UNI.

ASIA GENERAL INSURANCE BERHAD

(16688-K)
HEAD OFFICE: 9th Floor, Menara Uni.Asia, 1008 Jalan Sultan Ismail, 50250 Kuala Lumpur
PO BOX 6120, PUDU, 55916 KUALA LUMPUR.
TEL: 603-2619 9000 FAX: 603-2693 0111 Website: www.uniasiageneral.com.my

CONFIRMATION OF PURCHASE OF INSURANCE

JPJ Code No.
Cover Note No.
Issued Date
Transaction Type
Insured
New IC/Old IC
Address

:
:
:
:
:
:
:

30
SB06-149466
21-07-2014
RENEWAL
SARAVANAMUTHU A/L SINNATHAMBY
001460633-T
180, TAMAN INDAH JAYA JALAN SEREMBAN 71010
PORT DICKSON NEGERI SEMBILAN

Contact No.

Motor Vehicle
Class
Cover Type
Cover Period
Registration No.
Engine No.
Chassis No.
Logbook No.
Named Driver(s)
Make and Model
Year of Manufactured
Capacity
Hire Purchase

: COMMERCIAL VEHICLE ( C PERMIT

: COMPREHENSIVE COVER
: 22/07/2014 to 21/07/2015
: NBQ9236
: FD46-026249
: PNDYU41H54T055340
: A3025544
: 1) THE POLICYHOLDER ()
: NISSAN YU41H5
: 2005
: 3 TON
: NIL

JPJ Status:
Reply Message

: ACCEPTED

Agent Information:
Agent Name
Address
Telephone

Sum Insured
: RM 30000.00
Basic Premium
: 1384.30
NCD
: 25.00% (397.99)
Loading
: 15.00 % (207.65)
Excess
: 600.00
Stamp Duty/Service Tax : 10.00 / 71.64
Additional Coverage
:
NAMED PERSONS - RM 0.00

Amount Payable

: 1275.60

: RTS PRO TECH AGENCY (SBAN077)

: NO 63 TAMAN TELUK MERBAU SELANGOR DARUL EHSAN 43950 SUNGAI PELEK
SELANGOR
: 03-31412951,013-3547763

Note to Policyholder:
If "Reply Message" is "OK", you may proceed to any JPJ or Pos Malaysia branch to purchase/renew the road tax for your vehicle.
If "Reply Message" is "Pending" or "Rejected", please wait until the next working day before proceeding to any JPJ or Pos Malaysia branch
to
purchase/renew the road tax for your vehicle. If in the mean time, you would like to check on whether the status of the "Reply Message"
has been updated
to "OK", please call your agent for an update.
Note: The policy Terms and Conditions remain unchanged subject to No Claim made until expiry of period of insurance.
Note: You should receive the Company's policy within 30 days from inception of risk. If not, please refer to the Company's head office or
the nearest branch office.
Nota: Anda patut menerima polisi syarikat dalam tempoh 30 hari dari tarikh permulaan tempoh risiko. Jika anda tidak menerima polisi,
anda patut merujuk kepada ibu pejabat syarikat atau mana-mana cawangan syarikat yang berdekatan.

This is computer generated document and no signature is required.

UNI.ASIA GENERAL INSURANCE BERHAD

(16688-K)
HEAD OFFICE: 9th Floor, Menara Uni.Asia, 1008 Jalan Sultan Ismail, 50250 Kuala Lumpur
PO BOX 6120, PUDU, 55916 KUALA LUMPUR.
TEL: 603-2619 9000 FAX: 603-2693 0111 Website: www.uniasiageneral.com.my

CONFIRMATION OF PURCHASE OF INSURANCE

JPJ Code No.
Cover Note No.
Issued Date
Transaction Type
Insured
New IC/Old IC
Address

:
:
:
:
:
:
:

30
SB06-149467
21-07-2014
NEW INSURANCE (REGISTERED)
A FIVE ATAR SMARTT METAL TRADING
SA0083099-U
LOT PT 38181, JALAN MASYHUR 25/50. TAMAN SRI MUDA 42400
SHAH ALAM SELANGOR

Contact No.

Motor Vehicle
Class
Cover Type
Cover Period
Registration No.
Engine No.
Chassis No.
Logbook No.
Named Driver(s)
Make and Model
Year of Manufactured
Capacity
Hire Purchase

: COMMERCIAL VEHICLE ( C PERMIT )

: Comprehensive
: 21/07/2014 to 20/07/2015
: BKV5603
: 14B1860240
: JDA00V11600A17062
: NA
: NA
: DAIHATSU - DAIHATSU DELTA V116-HA
: 2010
: 3 TON
: NIL

JPJ Status:
Reply Message

: ACCEPTED

Agent Information:
Agent Name
Address
Telephone

Sum Insured
Basic Premium
NCD
Loading
Excess
Stamp Duty/Service Tax
Additional Coverage
NA

: RM 75000.00
: 2846.80
: 25.00% (782.87)
: 10.00 % (284.68)
: 1500.00
: 10.00 / 140.92
:

Amount Payable

: 2499.53

: RTS PRO TECH AGENCY (SBAN077)

: NO 63 TAMAN TELUK MERBAU SELANGOR DARUL EHSAN 43950 SUNGAI PELEK
SELANGOR
: 03-31412951,013-3547763

Note to Policyholder:
If "Reply Message" is "OK", you may proceed to any JPJ or Pos Malaysia branch to purchase/renew the road tax for your vehicle.
If "Reply Message" is "Pending" or "Rejected", please wait until the next working day before proceeding to any JPJ or Pos Malaysia branch to
purchase/renew the road tax for your vehicle. If in the mean time, you would like to check on whether the status of the "Reply Message" has
been updated
to "OK", please call your agent for an update.
Note: The policy Terms and Conditions remain unchanged subject to No Claim made until expiry of period of insurance.
Note: You should receive the Company's policy within 30 days from inception of risk. If not, please refer to the Company's head office or the
nearest branch office.
Nota: Anda patut menerima polisi syarikat dalam tempoh 30 hari dari tarikh permulaan tempoh risiko. Jika anda tidak menerima polisi, anda
patut merujuk kepada ibu pejabat syarikat atau mana-mana cawangan syarikat yang berdekatan.

This is computer generated document and no signature is required.

UNI.ASIA GENERAL INSURANCE BERHAD

(16688-K)
HEAD OFFICE: 9th Floor, Menara Uni.Asia, 1008 Jalan Sultan Ismail, 50250 Kuala Lumpur
PO BOX 6120, PUDU, 55916 KUALA LUMPUR.
TEL: 603-2619 9000 FAX: 603-2693 0111 Website: www.uniasiageneral.com.my

CONFIRMATION OF PURCHASE OF INSURANCE

JPJ Code No.
Cover Note No.
Issued Date
Transaction Type
Insured
New IC/Old IC
Address

:
:
:
:
:
:
:

30
SB06-149468
21-07-2014
NEW INSURANCE (REGISTERED)
YOGISVARY A/P VERAMUTHU
800407-05-5528
35, TAMAN KSM sungai pelek SUNGAI PELEK 43950
SUNGAI PELEK SELANGOR

Contact No.

Motor Vehicle
Class
Cover Type
Cover Period
Registration No.
Engine No.
Chassis No.
Logbook No.
Named Driver(s)
Make and Model
Year of Manufactured
Capacity
Hire Purchase

: PRIVATE CAR FOR INDIV

: Comprehensive
: 21/07/2014 to 20/07/2015
: WUC2556
: G96A11C
: PM2M502G002029445
: 9740882
: NA
: PERODUA - PERODUA ALZA 1.5 EZI AUTO
: 2010
: 1495 CC
: NIL

