Car Owner’s Name

Address 1
Address 2
Address 3

Date :

UFirst Perodua Passport

To UFirst Admin,

LETTER TO AUTHORIZE THE DECLARED DRIVER AS THE CAR BENEFICIARY FOR UFIRST MEMBERSHIP

 Car Registration Number : Car Model: _________________________

I (Name of the car owner as per NRIC/Passport) bearing the IC/Passport

No.___________________(IC/Passport Number) the registered Owner of the Car, do hereby authorize
UFirst Perodua Passport to register the Car under the name of
____________________________(Name of the driver as per NRIC/Passport) bearing the IC/Passport No.
___________________(IC/Passport Number) and UFirst Membership No.____________________ (UFirst
Membership Number) (‘the Member’) for the purpose of UFirst Perodua Passport Membership only.

With this authorization, I do hereby relieve and waive whatever rights, points or benefits given to
the Member or the Car under UFirst Perodua Passport Membership and I shall not commence any
demand or legal action against Perodua to claim for any rights or benefits given to the Member or
the Car under UFirst Perodua Passport membership starting from the date this letter is processed by
UFirst Admin. Enclosed is a copy of Car Registration Card/Insurance Cover Note as required by
UFirst.

Thank you.

Sincerely,

_______________________

Full Name: