TAKAFUL IKHLAS BERHAD ( U) IKHLAS POINT Corporate Head Office Tower 11A,Avenue 5, Bangsar South, No. 8, JalanKerinchi, Kuala Lumpur.

Size: px
Start display at page:

Download "TAKAFUL IKHLAS BERHAD ( U) IKHLAS POINT Corporate Head Office Tower 11A,Avenue 5, Bangsar South, No. 8, JalanKerinchi, Kuala Lumpur."

Transcription

1 TAKAFUL IKHLAS BERHAD ( U) IKHLAS POINT Corporate Head Office Tower 11A,Avenue 5, Bangsar South, No. 8, JalanKerinchi, Kuala Lumpur. Tel: Fax: Website: (A subsidiary of MNRB Holdings Berhad) Untuk kegunaan pejabat / For office use only No. Siri / Serial No : KodEjen/ Agent Code : BORANG CADANGAN SKIM TAKAFUL KEMASUKAN HOSPITAL & PEMBEDAHAN PEKERJA ASING (SKHPPA) FOREIGN WORKER HOSPITALIZATION AND SURGICAL TAKAFUL SCHEME PROPOSAL FORM (SKHPPA) A. BUTIR-BUTIR MAJIKAN / EMPLOYER S PARTICULARS 1. No. Pendaftaran Syarikat/KP / Business Registration No./NRIC 2. Nama Pencadang / Majikan / Name of Proposer / Employer 3. Alamat Majikan / Address of Employer Poskod/ Postcode Bandar /Town Negeri /State 4. No. Telefon / Telephone No Pejabat / Office - Rumah / House - Bimbit / Hand phone - 5. Alamat E-Mel / Address 6. Perniagaan/Pekerjaan / Business/Occupation Syarikat berhak untuk tidak menerima sebarang permohonan sekiranya pekerja terlibat dengan aktiviti-aktiviti yang tidak mematuhi syariah. The Company has the right not to accept any proposal where the worker is involved in any non-shariah compliance activities. B. TEMPOH PERLINDUNGAN TAKAFUL / PERIOD OF TAKAFUL COVERAGE 7. Tempoh Perlindungan / Period of Coverage Bulan/ Months

2 8. Tarikh Perlindungan / Date of Coverage : Dari / From Hingga / To 9. Bilanganpekerja yang akandilindungi / No. of worker(s) to be covered Pekerja/workers (jika lebih dari seorang (1) pekerja, sila lengkapkan Borang Butir-Butir Pekerja yang disertakan dalam lampiran ini) (if more than one (1) worker, please complete the Workers Particulars Form) C. TEMPAT PEKERJAAN / PLACE OF EMPLOYMENT 10. Hanya perlu diisi sekiranya Alamat Tempat Pekerjaan berlainan dengan Alamat Majikan di atas :- To be filled up only if Place of Employment Address is not the same as the Address of Employer above :- a) No. Pendaftaran Syarikat / Rujukan Tapak Pembinaan / Rujukan Projek Business Registration No./ Construction Site No. / Project Reference No b) Alamat Tempat Pekerjaan / Place of Employment Address Poskod/ Postcode Bandar /Town Negeri /State D. BUTIR-BUTIR PEKERJA ASING [jikapermohonanuntukseorang (1) pekerja, silalengkapkanbutir-butirberikut] : FOREIGN WORKER'S PARTICULARS [ If application is for only one (1) worker, please complete the following particular] :- 11. Nama Pekerja / Name of Worker 12. Warganegara / Nationality 13. No. Pasport / Passport No 14. Tarikh Lahir (HH/BB/TT) / Date of Birth (DD/MM/YY) 15. Jantina/ Gender Lelaki / Male Perempuan / Female 16. Taraf Perkahwinan / Marital Status Bujang/Single Kahwin/Married Bercerai/Divorced Janda/Duda/Widow/Widower 17. No. Permit Kerja/ Work Permit No.

3 18. Tarikh Luput Permit Kerja/ Work Permit Expiry Date 19. Jenis Pekerjaan / Nature of Work 20. Siapakah yang akan membayar sumbangan untuk pelan Takaful ini? / Who will pay the contribution for this Takaful plan? Majikan / Employer Pekerja asing sendiri /Foreign worker themselves E. PENGISYTIHARAN OLEH PENCADANG/ DECLARATION BY PROPOSER Saya / Kami dengan ini mengaku bahawa semua pernyataan di atas dan dokumen yang disertakan berhubung dengan permohonan ini adalah lengkap dan benar sepanjang pengetahuan dan kepercayaan Saya / Kami. Saya / Kami bersetuju bahawa segala pernyataan dan akuan yang terkandung dalam borang permohonan ini akan menjadi asas kepada perjanjian Takaful antara Saya / Kami dan Takaful Ikhlas Berhad (selepas ini dirujuk sebagai pihak Syarikat ) dan ianya disifatkan sebagai termaktub dalam perjanjian ini. Saya / Kami bersetuju bahawa Sumbangan Takaful Saya / Kami akan diuruskan oleh pihak Syarikat berdasarkan prinsip Wakalah sebagaimana yang ditakrifkan oleh pihak Syarikat serta menepati Shariah. Saya / Kami bersetuju membenarkan pihak Syarikat mengambil 25% daripada Sumbangan tersebut sebagai Yuran Wakalah. Lanjutan daripada itu, Saya / Kami juga bersetuju bahawa baki daripada Sumbangan Takaful Saya / Kami akan disalurkan ke dalam Dana Risiko berdasarkan Tabarru' (derma) untuk membantu Peserta lain yang ditimpa musibah dan baki yang masih ada di dalam Dana Risiko berkenaan akan dilaburkan oleh pihak Syarikat. Sebarang keuntungan daripada pelaburan tersebut, jika ada, akan dimasukkan semula ke dalam Dana Risiko. Saya / Kami juga bersetuju membenarkan pihak Syarikat menolak Caj Pengurusan Lebihan (SAC) 50% daripada lebihan boleh-agih kasar dari Dana Risiko pada setiap tahun. Walau bagaimanapun, pihak Syarikat boleh, mengikut budi bicara dan di mana bersesuaian, mengenakan caj kurang daripada 50% daripada lebihan boleh-agih kasar sebagai SAC. Saya / Kami juga memahami bahawa lebihan boleh-agih bersih dari Dana Risiko, jika ada, akan dikendalikan oleh pihak Syarikat mengikut kaedah dan peruntukan berlandaskan prinsip Shariah yang akan memanfaatkan Peserta. (Untuk maklumat lengkap, sila rujuk kepada Sijil Takaful yang berkenaan). I/We hereby declare that all statements made above and other documents submitted in connection with this application are complete and true to the best of My/Our knowledge and belief. I/We agree that this declaration and all statements made above shall form the basis of the Takaful contract between Me/Us and Takaful Ikhlas Berhad (hereinafter referred as the Company ) and they are deemed to be incorporated in the contract. I/We agree that My/Our Takaful contribution shall be managed by the Company based on the Wakalah principle as defined by the Company and in accordance to Shariah. In return, I/We agree to allow the Company to deduct 25% of the contribution as Wakalah Fee. I/We further agree that the balance of My/Our contribution shall be allocated into the Risk Fund and Special Fund on a Tabarru' (donation) basis and be used to help other Participants in time of misfortune and the balance shall be invested by the Company. Any profit arising out of this investment, if any, shall be allocated to the Risk Fund. I agree to allow the Company to deduct a Surplus Administration Charge (SAC) of 50% from any gross distributable surplus arising from the Risk Fund. However, the Company may at its discretion and where appropriate charge less than 50% from gross distributable surplus as SAC. I / We also understand that the net distributable surplus arising from the Risk Fund, if any, shall be managed by the Company according to the method and allocation in accordance to the Shariah principle that will benefit the Participant." (For further details, please refer to the respective Takaful Certificates). Perlindungan Data Peribadi/ Personal Data Protection Saya mengakui dan faham bahawa Syarikat akan memberi sesalinan informasi peribadi tersebut dengan membayar kos munasabah apabila permohonan dibuat oleh saya. I hereby acknowledge that the Company will provide a copy of all my personal information to me upon request with a nominal fees. Saya bersetuju dan mengakui bahawa Syarikat boleh menggunakan informasi peribadi saya untuk mencadangkan lain-lain produk dan perkhidmatan Syarikat yang mana pada pendapat Syarikat adalah memberi manafaat kepada saya sehinggalah notis untuk menarik balik kebenaran ini diberikan. I hereby consent and acknowledge that the Company may use my personal information to recommend me with detail of other products or services of the Company which the Company feels may be beneficial to me until written notice is issued to revoke such authorization. Tarikh / Date Tandatangan Pencadang/Cop Syarikat (Signature of Proposer / Company Rubber Stamp)