JPJ Status:
Reply Message

: ACCEPTED

Agent Information:
Agent Name
Address
Telephone

Sum Insured
Basic Premium
NCD
Loading
Excess
Stamp Duty/Service Tax
Additional Coverage
NA

: RM 45000.00
: 1436.00
: 45.00% (646.20)
: 0.00 % (0.00)
: 0.00
: 10.00 / 0.00
:

Amount Payable

: 799.80

: RTS PRO TECH AGENCY (SBAN077)

: NO 63 TAMAN TELUK MERBAU SELANGOR DARUL EHSAN 43950 SUNGAI PELEK
SELANGOR
: 03-31412951,013-3547763

Note to Policyholder:
If "Reply Message" is "OK", you may proceed to any JPJ or Pos Malaysia branch to purchase/renew the road tax for your vehicle.
If "Reply Message" is "Pending" or "Rejected", please wait until the next working day before proceeding to any JPJ or Pos Malaysia branch to
purchase/renew the road tax for your vehicle. If in the mean time, you would like to check on whether the status of the "Reply Message" has
been updated
to "OK", please call your agent for an update.
Note: The policy Terms and Conditions remain unchanged subject to No Claim made until expiry of period of insurance.
Note: You should receive the Company's policy within 30 days from inception of risk. If not, please refer to the Company's head office or the
nearest branch office.
Nota: Anda patut menerima polisi syarikat dalam tempoh 30 hari dari tarikh permulaan tempoh risiko. Jika anda tidak menerima polisi, anda
patut merujuk kepada ibu pejabat syarikat atau mana-mana cawangan syarikat yang berdekatan.

This is computer generated document and no signature is required.

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CONFIRMATION OF PURCHASE OF INSURANCE

JPJ Code No.
Cover Note No.
Issued Date
Transaction Type
Insured
New IC/Old IC
Address
Contact No.

:
:
:
:
:
:
:
:

30
SB06-149469
22-07-2014
RENEWAL
NADARAJA A/L NAGAPAN
740101-10-6511
10, JALAN 8 TAMAN SRI SUNGAI PELEK 43950
SUNGAI PELEK SELANGOR

Motor Vehicle
Class
Cover Type
Cover Period
Registration No.
Engine No.
Chassis No.
Logbook No.
Named Driver(s)

: PRIVATE CAR FOR INDIV

: COMPREHENSIVE COVER
: 22/07/2014 to 21/07/2015
: BJV3893
: 4G13PNW6428
: PL1C21LNR8B244048
: 6015893
: 1) THE POLICYHOLDER (740101-106511)
: PROTON ISWARA 1.3S A/B LMST
NPS

Make and Model

Year of
Manufactured
Capacity
Hire Purchase

Sum Insured
: RM 12000.00
Basic Premium
: 547.65
NCD
: 25.00% (136.91)
Loading
: 0.00 % (0.00)
Excess
: 0.00
Stamp Duty/Service Tax
: 10.00 / 0.00
Additional Coverage
:
NAMED PERSONS - RM 0.00
COMPENSATION FOR ASSESSED REPAIR TIME
- RM 0.00

: 2008
: 1298 CC
: AM BANK BERHAD

JPJ Status:
Reply Message

Amount Payable

: 420.74

: ACCEPTED

Agent Information:
Agent Name
: RTS PRO TECH AGENCY (SBAN077)
: NO 63 TAMAN TELUK MERBAU SELANGOR DARUL EHSAN 43950 SUNGAI PELEK
Address
SELANGOR
Telephone
: 03-31412951,013-3547763
Note to Policyholder:
If "Reply Message" is "OK", you may proceed to any JPJ or Pos Malaysia branch to purchase/renew the road tax for your vehicle.
If "Reply Message" is "Pending" or "Rejected", please wait until the next working day before proceeding to any JPJ or Pos Malaysia branch
to
purchase/renew the road tax for your vehicle. If in the mean time, you would like to check on whether the status of the "Reply Message"
has been updated
to "OK", please call your agent for an update.
Note: The policy Terms and Conditions remain unchanged subject to No Claim made until expiry of period of insurance.
Note: You should receive the Company's policy within 30 days from inception of risk. If not, please refer to the Company's head office or
the nearest branch office.
Nota: Anda patut menerima polisi syarikat dalam tempoh 30 hari dari tarikh permulaan tempoh risiko. Jika anda tidak menerima polisi,
anda patut merujuk kepada ibu pejabat syarikat atau mana-mana cawangan syarikat yang berdekatan.

