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  • E-Policy Submission Sheet (Motor) : Allianz General Insurance Company (Malaysia) Berhad (735426-V)

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    Syahir Ahmad
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    Allianz General Insurance Company submitted an e-policy for a motor insurance policy on March 20, 2013. The submission included an insured named Juhairiah Binti Ja'i with a vehicle number of BHM9881. The total premium was 1,169.61 Malaysian Ringgit and the amount payable after discounts was 1,053.65 Malaysian Ringgit, which was paid via cheque number 456772.

    Original Description:

    submission batch

    Original Title

    SubmissionBatch_1363752765130

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    Allianz General Insurance Company submitted an e-policy for a motor insurance policy on March 20, 2013. The submission included an insured named Juhairiah Binti Ja'i with a vehicle number of BHM9881. The total premium was 1,169.61 Malaysian Ringgit and the amount payable after discounts was 1,053.65 Malaysian Ringgit, which was paid via cheque number 456772.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    57 views1 page

    E-Policy Submission Sheet (Motor) : Allianz General Insurance Company (Malaysia) Berhad (735426-V)

    Uploaded by

    Syahir Ahmad
    Allianz General Insurance Company submitted an e-policy for a motor insurance policy on March 20, 2013. The submission included an insured named Juhairiah Binti Ja'i with a vehicle number of BHM9881. The total premium was 1,169.61 Malaysian Ringgit and the amount payable after discounts was 1,053.65 Malaysian Ringgit, which was paid via cheque number 456772.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    Allianz General Insurance Company (Malaysia) Berhad (735426-V)

    e-Policy Submission Sheet (Motor)


    Agent Name
    Submitted Date
    Submitted By
    Batch No. MT13KL008663
    KL15347 KL15347-01
    HASDILLAH MARKETING
    20-03-2013 12:12:44 PM
    Account No.
    Printed Date 20-03-2013 12:12:45 PM
    C/N
    Type
    Net Prem Date of Issue
    Total
    Payable
    C/Note No. Insured Name S/Duty Comm. NCD% Vehicle No. Gross S/Tax Pay By
    1159.61 25.00 115.96 10.00 1053.65 0.00 AEKL0149197 JUHAIRIAH BINTI JA'I 1169.60 15-03-2013 NWOO BHM9881 N
    1,159.61 1,169.61 115.96 10.00 1,053.65 0.00 Grand Total
    Cheque No. / Card No. Payment Mode No. Amount (RM)
    1.
    1,053.65 Cheque 456772
    1,053.65 Total Amount Received (RM)
    Agent's Stamp & Signature
    * Credit Card, Signatory must be Cardmember and signature as per Card Account.
    Page 1

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