4 F. PERLINDUNGAN MAKLUMAT PERIBADI / PERSONAL DATA PROTECTION 1. Saya memberi izin dan kuasa kepada: (a) Takaful Ikhlas Berhad (bermaksud mana-mana anak-anak syarikat milik penuh dan berkaitan dengan MNRB Holdings Berhad atau Takaful Ikhlas Berhad atau mana-mana penyedia perkhidmatan yang dilantik) (selepas ini dirujuk sebagai Takaful IKHLAS) untuk memperolehi dan memproses; dan (b) mana-mana pengamal perubatan, hospital atau institusi perubatan (sama ada diperbadankan atau tidak) yang pernah merawat saya atau memiliki rekod mengenai saya atau kesihatan saya untuk menyediakan maklumat yang relevan dan dokumen-dokumen yang diperlukan oleh Takaful IKHLAS untuk menentukan sama ada untuk menerima permohonan saya atau meluluskan sebarang tuntutan yang dibuat ke atas Sijil Takaful yang dikeluarkan kepada saya. Saya juga bersetuju bahawa Salinan pemberian kuasa ini adalah berkuatkuasa dan sah seperti salinan asal. I hereby consent and authorize: (a) Takaful Ikhlas Berhad (means any of MNRB Holdings Berhad or Takaful Ikhlas Berhad owned subsidiaries and associate companies or Takaful IKHLAS or any of its appointed service providers) (hereinafter defined as Takaful IKHLAS) to obtain and process; and (b) any medical practitioner, hospital, medical institution or any person (whether incorporated or not) who has ever attended to me or has records on me or my health to provide relevant information and documents required by Takaful IKHLAS to determine whether to accept my proposal or approve any claim arising from the Takaful Certificate issued to me. I further agree that a photocopy of this authorization will be as effective and valid as the original. 2. I hereby irrevocably consent and agree that Takaful IKHLAS may process, use, store, disclose, transfer, compile, match, obtain and/or exchange (all whether within or outside Malaysia) all my personal information provided to and/or obtained by Takaful IKHLAS as well as any information derived from or relating to my Takaful Certificate issued based on this Takaful application (collectively referred to as Personal Data ), to, from or with any person as Takaful IKHLAS may consider necessary including without limitation any agent, contractor, service provider or selected third party that provide services to Takaful IKHLAS and/or Bank Negara Malaysia or any other relevant authorities that Takaful IKHLAS is under obligation to make disclosure to, under the requirements of any law or court for any and all purposes including without limitation to: I hereby irrevocably consent and agree that Takaful IKHLAS may process, use, store, disclose, transfer, compile, match, obtain and/or exchange (all whether within or outside Malaysia) all my personal information provided to and/or obtained by Takaful IKHLAS as well as any information derived from or relating to my Takaful Certificate issued based on this Takaful application (collectively referred to as Personal Data ), to, from or with any person as Takaful IKHLAS may consider necessary including without limitation any agent, contractor, service provider or selected third party that provide services to Takaful IKHLAS and/or Bank Negara Malaysia or any other relevant authorities that Takaful IKHLAS is under obligation to make disclosure to, under the requirements of any law or court for any and all purposes including without limitation to: a) Berhubung dengan produk-produk dan/atau perkhidmatan-perkhidmatan yang ditawarkan oleh Takaful IKHLAS kepada saya dan/atau berkaitan dengan pemadanan bagi sebarang tujuan mana-mana Maklumat Peribadi saya di dalam simpanan Takaful IKHLAS; dan/atau In connection with the products and/or services offered by Takaful IKHLAS to me and/or in connection to matching for whatever purpose of any of my Personal Data under the possession of Takaful IKHLAS; and/or b) Untuk memudahkan pengendalian perniagaan Takaful IKHLAS atau operasi prosedur-prosedur dalaman Takaful IKHLAS; dan/atau To facilitate the conduct of Takaful IKHLAS s business or the operations of the Takaful IKHLAS s internal procedures; and/or c) Bagi tujuan mempromosi produk-produk lain dan/atau perkhidmatan oleh Takaful IKHLAS dan/atau mana-mana rakan strategiknya secara amnya kepada saya. Sekiranya saya tidak ingin menerima sebarang maklumat promosi daripada atau mana-mana rakan strategiknya, saya akan memaklumkan secara bertulis ke alamat Takaful IKHLAS yang disediakan di dalam borang ini. For the purpose of promoting other products and/or services by Takaful IKHLAS and/or its strategic partners, generally to me. If I do not wish to receive any promotional information from any of its strategic partners, I will notify by writing to Takaful IKHLAS s address provided in this form. d) Untuk menambahbaik produk dan/atau perkhidmatan yang disediakan oleh Takaful IKHLAS; To improve the products and/or services provided by Takaful IKHLAS; e) Untuk tujuan menyiasat, melaporkan dan pencegahan atau sebaliknya aktiviti-aktiviti yang berkaitan dengan pengubahan wang haram, pembiayaan keganasan, penyelewengan, pengelakan cukai dan aktiviti-aktiviti jenayah secara amnya, penyenggaraan pangkalan data, analisa statistik, pengesahan tuntutan, audit, pengendalian dan penyelesaian aduan pelanggan, dan hal-hal operasi seperti yang diperuntukkan oleh undang-undang; dan /atau For purposes of investigating, reporting and preventing or otherwise in relation to money laundering, terrorist financing, fraud, tax evasion and criminal activities generally, maintenance of databases, statistical analysis, claim verification, audit, customer complaints handling and resolution, and operational matters as required by the law; and/or f) Untuk sebarang tujuan proses undang-undang atau mahkamah yang dimulakan oleh atau diserahkan terhadap saya atau Takaful IKHLAS, sama ada Takaful IKHLAS adalah pihak yang terlibat atau tidak. For purposes of any legal or court process initiated by or served on me or Takaful IKHLAS, whether or not Takaful IKHLAS is a party. 3. Saya faham bahawa saya boleh meminta akses kepada dan akan memaklumkan Takaful IKHLAS jika terdapat perubahan kepada Maklumat Peribadi saya secepat yang mungkin dan bersetuju bahawa Takaful IKHLAS tidak akan dipertanggungjawabkan atas sebarang kerugian sama ada secara langsung atau tidak, atau lain-lain liability sama ada sivil atau jenayah disebabkan kesalahnyataan fakta sebenar atau penyembunyian tentang sesuatu fakta material untuk mempengaruhi orang lain untuk melakukan perbuatan yang merugikannya, serta Maklumat Peribadi yang tidak tepat atau tidak lengkap yang diberikan oleh saya.

