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    Agency Application CheckList - 20210129

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    iesmaromli Work
    This document is an agency application checklist that lists the required documents to submit along with an application. It includes common documents like the application form, agreement forms, NRIC copies, and payment receipt. For different business structures there are additional required documents such as a business registration certificate, partnership documents, or incorporation documents. It provides important notes on the limit of liability for guarantors and ensuring client names and addresses match across documents.

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    Agency Application CheckList - 20210129

    Uploaded by

    iesmaromli Work
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    This document is an agency application checklist that lists the required documents to submit along with an application. It includes common documents like the application form, agreement forms, NRIC copies, and payment receipt. For different business structures there are additional required documents such as a business registration certificate, partnership documents, or incorporation documents. It provides important notes on the limit of liability for guarantors and ensuring client names and addresses match across documents.

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    Agency Application CheckList_20210129

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    This document is an agency application checklist that lists the required documents to submit along with an application. It includes common documents like the application form, agreement forms, NRIC copies, and payment receipt. For different business structures there are additional required documents such as a business registration certificate, partnership documents, or incorporation documents. It provides important notes on the limit of liability for guarantors and ensuring client names and addresses match across documents.

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

    Agency Application CheckList - 20210129

    Uploaded by

    iesmaromli Work
    This document is an agency application checklist that lists the required documents to submit along with an application. It includes common documents like the application form, agreement forms, NRIC copies, and payment receipt. For different business structures there are additional required documents such as a business registration certificate, partnership documents, or incorporation documents. It provides important notes on the limit of liability for guarantors and ensuring client names and addresses match across documents.

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    of 1

    AGENCY APPLICATION CHECKLIST

    NOTE: You are required to submit the following documents along with the application.
    Please mark [] the documents that are produced.

    Part 1 Common Documents


    01. Agency Application Form
    02. Agency Agreement (undated) (2 copies)
    03. Consent for Disclosure of Credit Information
    04. PIAM Application Form for the Registration of General Insurance Agents
    05. Photocopy of NRIC of Applicant or Corporate Nominee
    06. Guarantor Agreement 1 (undated)
    07. Photocopy of NRIC of Guarantor
    08. AXA Official Receipt 3 for PIAM Processing Fee (mandatory to state Client ID
    on receipt) :
    Sole Proprietorship : 1 st Principal - RM50.00
    2 nd Principal - RM35.00
    st
    Partnership or Private Limited : 1 Principal - RM80.00
    2 nd Principal - RM50.00
    09. AXA Partners Systems Access Application Form
    10. Photocopy of SPM (or higher qualification) Certificate
    11. Photocopy of MII Certificate (i.e. PCEIA)
    12. Photocopy of front page of saving or latest current account statement
    (for verification process of eTransfer of monthly commission)

    Part 2 Sole Proprietorship or Partnership


    01. Business Registration Certificate 2 (Form D and Form A)
    02. Photocopy of NRIC of Partner (Partnership only)

    Part 3 Private Limited or Sdn Bhd (document is required to be certified true copy)
    01. Form 9 / Section 15/17 Certificate of Incorporation of Private Company
    02. Form 13 / Section 28 Certificate of Incorporation on Change of Company Name (if any)
    03. Form 24 / Section 14 Return of Allotment of Shares
    04. Form 32A / Section 51 Form of Transfer of Securities (if any)
    (mandatory to affix common seal)
    05. Form 49 / Section 14 Return Giving Particulars in Register of Directors, Managers and
    Secretaries and Changes of Particulars
    06. Form 44 Notice Of Situation Of Registered Office
    07. Board Resolution
    08. Memorandum and Articles of Association
    09. Borang 2 - Tourism Industry Act 1992 (Trade Specific Agent only)

    IMPORTANT NOTES:
    1. Limit of liability of Guarantor:
    Sole Proprietorship RM10,000
    Trade Specific Agent RM20,000
    Partnership or Private Limited Company RM30,000
    2. The Business Registration Certificate must at least bearing “general insurance agent” or words with similar
    connotation as the type of business registered.
    3. The client name and address appear on the Official Receipt must be matched with the Business Name in the
    Business Registration Certificate and the Business Address in the PIAM Applicat ion Form respectively.

    Revision Date: 29 January 2021 Page 1 of 1

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