SCHEDULE / JADUAL MX1

CLASS OF CERTIFICATE : PRIVATE CAR COVER TYPE : MOTOR-COMPREHENSIVE

JENIS SIJIL JENIS PERLINDUNGAN
CERTIFICATE NO. : VPP-V1448423-09-DIR-18 AGENCY CODE : 09-104-0070201A
NOMBOR SIJIL KOD AGENSI
PARTICIPANT NAME : NORAIN BINTI MOHD NASIR NRIC : 801223-05-5042
NAMA PESERTA
ADDRESS : 202 BLOK F9 COMPANY REG. NO. :
ALAMAT SEKSYEN 1 NO. PENDAFTARAN
WANGSA MAJU SYARIKAT
SETAPAK
53300 W.P. KUALA LUMPUR
REPLACING CERT.NO. : REFERENCE NO. :
NOMBOR SIJIL ASAL NOMBOR RUJUKAN
BUSINESS / OCCUPATION :
PERNIAGAAN /
KEGUNAAN

ISSUED & SIGNED AT : IFiC JALAN TUN RAZAK

DIKELUARKAN DAN
DITANDATANGANI DI
PERIOD OF TAKAFUL (BOTH DATE INCLUSIVE) DATE OF SIGNATURE OF
TEMPOH PERLINDUNGAN (TERMASUK KEDUA-DUA TARIKH) PROPOSAL & DECLARATION
FORM
TARIKH TANDATANGAN BORANG
CADANGAN & AKUAN
a.) FROM : 24/08/2018 TO : 23/08/2019 24/08/2018
MULA TAMAT
b.) ANY SUBSEQUENT PERIOD FOR WHICH THE PARTICIPANT SHALL PAY AND THE COMPANY SHALL AGREE TO ACCEPT A RENEWAL
CONTRIBUTION
MANA-MANA TEMPOH SELANJUTNYA DI MANA PESERTA MEMBAYAR DAN SYARIKAT BERSETUJU MENERIMA SUMBANGAN
PEMBAHARUAN

DETAILS OF VEHICLE THE CERTIFICATE'S CONTRIBUTION (RM)

BUTIR KENDERAAN SUMBANGAN SIJIL (RM)
REGISTRATION NO. VAN1726 BASIC CONTRIBUTION 1,871.02
NO. PENDAFTARAN SUMBANGAN ASAS
MAKE & MODEL TOYOTA VIOS 1.5E (A)
BUATAN & MODEL
CUBIC CAPACITY 1,496
KEUPAYAAN PADU

TONNAGE / KG
TON / KG
SEATING CAPACITY INCLUDING 5
DRIVER
RUANG DUDUK TERMASUK
PEMANDU
YEAR OF MANUFACTURE 2017 NCD ENTITLEMENT 25.00 % 467.76
TAHUN DI BUAT KELAYAKAN NCD

ADDITIONAL COVERAGE
PERLINDUNGAN TAMBAHAN
ENGINE NO. 2NR0N18181 BREAKAGE OF GLASS IN W/SCREEN 1,000.00 150.00
NO. ENJIN

CHASSIS NO. PN153SYF103019433

NO. CASIS
SUM COVERED RM 65,000
JUMLAH PERLINDUNGAN
EXCESS / AKSES RM 0.00 SUB TOTAL / JUMLAH KECIL 1,553.26

REBATE / REBAT 155.32

USE OF VEHICLE PRIVATE CAR-PRIVATE USE GST / CUKAI BARANG dan PERKHIDMATAN 0.00%
KEGUNAAN KENDERAAN
STAMP DUTY / DUTI SETEM 10.00
REPLACING COVER NOTE NO. TOTAL AMOUNT PAYABLE / JUMLAH 1,407.94
NO. PENGGANTIAN / PEMBAYARAN
PEMBATALAN NOTA LINDUNG
PREVIOUS CERTIFICATE NO. ACT CONTRIBUTION 91.13
NO. SIJIL TERDAHULU SUMBANGAN AKTA

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HIRE PURCHASE/LEASING COMPANY/EMPLOYER : TC CAPITAL RESOURCES SDN BHD
SEWA BELI/SYARIKAT MENYEWA/MAJIKAN
NAMED DRIVERS : THE POLICYHOLDER
PEMANDU YANG DINAMAKAN MEOR MUHAMMAD FUAD MEOR YAHYA

SUBJECT TO FOLLOWING OPERATIVE ENDORSEMENTS ATTACHED : C089, C113

TERTAKLUK KEPADA ENDOSMEN-ENDOSMEN BERIKUT YANG DISERTAKAN

PERSONS OR CLASSES OF PERSONS ENTITLED TO DRIVE AND LIMITATIONS AS TO USE AS SPECIFIED IN THE CERTIFICATE OF TAKAFUL
ISSUED IN RELATION TO THIS SCHEDULE.
MANA-MANA ORANG YANG DIBENARKAN MEMANDU DAN HAD ATAS KEGUNAAN ADALAH TERMAKTUB DALAM SIJIL TAKAFUL YANG
DIKELUARKAN SEHUBUNGAN DENGAN JADUAL INI.

SUBJECT TO THE FOLLOWING WARRANTIES/CLAUSES/ENDORSEMENTS AS PRINTED HEREIN OR ATTACHED HERETO:

TERTAKLUK KEPADA WARANTI/KLAUSA/ENDOSMEN YANG DICETAK ATAU DILAMPIRKAN SEPERTI BERIKUT :

C089 COVER FOR WINDSCREENS, WINDOWS AND SUNROOF

C113 REFERENCE TO MOTOR VEHICLE MARKET VALUATION SYSTEM

IN WITNESS WHEREOF THIS CERTIFICATE HAS BEEN SIGNED ON BEHALF AND WITH THE AUTHORITY OF THE COMPANY.
BAHAWASANYA SIJIL INI TELAH DITANDATANGANI DENGAN KEBENARAN DAN BAGI PIHAK SYARIKAT.

DATE : 24/08/2018
TARIKH
SIGNED AT : IFiC JALAN TUN RAZAK
LOKASI

SYARIKAT TAKAFUL MALAYSIA AM BERHAD (1246486-D)

AUTHORISED SIGNATORY
PENANDATANGAN YANG SAH

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