This is computer generated document and no signature is required.

UNI.ASIA GENERAL INSURANCE BERHAD (16688-K)
HEAD OFFICE: 9th Floor, Menara Uni.Asia, 1008 Jalan Sultan Ismail, 50250 Kuala Lumpur
PO BOX 6120, PUDU, 55916 KUALA LUMPUR.
TEL: 603-2619 9000 FAX: 603-2693 0111 Website: www.uniasiageneral.com.my

CONFIRMATION OF PURCHASE OF INSURANCE

JPJ Code No.
Cover Note No.
Issued Date
Transaction Type
Insured
New IC/Old IC
Address
Contact No.
Motor Vehicle

:
:
:
:
:
:
:
:

30
SB06-149470
22-07-2014
NEW INSURANCE (REGISTERED)
THANASEKARAN A/L RAMASAMY
890528-01-5719
7, JALAN 26, TAMAN KOTA PALOH KLUANG 86600
PALOH JOHOR

Class
Cover Type
Cover Period
Registration No.
Engine No.
Chassis No.
Logbook No.
Named Driver(s)
Make and Model
Year of
Manufactured
Capacity
Hire Purchase
JPJ Status:
Reply Message

: PRIVATE CAR FOR INDIV

: Comprehensive
: 25/07/2014 to 24/07/2015
: WYN2322
: T21A97R
: PM2M602S002118426
: 5201343
: 1) THANASEKARAN A/L RAMASAMY
(890528-01-5719)
2) RAMASAMY A/L PERIASAMY ()
: PERODUA - PERODUA MYVI 1.3 EZ
(AUTO)

Sum Insured
: RM 40000.00
Basic Premium
: 1275.65
NCD
: 25.00% (318.91)
Loading
: 0.00 % (0.00)
Excess
: 0.00
Stamp Duty/Service Tax
: 10.00 / 0.00
Additional Coverage
:
NAMED PERSONS - RM 0.00
BREAKAGE OF GLASS IN WINDSCREEN OR
WINDOW (RM 600.00) - RM 90.00

: 2013
: 1298 CC
: NIL

Amount Payable

: 1056.74

: ACCEPTED

Agent Information:
Agent Name
: RTS PRO TECH AGENCY (SBAN077)
: NO 63 TAMAN TELUK MERBAU SELANGOR DARUL EHSAN 43950 SUNGAI PELEK
Address
SELANGOR
Telephone
: 03-31412951,013-3547763
Note to Policyholder:
If "Reply Message" is "OK", you may proceed to any JPJ or Pos Malaysia branch to purchase/renew the road tax for your vehicle.
If "Reply Message" is "Pending" or "Rejected", please wait until the next working day before proceeding to any JPJ or Pos Malaysia branch to
purchase/renew the road tax for your vehicle. If in the mean time, you would like to check on whether the status of the "Reply Message" has
been updated
to "OK", please call your agent for an update.
Note: The policy Terms and Conditions remain unchanged subject to No Claim made until expiry of period of insurance.
Note: You should receive the Company's policy within 30 days from inception of risk. If not, please refer to the Company's head office or the
nearest branch office.
Nota: Anda patut menerima polisi syarikat dalam tempoh 30 hari dari tarikh permulaan tempoh risiko. Jika anda tidak menerima polisi, anda
patut merujuk kepada ibu pejabat syarikat atau mana-mana cawangan syarikat yang berdekatan.

This is computer generated document and no signature is required.