5 I understand that I can request access to and will keep Takaful IKHLAS updated of any change to my Personal Data as soon as practicable and agree that Takaful IKHLAS shall not be liable for any direct or indirect loss or other liabilities under civil or criminal due to misrepresentation of the truth or concealment of a material fact to induce another to act to its detriment, inaccurate or incomplete Personal Data provided by me. G. BUTIR-BUTIR BAYARAN / DETAIL OF PAYMENT Sumbangan Tahunan / Annual Contribution Jumlah Sumbangan / Total Contribution Cukai Perkhidmatan( 6%) / Service Tax (6%) Duti Setem / Stamp Duty JUMLAH / TOTAL RM (setiap pekerja/per worker) RM RM RM10.00 RM Semua Cek hendaklah dibayar atas nama Takaful Ikhlas Berhad/ All Cheques must be made payable to Takaful Ikhlas Berhad H. UNTUK KEGUNAAN PEJABAT SAHAJA / FOR OFFICE USE ONLY Bersama ini disertakan Bayaran Tunai / Cek No Enclose herewith Cash Payment / Cheque No Jumlah / Amount RM Tarikh/MasaDiterima / Date/Time Received Tandatangan / Signature I. NOTA PENTING / IMPORTANT NOTE Caj kami tidak termasuk cukai yang dikenakan oleh kerajaan dan/atau pihak berkuasa pada masa akan datang (termasuk Cukai Barangan dan Perkhidmatan (GST)). Setelah perlaksanaan GST, kami berhak mengenakan caj GST bagi maksud Sijil Takaful ini yang dikehendaki dibayar di bawah undang-undang. / Our charges exclude tax that would be imposed by government and/or the authority in the future (including Goods and Services Tax (GST)). Upon implementation of the GST, we shall be entitled to recover from you in the respect of this Takaful Certificate that is required under the law. J. PENGESAHAN KE ATAS KESAHIHAN PENGENALAN DIRI / VERIFICATION ON AUTHENTICATION OF IDENTITY (Untuk kegunaan kakitangan Syarikat atau Wakil sahaja / For Use by Company Staff or Intermediary only) Menurut Seksyen 16(2) Akta Pencegahan Pengubahan Wang Haram & Pencegahan Pembiayaan Keganasan 2001, saya dengan ini mengesahkan perkara berikut :In compliance with section 16(2) of Anti-Money Laundering & Counter Terrorism Financing Act 2001, I hereby confirm the following : [ ] Dokumen asal pengenalan diri di semak / Original identity document sighted [ ] Salinandokumenpengenalandiridilampirkanuntukindividudengansumbangantahunanmelebihi RM 50,000. / Photocopy of identity document attached for Individuals with annual contribution exceeding RM50,000. [ ] SalinanSijilPendaftaranPerniagaanuntuksyarikatdengansumbangantahunanmelebihi RM 100,000 / Photocopy of Business Registration Certificate for Company with annual contribution exceeding RMI00, Tarikh/Date Tandatangan/Signature Nama Kakitangan Syarikat atau Wakil/ No KadPengenalan/ NRIC No Name of Company Staff or Representative

6 K. KETERANGAN FAEDAH / PERLINDUNGAN / DESCRIPTION OF BENEFITS /COVERAGE MANFAAT KEMASUKAN KE HOSPITAL & PEMBEDAHAN / HOSPITAL & SURGICAL BENEFITS 1) (a) Bilik & Makan Harian (Maksimum tiga puluh (30) hari) Daily Hospital Room & Board (Maximum up to thirty (30) days) (b) Unit RawatanIntensif (Maksimum lima belas (15) hari) Intensive Care Unit [ICU] (Maximum up to fifteen (15) days) 2) BekalandanKhidmat Hospital / Hospital Supplies and Services 3) BilikPembedahan / Operating Theatre 4) Yuran Pembedahan (Tidak termasuk pemindahan organ) Surgical Fees (Exclude organ transplantation) 5) YuranPakarBius / Anesthetist's Fees 6) LawatanPakarPerubatanDalam Hospital (Maksimumtigapuluh (30) hari) In-Hospital Physician Visits (Maximum up to thirty (30) days) 7) LawatanPakarPerundinganDalam Hospital (Maksimumtigapuluh (30) hari) In-Hospital Specialist Consultation Visits (Maximum up to thirty (30) days) 8) YuranAmbulan/LaporanPerubatan / Ambulance Fees/Medical Report Fees HAD MAKSIMUM TAHUNAN KESELURUHAN (Butiran 1 hingga 8) MAXIMUM OVERALL ANNUAL LIMIT (Item 1 to 8) Bayaran yang dikenakan mengikut bayaran yang selaras dengan Bilik & Makan Kelas Ketiga (ke-3) sehingga maksimum RM60 sehari di Hospital Kerajaan Malaysia Bukan Korporat mengikut Akta Fi 1951, Perintah Fi (Perubatan) 1982 As charged in accordance to charges consistent with Third (3rd) Class Room and Board to a maximum of RM60.00 per day in a Non- Corporatised Malaysian Government Hospital in conformance to the charges specified under Perintah Fi (Perubatan) RM10, SUMBANGAN TAHUNAN (Sebelum 6% CukaiPerkhidmatandan RM10.00 DutiSetem) RM (SetiapPekerja) ANNUAL CONTRIBUTION (Before 6% Service Tax and RM10.00 Stamp Duty) (Per Worker) Nota Penting: Important Note: Semua faedah-faedah yang dibayar bagi setiap ketidakupayaan bagi setiap tempoh Takaful yang diberi tertakluk kepada Had Tahunan Keseluruhan sebanyak RM10, bagi setiap pekerja yang dilindungi. All benefits payable for any number of disabilities in any one given period of Takaful is subject to Overall Annual limit of RM10, per covered worker.

