan :
Business Registration No :
Perkerjaan atau berniaga :
Profession or Business :
GOVERNMENT SERVANT
Jenis Sijil :
Class of Certificate :
PRIVATE CAR Pada :
On :
27-09-2011
Dikeluarkan & ditandatangani di :
Issued & signed at :
Kod Agensi :
Agency Code :
GI00026
Rujukan Sijil :
Certificate Ref. No. :
ML1000892
Tempoh Takaful :
Period of Takaful :
Tarikh tandatangan
Pengakuan &
borang :
a) Mula
From
07/10/2011 Tamat
To
06/10/2012 Date of signature of
Proposal & declaration :
(Termasuk kedua-dua tarikh ) (both dates inclusive )
b)Mana-mana tempoh selanjutnya Peserta membayar dan Syarikat bersetuju menerima sumbangan pembaharuan.
Any subsequent period for which the participant shall pay and the Companyshall agree to accept a renewal contribution.
BUTIR KENDERAAN
THE MOTOR VEHICLE
SUMBANGAN SIJIL (RM)
THE CERTIFICATE'S CONTRIBUTION (RM)
No. Pendaftaran :
Registration No :
PDJ5951 Sumbangan Asas :
Basic Contribution :
667.90
Buatan & Model :
Make & Type of body :
318I(A) Tambahan :
Loading :
0.00
Keupayaan Padu :
Cubic Capacity :
1796CC Kelayakan NCD (55.00) :
NCD (55.00) :
367.35
Ruang duduk termasuk pemandu :
Seating capacity including driver :
5 Perlindungan Tambahan :
Extra-Benefits :
Tahun di buat :
Year of Manufacture :
1996 NIL
No. Enjin :
Engine No :
8082M659 Jumlah Kecil :
Sub-Total :
300.55
No. Casis :
Chassis No :
AC80825 Rebate :
Rebate :
30.06
Jumlah Perlindungan :
Sum Covered :
16,000.00 Cukai Kerajaan :
Govt. Tax :
0.00
Ekses :
Excess :
160.00 Cukai setem :
Stamp Duty :
10.00
No. Pembaharuan Sijil :
Renewal of Certificate No :
NIL Jumlah Pembayaran :
Total Payable :
280.49
Sumbangan Akta :
Act Contribution :
34.42
Sewa beli / Syarikat menyewa / Majikan :
Hire Purchase/Leasing Company/Employer :
MAYBAN FINANCE BERHAD
Nama Pemandu :
Named Drivers :
NIL
Tertakluk kepada endorsemen-endorsemen berikutnya :
Subject to the following operative endorsements attached :
M02 - EXCESS DAMAGE CLAIM
M2(f) - COMPULSORY EXCESS
M30 - REPLACEMENT PARTS
M106 - INSURER'S AUTHORISED WORKSHOP
Mana-mana orang yang dibenarkan memandu dan had atas kegunaan adalah termaktub dalam Sijil
Takaful yang dikeluarkan sehubungan dengan Sijil ini.
Person or classes of persons entitled to Drive and limitations as to use, are as Specified in the
Certificate of Takaful Issued in relation to this Certificate
_______________________________
Salinan Asal Telah Ditandatangani
(Original Duly Sign)

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TAKAFUL IKHLAS SDN BHD(593075 U)

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