41812019 TN: “@. TakaFuL coim Forn a eee 7 SE SE ofr [ober | a lessen Seema Hise? Dcrmsigr ia Regt i yas twas | wgveSi nos mis ma ea a Soa c evStrafanancecan [S087 Seeks [ERA ci seca] [ome tac SS oro wee weairasies | ee [ye.S0. [eer ane a 3 ae Seingay ame? [exsursccxonen ac raw hie eye he Raerermarencermyeeee ——acaca etapa cae re pateearerecen nee ° [eeetezes! _| Sa ars mat Toon ne = ees [ome coats a | Deasngt [mou aan Alara Eat [ymcon78iRyrail som - Germracnes ase! o> 20.AN 5507. HESGRANDS SEASYENGS, SrtA, Sige Dan ean, Naeyea eo sao : . eset oa laggy nome eam me Sane ee a fscacenat [romnroin arent om [1 tury Owe Passenner /Recedetan rezacs Pasumaan Senin ~ were o sere E> se mney meran ons a en aca me mm ny [rics pene ter Toast te ro rename T see have stoves cng wd nor Dak arin) ave pn) tanberten martes yar Sat bra tg nye etn total Sods hay wee seh Pon Soy Bk soubor mac sopahan ncays uates oven pany a | ol marca ocalon ilar sehogm permit imjzham sac an eayeharn MOTION tee gorgeous i me oi petaaraypend Con stans honoe ak Spat seaman yg oma ak Synth age han piel Peis Ofc Sol ple! ‘Statham ater rey ded a> abst yr awe. shove sales we eat dv al yoga ay fla Zenars 6 apa is Gn RE om wax conlaa Saran on ob le Tey anche Ua al Sitar ponded ya Wer bende esters poee el fea Gey mesmo ss sss He | Secor we shal sets ints Company end ay che Fase een Compa soon iB radi ev para peeve wont Saya state mega the Panta oy 4 hitpsyfwwvemerimen.com. my/taime/inde. iy huzebox=M Rinsurerdfussecton-gen_printelnformérolayoutsicaztid-255 19096 CFID=967963696... ae42019 Insurer Offer Lete70V DISCHARGE VOUCHER / BAUCER PERLEPASAN Claim Ne :ven476e, No. Tontuten Gertficate Not :1a39858 Nosrtoor Sift Deto 2 10-Apr-2019 Tarik We hereby acknowledge that all approved repalrsireplacement {0 be carried out on my/our vehicle/windssreen beanng Registration No. BHY8217 ss completed, \lenvWe are satisfied with tne repair ob/replacement carried out and acknowledge the ensts ta ba bome by Syatikat Takaful Malaysia Am Berhad (‘STMAB") to Chiong Brothers Motor Works Sdn hd amountng RM1,080.22 (Ringgit Rlalaysia ONE ‘THOUSAND NINE HUNDRED AND FIFTY AND CENTS EIGHTY TWO ONLY). Ive hereby ful releagelaischarge STAB from any further obligations, dims, presentand future, arising drecty or natecty from the accident on 27/03/2019. " bits pe $ Wie agreed that in consideration of ine above paymert, all the damaged parts sha be the property of STMAB. {ive hereby dectare that STMAB shall have cuthonty to use our rame to the extent necessary effectively to exercise all or such Tights and remedies and we shall fumish them with ary assistance they may reasonably require of uo when exercising Such rights and remedies: whist on their port, they wil indemnify us against labity for eesis, charges and expenses arising connection with proceeding which they may take in aur name in the exercise of such rights and remedies, ‘Saya/Kami dengan ini memperakukan hahawa pembalkandpenggentian yang telah dilatesksn kepada kendorean / cermin Fanderaan sayakerrs, Nombor Pandotteron BHY8217 talch soloces soperuinny ‘Seya/Kami sesungqunnye berouashati di atas pembaken/eenggantian tersebut dengan mengambil kirs kos pembayarcan yong akon diovet oloh Srarikat Takastul Malaysia Am Berhad ("STMAB") kepada Chiang Brouhers Motor Works Sdn Bhd SRRaiGh Pat 800.82 (nage Malaysia SERIBU SEMBILAN RATUS DAN Lina ‘PULUM DAN SEN TAPAN PULUH DUA Dengan ini, sayalkami metepaskan sopenuhnys STMAB daripada apa-apa tenggungen, ‘untutan, semaca atau pada mesa ‘hadepan yang berkartan secora langsung atau tidak langsung oi oles Komalangan pata 27/03/2019, Saya/Kemi bersetuju bahawa dengan pembayaran tersebul, maka STMAB adalah penggant! hak kepada semue nek dan ‘manteat terhadap alatalat yang 080k. Saya/Kemi juga ingin menyatekan banava STMAB mempunyai kuasa untuk menogunakan nama sayalkami ke tahap yang etl Secara efekit untuk melaksanakan semua atau sebshagian hak dan romed. SoyaKorni akan momborikan moreka ‘Seberang bantuan Yang mungkin morok pertukan apabila meleksenakan hek dan remedi sedemikian- manekala di pihah hair, ‘mereka akon menanggung karni daripada sebareng abil beg! kos, caj dan perbetanyan yang iimbul berkatan dengan proses ‘ondtemg-undeng yang mungkin mereka Gi atas nama sayakkami dalam melaksenakan hak dan remed) sademikian, Dated Tarik Day ottanbutsn_5 YoauTonun 26/9 _ x fof Signore of Pipa Tandatargan pesera Sigranue of winess Tancatangan Saks NemewWame: ZA) ZULALIZ® AD CA H/M officer in Crarge/ttama Pegawai NRICNo.INo KP: FRYE) —b —SLEY NRIC Nowe. KP: Addressialamat: 4/0 90, GLU 36/34, Designation/Jawatan a 3%, [OYAD, Company Stamp!Cop Raemi be lend Bi ay ean ° Taxith kenderaan disarah kepada peserta ‘The panel repairer shallatow fe Parcipant to lodge any complaint win rade te ropa cated ut bythe pana ropa win (6) ments fom the dete of ceiver of ho vahiclo horn referred us the Mepor WATERY pele ae #0 rogured by Ye Parfebani e racity Ne Same, Bo GSS ‘and axpenses shal be tome byte paral epee ‘Phak barghol pane! heméaish menbenartan Peserta ent membustsebarang aduan berkonasn pembsian yang dalancan oleh Benak penal {orsetut dalam tempo (@) Bulan dan tnt penyerahon Koadzraan (sii dk sebsge Yersch fannan bembcika') don soko Pacers ‘momerickan perbakan semur, sebarang kos dan neretancan akan clangg.ng bh borgral areal terse