7 BORANG BUTIR-BUTIR PEKERJA ASING FOREIGN WORKER'S PARTICULARS FORM SENARAI NAMA PEKERJA YANG DILINDUNGI DI BAWAH SKHPPA / LIST OF WORKERS TO BE COVERED UNDER SKHPPA Nama Pencadang / Majikan / Name of Proposer / Employer Pendaftaran Syarikat / KP / Pasport / Business Registration No./ NRIC / Passport Bil No. Item No. Nama Pekerja Name of Worker Warganegara Nationality No. Pasport Passport No. Tarikh Lahir Date of Birth (* Jantina)/ (* Gender) **Taraf Perkahwinan / Marital Status No. Permit Kerja/ Work Permit No (DD/MM/YY) Tarikh Luput Permit Kerja/ Work Permit Expiry Date Jenis Pekerja / Nature of Work *** Siapakah yang akan membayar sumbangan untuk pelani Takaful ini? Who will be paying the contribution for this Takaful plan? Rujukan / Reference: * Jantina / Gender:(L) Lelaki / Male;(P) Perempuan / Female **Taraf Perkahwinan / Marital Status S - Bujang/Single M- Kahwin/Married D - Bercerai /Divorced W - Janda/Duda / Widow/Widower ***Sumbangan dibuat oleh/contribution paid by: E - Employer/Majikan FW Pekerja asing/foreign worker

BORANG CADANGAN IKHLAS EQUIPMENT COMPREHENSIVE PERILS TAKAFUL IKHLAS EQUIPMENT COMPREHENSIVE PERILS TAKAFUL PROPOSAL FORM

BORANG CADANGAN IKHLAS EQUIPMENT COMPREHENSIVE PERILS TAKAFUL IKHLAS EQUIPMENT COMPREHENSIVE PERILS TAKAFUL PROPOSAL FORM TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

BORANG CADANGAN IKHLAS MACHINERY BREAKDOWN TAKAFUL IKHLAS MACHINERY BREAKDOWN TAKAFUL PROPOSAL FORM

BORANG CADANGAN IKHLAS MACHINERY BREAKDOWN TAKAFUL IKHLAS MACHINERY BREAKDOWN TAKAFUL PROPOSAL FORM TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

BORANG CADANGAN IKHLAS COMPREHENSIVE PERILS TAKAFUL IKHLAS COMPREHENSIVE PERILS TAKAFUL PROPOSAL FORM. Bandar / Town

BORANG CADANGAN IKHLAS COMPREHENSIVE PERILS TAKAFUL IKHLAS COMPREHENSIVE PERILS TAKAFUL PROPOSAL FORM. Bandar / Town A. BUTIRAN PENCADANG / THE PROPOSER 1. Nama Pencadang Name of Proposer 2. Alamat Surat Menyurat Correspondence Address TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South,

More information

BORANG CADANGAN IKHLAS PERSONAL ACCIDENT TAKAFUL IKHLAS PERSONAL ACCIDENT TAKAFUL PROPOSAL FORM

BORANG CADANGAN IKHLAS PERSONAL ACCIDENT TAKAFUL IKHLAS PERSONAL ACCIDENT TAKAFUL PROPOSAL FORM TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

BORANG CADANGAN IKHLAS PERDANA PERSONAL ACCIDENT TAKAFUL PROPOSAL FORM IKHLAS PERDANA PERSONAL ACCIDENT TAKAFUL

BORANG CADANGAN IKHLAS PERDANA PERSONAL ACCIDENT TAKAFUL PROPOSAL FORM IKHLAS PERDANA PERSONAL ACCIDENT TAKAFUL TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

BORANG CADANGAN IKHLAS COMPUTER COMPREHENSIVE PERILS TAKAFUL IKHLAS COMPUTER COMPREHENSIVE PERILS TAKAFUL PROPOSAL FORM

BORANG CADANGAN IKHLAS COMPUTER COMPREHENSIVE PERILS TAKAFUL IKHLAS COMPUTER COMPREHENSIVE PERILS TAKAFUL PROPOSAL FORM TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

Title Dato Datin Mr Ms Mr Mrs Dr Others

Title Dato Datin Mr Ms Mr Mrs Dr Others TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

PACIFIC MUTUAL FUND BHD IMPORTANT NOTICE ON PERSONAL DETAILS NOTIS PENTING BERKENAAN MAKLUMAT PERIBADI

PACIFIC MUTUAL FUND BHD IMPORTANT NOTICE ON PERSONAL DETAILS NOTIS PENTING BERKENAAN MAKLUMAT PERIBADI PACIFIC MUTUAL FUND BHD IMPORTANT NOTICE ON PERSONAL DETAILS NOTIS PENTING BERKENAAN MAKLUMAT PERIBADI The Personal Data Protection Act 2010 (hereinafter referred to as the Act ) came into effect on 15

More information

GUW-PFR029/00 Permata (01/12/11)

GUW-PFR029/00 Permata (01/12/11) TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

BORANG CADANGAN IKHLAS MACHINERY BREAKDOWN TAKAFUL IKHLAS MACHINERY BREAKDOWN TAKAFUL PROPOSAL FORM

BORANG CADANGAN IKHLAS MACHINERY BREAKDOWN TAKAFUL IKHLAS MACHINERY BREAKDOWN TAKAFUL PROPOSAL FORM TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9696 (General Line) Fax : 03-2723 9998 (General Fax Line) Website

More information

BORANG CADANGAN IKHLAS MONEY TAKAFUL IKHLAS MONEY TAKAFUL PROPOSAL FORM. Bandar / Town

BORANG CADANGAN IKHLAS MONEY TAKAFUL IKHLAS MONEY TAKAFUL PROPOSAL FORM. Bandar / Town TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

BORANG CADANGAN IKHLAS ELECTRONIC EQUIPMENT TAKAFUL IKHLAS ELECTRONIC EQUIPMENT TAKAFUL PROPOSAL FORM. Bandar / Town

BORANG CADANGAN IKHLAS ELECTRONIC EQUIPMENT TAKAFUL IKHLAS ELECTRONIC EQUIPMENT TAKAFUL PROPOSAL FORM. Bandar / Town TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

Foreign Worker Hospitalization And Surgical Scheme Proposal Form (SKHPPA)

Foreign Worker Hospitalization And Surgical Scheme Proposal Form (SKHPPA) Foreign Worker Hospitalization And Surgical Scheme Proposal Form (SKHPPA) Zurich General Insurance Malaysia Berhad is licensed under the Financial Services Act 2013 and regulated by Bank Nagara Malaysia.

More information

This Policy reflects the terms and conditions of the contract of insurance as agreed between you and the Company.

This Policy reflects the terms and conditions of the contract of insurance as agreed between you and the Company. (62605-U) This Policy is issued in consideration of the payment of premium as specified in the Policy Schedule and pursuant to the answers given in your Proposal Form (or when you applied for this insurance)

More information

Alamat Surat Menyurat : Poskod : No. telefon : Emel : RM 100 PELAN B RM 80,000 RM 80,000 RM 1,000

Alamat Surat Menyurat : Poskod : No. telefon : Emel : RM 100 PELAN B RM 80,000 RM 80,000 RM 1,000 BORANG CADANGAN TAKAFUL AMANI (PELAN TAKAFUL KEMALANGAN DIRI BERKELOMPOK) NOTA PENTING : MENURUT SEKSYEN 28 AKTA TAKAFUL 1984, ANDA DIKEHENDAKI MENYATAKAN DI DALAM BORANG CADANGAN INI DENGAN BENAR DAN

More information

BORANG CADANGAN IKHLAS NIAGA TAKAFUL ( OFFICE NIAGA) IKHLAS NIAGA TAKAFUL (OFFICE NIAGA) PROPOSAL FORM

BORANG CADANGAN IKHLAS NIAGA TAKAFUL ( OFFICE NIAGA) IKHLAS NIAGA TAKAFUL (OFFICE NIAGA) PROPOSAL FORM A. IKHLAS Point, Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 Fax : 03-2723 9998 Call Centre No : 03-2723 9696 Website : www.takaful-ikhlas.com.my PENCADANG

