STAMP DUTY PAID

E-SCHEDULE / E-JADUAL MX1

CLASS OF CERTIFICATE : PRIVATE CAR COVER TYPE : COMPREHENSIVE
JENIS SIJIL JENIS PERLINDUNGAN

E-CERTIFICATE NO : TMCA2014112 AGENCY CODE : GCA04592

NO. E-SIJIL KOD AGENSI
PARTICIPANT AZWEEN NOR BINTI AB WAHID NRIC : 890725-01-5208
PESERTA
ADDRESS : 2143-A, BLOK D, KUARTERS GURU FELDA BUKIT APING BARAT, COMPANY REG NO :
ALAMAT KOTA NO PENDAFTARAN SYARIKAT
81900 KOTA TINGGI
PROFESSION OR BUSINESS : JOHOR
PEKERJAAN ATAU PERNIAGAAN OTHERS
PERIOD OF TAKAFUL (BOTH DATE INCLUSIVE) DATE OF SIGNATURE OF PROPOSAL & DECLARATION FORM
TEMPOH TAKAFUL (TERMASUK KEDUA-DUA TARIKH) TARIKH TANDATANGAN BORANG CADANGAN & AKUAN
a) FROM : 21-02-2021 TO : 20/02/2022 03/02/2021
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 JRY8720 BASIC CONTRIBUTION 1,574.62
NO. PENDAFTARAN SUMBANGAN ASAS

MAKE & MODEL HONDA - HONDA BR-V 1.5E

BUATAN & MODEL

CUBIC CAPACITY 1497CC NCD ENTITLEMENT 45.00% 708.58

KEUPAYAAN PADU KELAYAKAN NCD

SEATING CAPACITY INCLUDING DRIVER 7 ADDITIONAL COVERAGE

RUANG DUDUK TERMASUK PEMANDU PERLINDUNGAN TAMBAHAN

YEAR OF MANUFACTURE 2017 SUB TOTAL 866.04

TAHUN DI BUAT JUMLAH KECIL

ENGINE NO L15Z19100439
NO. ENJIN

CHASSIS NO PMHDG1820HD800409 SERVICE TAX 51.96

NO. CASIS CUKAI PERKHIDMATAN

SUM COVERED RM 53,000.00 STAMP DUTY 10.00

JUMLAH PERLINDUNGAN DUTI SETEM

EXCESS RM 0.00 TOTAL AMOUNT PAYABLE 928.00

AKSES JUMLAH PEMBAYARAN

HIRE PURCHASE / LEASING COMPANY /EMPLOYER

:
SEWA BELI / SYARIKAT MENYEWA / MAJIKAN
NAMED DRIVERS : -
PEMANDU YANG DINAMAKAN
SUBJECT TO FOLLOWING OPERATIVE ENDORSEMENTS ATTACHED : C002,C087,C113
TERTAKLUK KEPADA ENDOSMEN-ENDOSMEN BERIKUTNYA

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 E-SCHEDULE
MANA-MANA ORANG YANG DIBENARKAN MEMANDU DAN HAD ATAS KEGUNAAN ADALAH TERMAKTUB DALAM SIJIL TAKAFUL YANG DIKELUARKAN SEHUBUNGAN DENGAN E-JADUAL INI

DATE OF SIGNING OF CERTIFICATE : 03/02/2021

TARIKH TANDATANGAN PADA SIJIL

DATE AND TIME OF CERTIFICATE PRINTED :

TARIKH DAN MASA SIJIL DI CETAK

SYARIKAT TAKAFUL MALAYSIA AM BERHAD [201701032316 (1246486-D)]

_____________________________________________
AUTHORISED SIGNATORY
PENANDATANGAN YANG SAH

E-CERTIFICATE NO : TMCA2014112

ENDORSEMENTS

C002 - EXCESS DAMAGE CLAIM

C087 - AGREED VALUE
C113 - REF MOTOR MARKET VALUATION

Please read the e-Schedule carefully which contains important information about the takaful coverage. You are advised to visit our website at www.takaful-malaysia.com.my and download the full Certificate to better understand the terms
and conditions mentioned therein at your convenience. Please note that the e-Schedule and the full Certificate together form the terms of your contract with STMAB.

Sila baca e-Jadual Sijil ini dengan teliti kerana ia mengandungi maklumat penting mengenai perlindungan takaful tersebut. Anda dinasihati untuk melayari laman web kami di www.takaful-malaysia.com.my untuk muat turun Sijil lengkap
tersebut bagi memahami dengan lebih lanjut mengenai terma-terma dan syarat-syarat yang dinyatakan. Sila ambil perhatian bahawa kedua-dua e-Jadual Sijil dan Sijil lengkap ini merupakan kontrak anda dengan STMAB.

For all Takaful Malaysia's Comprehensive Private Motor Takaful Customer, you will be provided with a complimentary personal accident takaful covering the driver and all passengers travelling in your vehicle. You will also be
automatically enrolled as a member of our Tele Bantuan program – a 24/7 emergency car assistance program. This program provides extensive roadside assistance services, including a dedicated 24-Hour Hotline: 1-800-888-788 that is
made available to attend to your needs in the event of emergency. Please visit our website for more information.

Untuk semua pelanggan Takaful Motor Persendirian Komprehensif Takaful Malaysia, anda dan semua penumpang di dalam kenderaan anda akan diberikan perlindungan takaful kemalangan diri secara percuma. Anda juga akan didaftarkan
secara automatik sebagai ahli program Tele Bantuan kami – iaitu sebuah program bantuan kecemasan 24/7. Program ini menyediakan perkhidmatan bantuan kerosakan di bahu jalan yang ekstensif, termasuk talian bantuan 24-Jam: 1-800-
888-788 yang disediakan bagi memenuhi keperluan anda sekiranya berlaku kecemasan. Sila layari laman web kami untuk maklumat lanjut.

In the event of a road accident, customers are advised to refer to the Claims Guide for Motor Accidents available at https://www.takaful-malaysia.com.my/Handbooks/ClaimsGuide_MotorAccidents_en.pdf for claims process.
Sekiranya berlaku kemalangan jalan raya, pelanggan dinasihatkan untuk merujuk kepada Panduan Tuntutan untuk Kemalangan Motor yang boleh didapati di https://www.takaful-
malaysia.com.my/Handbooks/ClaimsGuide_MotorAccidents_my.pdf untuk proses tuntutan.