More information

BORANG CADANGAN TAKAFUL KEBAKARAN - BUKAN KEDIAMAN FIRE TAKAFUL PROPOSAL FORM - NON-RESIDENTIAL

BORANG CADANGAN TAKAFUL KEBAKARAN - BUKAN KEDIAMAN FIRE TAKAFUL PROPOSAL FORM - NON-RESIDENTIAL TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

APPLICATION FOR A PERFORMANCE BOND / ADVANCE PAYMENT BOND

APPLICATION FOR A PERFORMANCE BOND / ADVANCE PAYMENT BOND APPLICATION FOR A PERFORMANCE BOND / ADVANCE PAYMENT BOND Pursuant to Paragraph 4(1) of Schedule 9 of the Financial Services Act 2013, if you are applying for this Insurance for a purpose related to your

More information

School Children Personal Accident Insurance Plan - List Of Insured Persons

School Children Personal Accident Insurance Plan - List Of Insured Persons School Children Personal Accident Insurance Plan - List Of Insured Persons IMPORTANT NOTE Pursuant to Paragraph 5 of Schedule 9 of the Financial Services Act 2013, if you are applying for this Insurance

More information

The above duty of disclosure shall continue until the time your contract of insurance is entered into, varied or renewed with us.

The above duty of disclosure shall continue until the time your contract of insurance is entered into, varied or renewed with us. LONPAC INSURANCE BHD (307414-T) Head Office : LG, 6th, 7th, 21st to 26th Floor, Bangunan Public Bank, 6, Jalan Sultan Sulaiman, 50000 Kuala Lumpur, Malaysia. P.O. Box 10708, 50722 Kuala Lumpur, Malaysia.

More information

Foreign Workers Hospitalization & Surgical Scheme (Proposal Form) Skim Kemasukan Hospital & Pembedahan Pekerja Asing (Borang Cadangan)

Foreign Workers Hospitalization & Surgical Scheme (Proposal Form) Skim Kemasukan Hospital & Pembedahan Pekerja Asing (Borang Cadangan) SKHPPA Foreign Workers Hospitalization & Surgical Scheme (Proposal Form) Skim Kemasukan Hospital & Pembedahan Pekerja Asing (Borang Cadangan) Statement Pursuant to Financial Services Act 2013, Schedule

More information

TAKAFUL IKHLAS BERHAD HELAIAN PENERANGAN PRODUK. Skim Takaful Kemasukan Hospital dan Pembedahan Pekerja Asing (SKHPPA)

TAKAFUL IKHLAS BERHAD HELAIAN PENERANGAN PRODUK. Skim Takaful Kemasukan Hospital dan Pembedahan Pekerja Asing (SKHPPA) HELAIAN PENERANGAN PRODUK Sila baca Helaian Keterangan Produk ini sebelum membuat keputusan untuk mengambil Skim Takaful Kemasukan Hospital dan Pembedahan Pekerja Asing (SKHPPA). Sila pastikan juga bahawa

More information

BORANG CADANGAN IKHLAS PLATE GLASS TAKAFUL IKHLAS PLATE GLASS TAKAFUL PROPOSAL FORM. Bandar / Town

BORANG CADANGAN IKHLAS PLATE GLASS TAKAFUL IKHLAS PLATE GLASS TAKAFUL PROPOSAL FORM. Bandar / Town TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

BORANG CADANGAN IKHLAS MONEY TAKAFUL IKHLAS MONEY TAKAFUL PROPOSAL FORM

BORANG CADANGAN IKHLAS MONEY TAKAFUL IKHLAS MONEY TAKAFUL PROPOSAL FORM TAKAFUL IKHLAS BERHAD. (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9696 (General Line) Fax : 03-2723 9998 (General Fax Line) Website

More information

BORANG CADANGAN IKHLAS PERDANA PERSONAL ACCIDENT TAKAFUL PROPOSAL FORM IKHLAS PERDANA PERSONAL ACCIDENT TAKAFUL

BORANG CADANGAN IKHLAS PERDANA PERSONAL ACCIDENT TAKAFUL PROPOSAL FORM IKHLAS PERDANA PERSONAL ACCIDENT TAKAFUL TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9696 (General Line) Fax : 03-2723 9998 (General Fax Line) Website

More information

BORANG CADANGAN IKHLAS PUBLIC LIABILITY TAKAFUL IKHLAS PUBLIC LIABILITY TAKAFUL PROPOSAL FORM

BORANG CADANGAN IKHLAS PUBLIC LIABILITY TAKAFUL IKHLAS PUBLIC LIABILITY TAKAFUL PROPOSAL FORM TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

BORANG CADANGAN IKHLAS NIAGA TAKAFUL ( OFFICE NIAGA) IKHLAS NIAGA TAKAFUL (OFFICE NIAGA) PROPOSAL FORM

BORANG CADANGAN IKHLAS NIAGA TAKAFUL ( OFFICE NIAGA) IKHLAS NIAGA TAKAFUL (OFFICE NIAGA) PROPOSAL FORM TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point, Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9696 Fax : 03-2723 9998 Website : www.takaful-ikhlas.com.my (Anak

More information

BORANG CADANGAN IKHLAS FIDELITY GUARANTEE TAKAFUL IKHLAS FIDELITY GUARANTEE TAKAFUL PROPOSAL FORM

BORANG CADANGAN IKHLAS FIDELITY GUARANTEE TAKAFUL IKHLAS FIDELITY GUARANTEE TAKAFUL PROPOSAL FORM TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

TAX CLEARANCE LETTER APPLICATION FOR COMPANIES, LIMITED LIABILITY PARTNERSHIPS (LLP) AND LABUAN ENTITIES (LABUAN COMPANIES & LABUAN LLP)

TAX CLEARANCE LETTER APPLICATION FOR COMPANIES, LIMITED LIABILITY PARTNERSHIPS (LLP) AND LABUAN ENTITIES (LABUAN COMPANIES & LABUAN LLP) OPERATIONAL GUIDELINE NO. 3 OF YEAR 2016 LEMBAGA HASIL DALAM NEGERI MALAYSIA TAX CLEARANCE LETTER APPLICATION FOR COMPANIES, LIMITED LIABILITY PARTNERSHIPS (LLP) AND LABUAN ENTITIES (LABUAN COMPANIES &

More information

PERSONAL ACCIDENT CLAIM FORM BORANG TUNTUTAN KEMALANGAN DIRI

PERSONAL ACCIDENT CLAIM FORM BORANG TUNTUTAN KEMALANGAN DIRI PERSONAL ACCIDENT CLAIM FORM BORANG TUNTUTAN KEMALANGAN DIRI The issuance of this form is not an admission of liability on the part of the Takaful Operator and if false statement or declaration be made

More information

KRITERIA BORANG NYATA CUKAI PENDAPATAN (BNCP) TIDAK LENGKAP PEMBERITAHUAN

KRITERIA BORANG NYATA CUKAI PENDAPATAN (BNCP) TIDAK LENGKAP PEMBERITAHUAN KRITERIA BORANG NYATA CUKAI PENDAPATAN (BNCP) TIDAK LENGKAP CRITERIA ON INCOMPLETE INCOME TAX RETURN FORM (ITRF) PEMBERITAHUAN MULAI 1 JANUARI 2012, BNCP YANG TIDAK LENGKAP AKAN DIPULANGKAN KEPADA PEMBAYAR

More information

Foreign Workers Compensation Scheme (FWCS) Proposal Form

Foreign Workers Compensation Scheme (FWCS) Proposal Form Foreign Workers Compensation Scheme (FWCS) Proposal Form SCHEDULE 9 OF THE FINANCIAL SERVICES ACT 2013 (FSA) Pursuant to Paragraph 4(1) of Schedule 9 of the Financial Services Act 2013, if you are applying

More information

HOSPITALISATION & SURGICAL CLAIM FORM / BORANG TUNTUTAN HOSPITAL & PEMBEDAHAN

HOSPITALISATION & SURGICAL CLAIM FORM / BORANG TUNTUTAN HOSPITAL & PEMBEDAHAN AmMetLife Insurance Berhad (15743-P) (Formerly known as AmLife Insurance Berhad) Licensed Insurer Level 19, Menara AmMetLife, No. 1, Jalan Lumut, 50400 Kuala Lumpur 1300 88 8800 +603 2171 3000 customercare@ammetlife.com

More information

PEMBERITAHUAN CATATAN NOTES. Hanya BNCP ASAL yang ditetapkan oleh LHDNM akan diterima. Menggunakan salinan fotostat BNCP adalah tidak dibenarkan.

PEMBERITAHUAN CATATAN NOTES. Hanya BNCP ASAL yang ditetapkan oleh LHDNM akan diterima. Menggunakan salinan fotostat BNCP adalah tidak dibenarkan. KRITERIA BORANG NYATA CUKAI PENDAPATAN (BNCP) TIDAK LENGKAP YANG TIDAK BOLEH DITERIMA CRITERIA ON INCOMPLETE INCOME TAX RETURN FORM (ITRF) WHICH IS UNACCEPTABLE PEMBERITAHUAN BNCP TIDAK LENGKAP YANG TIDAK

More information

BORANG CADANGAN TAKAFUL KEDIAMAN SAHAJA TAKAFUL PROPOSAL FORM - RESIDENTIAL ONLY

BORANG CADANGAN TAKAFUL KEDIAMAN SAHAJA TAKAFUL PROPOSAL FORM - RESIDENTIAL ONLY TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

GST 01 PERMOHONAN PENDAFTARAN CUKAI BARANG DAN PERKHIDMATAN APPLICATION FOR GOODS AND SERVICES TAX REGISTRATION

GST 01 PERMOHONAN PENDAFTARAN CUKAI BARANG DAN PERKHIDMATAN APPLICATION FOR GOODS AND SERVICES TAX REGISTRATION Panduan di bawah akan membantu anda mengisi borang yang berkaitan dengan permohonan anda. The guideline below will assist you in filling in the form relating to your application. GST 01 PERMOHONAN PENDAFTARAN

More information

BORANG CADANGAN IKHLAS PLATE GLASS TAKAFUL IKHLAS PLATE GLASS TAKAFUL PROPOSAL FORM

BORANG CADANGAN IKHLAS PLATE GLASS TAKAFUL IKHLAS PLATE GLASS TAKAFUL PROPOSAL FORM TAKAFUL IKHLAS SDN BHD. (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

LIVING CARE. Critical Illness Insurance

LIVING CARE. Critical Illness Insurance LIVING CARE Critical Illness Insurance PREMIUM TABLE ANNUAL PREMIUM (RM) (excluding Service Tax and Stamp Duty)/ SUM INSURED (RM) Attained Age 50,000 100,000 150,000 200,000 250,000 (Next Birthday) Male

More information

Foreign Workers Compensation Scheme (FWCS) Proposal Form

Foreign Workers Compensation Scheme (FWCS) Proposal Form Foreign Workers Compensation Scheme (FWCS) Proposal Form SCHEDULE 9 OF THE FINANCIAL SERVICES ACT 2013 (FSA) Pursuant to Paragraph 4(1) of Schedule 9 of the Financial Services Act 2013, if you are applying

More information

YAYASAN BURSA MALAYSIA SCHOLARSHIP PROGRAMME Scholarship Application Form 2018/2019

YAYASAN BURSA MALAYSIA SCHOLARSHIP PROGRAMME Scholarship Application Form 2018/2019 YAYASAN BURSA MALAYSIA SCHOLARSHIP PROGRAMME Scholarship Application Form 2018/2019 Paste a recent passport-sized photograph here. A. Personal Particulars Date of birth: Place of birth: Age: Citizenship:

More information

JABATAN KASTAM DIRAJA MALAYSIA ROYAL MALAYSIAN CUSTOMS DEPARTMENT

JABATAN KASTAM DIRAJA MALAYSIA ROYAL MALAYSIAN CUSTOMS DEPARTMENT JABATAN KASTAM DIRAJA MALAYSIA ROYAL MALAYSIAN CUSTOMS DEPARTMENT GST - 01 PERMOHONAN PENDAFTARAN CUKAI BARANG DAN PERKHIDMATAN APPLICATION FOR GOODS AND SERVICES TAX REGISTRATION Nota Penting (Important

More information

GROUP TERM LIFE ASSURANCE SCHEME (CELCOM-BIMA) - ANNEXURE

GROUP TERM LIFE ASSURANCE SCHEME (CELCOM-BIMA) - ANNEXURE GROUP TERM LIFE ASSURANCE SCHEME (CELCOM-BIMA) - ANNEXURE This Annexure forms part of the Group Term Life Assurance Scheme certificate of insurance ( Certificate of Insurance ) to which it is attached

More information

Agent s Tel No. / No. Tel Ejen : Agent s / Emel Ejen : Branch Code / Kod Cawangan :

Agent s Tel No. / No. Tel Ejen : Agent s  / Emel Ejen : Branch Code / Kod Cawangan : HEAD OFFICE/ IBU PEJABAT: Syarikat Takaful Malaysia Am Berhad (1246486-D) 26th Floor, Annexe Block, Menara Takaful Malaysia No. 4, Jalan Sultan Sulaiman, 50000 Kuala Lumpur P.O. Box 11483, 50746 Kuala

More information

BORANG CADANGAN IKHLAS (RETAIL NIAGA) IKHLAS NIAGA TAKAFUL (RETAIL NIAGA) PROPOSAL FORM

BORANG CADANGAN IKHLAS (RETAIL NIAGA) IKHLAS NIAGA TAKAFUL (RETAIL NIAGA) PROPOSAL FORM TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point, Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9696 Fax : 03-2723 9998 Website : www.takaful-ikhlas.com.my (Anak

More information

i-biz Muamalat Application Form Borang Permohonan Aplikasi i-biz Muamalat

i-biz Muamalat Application Form Borang Permohonan Aplikasi i-biz Muamalat i-biz Muamalat Application Form Borang Permohonan Aplikasi i-biz Muamalat A Enquiry (E) Subscription Type / Jenis Langganan Please mark the box(es) below with x / Sila isi kotak di bawah dengan x Payment

More information

KRITERIA BORANG NYATA CUKAI PENDAPATAN (BNCP) TIDAK LENGKAP CRITERIA ON INCOMPLETE INCOME TAX RETURN FORM (ITRF) PEMBERITAHUAN

KRITERIA BORANG NYATA CUKAI PENDAPATAN (BNCP) TIDAK LENGKAP CRITERIA ON INCOMPLETE INCOME TAX RETURN FORM (ITRF) PEMBERITAHUAN KRITERIA BORANG NYATA CUKAI PENDAPATAN (BNCP) TIDAK LENGKAP CRITERIA ON INCOMPLETE INCOME TAX RETURN FORM (ITRF) PEMBERITAHUAN (Pin. 1/2014) MULAI 1 JANUARI 2012, BNCP YANG TIDAK LENGKAP AKAN DIPULANGKAN

More information

TAX INVOICE / INVOIS CUKAI INVOICE NO. NO. INVOIS DATE TARIKH GST REGISTRATION NO. NO. PENDAFTARAN GST : POLITEKNIK KUCHING SARAWAK

TAX INVOICE / INVOIS CUKAI INVOICE NO. NO. INVOIS DATE TARIKH GST REGISTRATION NO. NO. PENDAFTARAN GST : POLITEKNIK KUCHING SARAWAK POLITEKNIK SARAWAK KM. 22 JALAN MATANG TAX INVOICE / INVOIS CUKAI INVOICE NO. NO. INVOIS DATE TARIKH GST REGISTRATION NO. NO. PENDAFTARAN GST : TI-GEN-2018-07-00094836 : 24/07/2018 : 000082276352 06-103-GCA02264

More information

PERMOHONAN SURAT PENYELESAIAN CUKAI BAGI SYARIKAT, PERKONGSIAN LIABILITI TERHAD (PLT) DAN ENTITI LABUAN (SYARIKAT LABUAN & PLT LABUAN)

PERMOHONAN SURAT PENYELESAIAN CUKAI BAGI SYARIKAT, PERKONGSIAN LIABILITI TERHAD (PLT) DAN ENTITI LABUAN (SYARIKAT LABUAN & PLT LABUAN) GARIS PANDUAN OPERASI BIL. 3 TAHUN 2016 LEMBAGA HASIL DALAM NEGERI MALAYSIA PERMOHONAN SURAT PENYELESAIAN CUKAI BAGI SYARIKAT, PERKONGSIAN LIABILITI TERHAD (PLT) DAN ENTITI LABUAN (SYARIKAT LABUAN & PLT

More information

BORANG CADANGAN IKHLAS PUBLIC LIABILITY TAKAFUL IKHLAS PUBLIC LIABILITY TAKAFUL PROPOSAL FORM

BORANG CADANGAN IKHLAS PUBLIC LIABILITY TAKAFUL IKHLAS PUBLIC LIABILITY TAKAFUL PROPOSAL FORM TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

Apartment and Condominium Insurance Package

Apartment and Condominium Insurance Package Apartment and Condominium Insurance Package APARTMENT AND CONDOMINIUM INSURANCE PACKAGE Anything can happen at any time. Protect the property under your management and get covered with our Apartment and

More information

M A X I S M O B I L E S E R V I C E S S D N B H D T 1 C P

M A X I S M O B I L E S E R V I C E S S D N B H D T 1 C P M A X I S M O B I L E S E R V I C E S S D N B H D 7 3 3 1 5 - T 1 C P - 8 1 6 7 0 6 ACE Jerneh Insurance Berhad (9827-A) Wisma ACE Jerneh, 38 Jalan Sultan Ismail 50250 Kuala Lumpur Malaysia Tel 03 2058

More information

Date : 07/05/2014. This product will compensate you in the event of permanent disability or death caused by Accident.

Date : 07/05/2014. This product will compensate you in the event of permanent disability or death caused by Accident. PRODUCT DISCLOSURE SHEET (Read this Product Disclosure Sheet before you decide to participate in the IKHLAS Perdana P.A. Takaful. Be sure to also read the general terms and conditions.) 1) What is this

More information

BORANG CADANGAN UNTUK IKHLAS FLEXI-EB TAKAFUL / PROPOSAL FORM FOR IKHLAS FLEXI-EB TAKAFUL

BORANG CADANGAN UNTUK IKHLAS FLEXI-EB TAKAFUL / PROPOSAL FORM FOR IKHLAS FLEXI-EB TAKAFUL TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS POINT,Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Telephone No : 03-2723 9999 Fax No : 03-2723 9998 Website : www.takaful-ikhlas.com.my

More information

PERFECT RIDER 24hr PROPOSAL FORM / BORANG CADANGAN PERFECT RIDER 24hr Cover Note No. No. Nota Perlindungan Name of Proposer Nama Pencadang NRIC / Passport No. No. Kad Pengenalan / Pasport Business Registration

More information

NO. RUJUKAN CUKAI PENDAPATAN: INCOME TAX REFERENCE NO. :... CAWANGAN LEMBAGA HASIL DALAM NEGERI: BRANCH OF INLAND REVENUE BOARD :...

NO. RUJUKAN CUKAI PENDAPATAN: INCOME TAX REFERENCE NO. :... CAWANGAN LEMBAGA HASIL DALAM NEGERI: BRANCH OF INLAND REVENUE BOARD :... JABATAN DASAR PERCUKAIAN, IBU PEJABAT LEMBAGA HASIL DALAM NEGERI MALAYSIA, MENARA HASIL, ARAS 17, PERSIARAN RIMBA PERMAI, CYBER 8, 63000 CYBERJAYA, SELANGOR. ---------------------------------------------------------------------------------------------------------

More information

Date: 07/05/2014. Please refer to the Takaful Certificate contract for more information.

Date: 07/05/2014. Please refer to the Takaful Certificate contract for more information. PRODUCT DISCLOSURE SHEET (Read this Product Disclosure Sheet before you decide to participate in the IKHLAS Fidelity Guarantee Takaful. Be sure to also read the general terms and conditions.) 1) What is

More information

BORANG CADANGAN IKHLAS ERECTION ALL RISKS TAKAFUL IKHLAS ERECTION ALL RISKS TAKAFUL PROPOSAL FORM

BORANG CADANGAN IKHLAS ERECTION ALL RISKS TAKAFUL IKHLAS ERECTION ALL RISKS TAKAFUL PROPOSAL FORM TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9696 (General Line) Fax : 03-2723 9998 (General Fax Line) Website

More information

BORANG CADANGAN IKHLAS NIAGA TAKAFUL (CLINIC NIAGA) IKHLAS NIAGA TAKAFUL (CLINIC NIAGA) PROPOSAL FORM

BORANG CADANGAN IKHLAS NIAGA TAKAFUL (CLINIC NIAGA) IKHLAS NIAGA TAKAFUL (CLINIC NIAGA) PROPOSAL FORM TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point, Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9696 Fax : 03-2723 9998 Website : www.takaful-ikhlas.com.my (Anak

More information

GUW-PFR002/00 Individual PA (01/06/11) A.BUTIRAN PENCADANG / THE PROPOSER. 1. Nama Name. Encik Mr. 2. Gelaran Title. Cik Ms. Dr Dr. Tuan Mr.

GUW-PFR002/00 Individual PA (01/06/11) A.BUTIRAN PENCADANG / THE PROPOSER. 1. Nama Name. Encik Mr. 2. Gelaran Title. Cik Ms. Dr Dr. Tuan Mr. TAKAFUL IKHLAS SDN BHD (593075 u) IKHLAS Point Tower 11A, Avenue 5 Bangsar South No. 8 Jalan Kerinchi 59200 Kuala Lumpur Telephone No: 03-2723 9999 Fax No: 03-2723 9998 Website: www.takaful-ikhlas.com.my

More information

MEDISECURE BOOSTER POLICY (Hospitalisation & Surgical Insurance) POLISI MEDISECURE BOOSTER (Insurans Hospital dan Pembedahan)

MEDISECURE BOOSTER POLICY (Hospitalisation & Surgical Insurance) POLISI MEDISECURE BOOSTER (Insurans Hospital dan Pembedahan) MEDISECURE BOOSTER POLICY (Hospitalisation & Surgical Insurance) POLISI MEDISECURE BOOSTER (Insurans Hospital dan Pembedahan) FOR CONSUMER INSURANCE CONTRACTS (INSURANCE WHOLLY FOR PURPOSES UNRELATED TO

More information

BORANG CADANGAN IKHLAS MOTORIST PA TAKAFUL IKHLAS MOTORIST PA TAKAFUL PROPOSAL FORM

BORANG CADANGAN IKHLAS MOTORIST PA TAKAFUL IKHLAS MOTORIST PA TAKAFUL PROPOSAL FORM TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9696 (General Line) Fax : 03-2723 9998 (General Fax Line) Website

More information

NO. RUJUKAN CUKAI PENDAPATAN: INCOME TAX REFERENCE NO. :... CAWANGAN LEMBAGA HASIL DALAM NEGERI: BRANCH OF INLAND REVENUE BOARD :...

NO. RUJUKAN CUKAI PENDAPATAN: INCOME TAX REFERENCE NO. :... CAWANGAN LEMBAGA HASIL DALAM NEGERI: BRANCH OF INLAND REVENUE BOARD :... JABATAN DASAR PERCUKAIAN, IBU PEJABAT LEMBAGA HASIL DALAM NEGERI MALAYSIA, MENARA HASIL, ARAS 17, PERSIARAN RIMBA PERMAI, CYBER 8, 63000 CYBERJAYA, SELANGOR. ---------------------------------------------------------------------------------------------------------------------------

More information

THE PORTABLE & PERSONAL MEDICAL PLAN

THE PORTABLE & PERSONAL MEDICAL PLAN A-Health Maximiser THE PORTABLE & PERSONAL MEDICAL HEALTH PLAN Maximising your protection to meet your changing needs Purchase with AIA PRS to fund your retirement years aia.com.my A-Health Maximiser Maximising

More information

BORANG CADANGAN TAKAFUL SEMUA RISIKO (HARTA BENDA PERIBADI) ALL RISKS TAKAFUL PROPOSAL FORM (PERSONAL EFFECTS)

BORANG CADANGAN TAKAFUL SEMUA RISIKO (HARTA BENDA PERIBADI) ALL RISKS TAKAFUL PROPOSAL FORM (PERSONAL EFFECTS) BORANG CADANGAN TAKAFUL SEMUA RISIKO (HARTA BENDA PERIBADI) ALL RISKS TAKAFUL PROPOSAL FORM (PERSONAL EFFECTS) NOTIS PENTING Kontrak Takaful Pengguna Menurut Perenggan 5 dari Jadual 9 Akta Perkhidmatan

More information

AmBank Credit Card Fee & Charges

AmBank Credit Card Fee & Charges AmBank Credit Card Fee & Charges Annual Fee Minimum Monthly Payment Finance Charges Cash Advance Fee Late Payment Interest Free Period Excess Limit Fee Credit Balance Refund Fee Free For Life 5% of the

More information

Please refer to the Takaful Certificate contract for more information.

Please refer to the Takaful Certificate contract for more information. PRODUCT DISCLOSURE SHEET (Read this Product Disclosure Sheet before you decide to take out the IKHLAS Foreign Worker Compensation Scheme Takaful. Be sure to also read the general terms and conditions.)

More information

Date: 07/05/2014. This product provides Takaful protection against incidents of theft to your property.

Date: 07/05/2014. This product provides Takaful protection against incidents of theft to your property. PRODUCT DISCLOSURE SHEET (Read this Product Disclosure Sheet before you decide to participate in the IKHLAS Burglary Takaful. Be sure to also read the general terms and conditions.) 1) What is this product

More information

BORANG CADANGAN "IKHLAS FIRE TAKAFUL - NON-RESIDENTIAL" PROPOSAL FORM FOR "IKHLAS FIRE TAKAFUL - NON-RESIDENTIAL"

BORANG CADANGAN IKHLAS FIRE TAKAFUL - NON-RESIDENTIAL PROPOSAL FORM FOR IKHLAS FIRE TAKAFUL - NON-RESIDENTIAL TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9696 (Call Centre) Fax : 03-2723 9998 (General Fax Line) Website

More information

ING INSURANCE SCHOLARSHIP APPLICATION CHECKLIST

ING INSURANCE SCHOLARSHIP APPLICATION CHECKLIST ING INSURANCE SCHOLARSHIP APPLICATION CHECKLIST Students are required to enclose copies of the following documents together with the ING Insurance Scholarship Application form: 1. Identity card 2. Diploma,

More information

Personal Accident (General) Application Form

Personal Accident (General) Application Form Personal Accident (General) Application Form IMPORTANT NOTE Pursuant to Paragraph 5 of Schedule 9 of the Financial Services Act 2013, if you are applying for this Insurance wholly for purposes unrelated

More information

1 of 5. Policy No. / Nombor Polisi. Name of Proposed Insured Nama Hayat yang Dicadangkan

1 of 5. Policy No. / Nombor Polisi. Name of Proposed Insured Nama Hayat yang Dicadangkan Application No. / Nombor Permohonan Questionnaire on Beneficial Owner Soal Selidik Mengenai Pemunya Benefisial Caution: Please complete this questionnaire if your Beneficial Owner is NOT the Proposed Insured

More information

INDUSTRY TRANSFORMATION INITIATIVE REGISTRATION FORM

INDUSTRY TRANSFORMATION INITIATIVE REGISTRATION FORM Local (KL and Selangor): RM180 per participant Please register me for: INDUSTRY TRANSFORMATION INITIATIVE REGISTRATION FORM Outstation (other states including East Malaysia): RM220 per participant Please

More information

(Mandatory / Mandatori)

(Mandatory / Mandatori) RM120,000 (Mandatory / Mandatori) All statements will be sent via e-mail/semua penyata bulanan akan dihantar melalui e-mel ** ** I hereby confirm that this is my valid e-mail for statement delivery / Dengan

More information

BORANG CADANGAN IKHLAS BURGLARY TAKAFUL IKHLAS BURGLARY TAKAFUL PROPOSAL FORM

BORANG CADANGAN IKHLAS BURGLARY TAKAFUL IKHLAS BURGLARY TAKAFUL PROPOSAL FORM TAKAFUL IKHLAS SDN BHD. (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

TAKAFUL AMANI. Date: 07/05/2014

TAKAFUL AMANI. Date: 07/05/2014 PRODUCT DISCLOSURE SHEET (Read this Product Disclosure Sheet before you decide to participate in the Takaful Amani. Be sure to also read the general terms and conditions.) 1) What is this product about?

More information

Borang Cadangan Liability Awam Public Liability Proposal Form

Borang Cadangan Liability Awam Public Liability Proposal Form Borang Cadangan Liability Awam Public Liability Proposal Form NOTIS PENTING Kontrak Takaful Pengguna Menurut Perenggan 5 dari Jadual 9 Akta Perkhidmatan Kewangan Islam 2013, jika anda memohon takaful ini

More information

EQUIPMENT ALL RISKS TAKAFUL PROPOSAL FORM / BORANG CADANGAN TAKAFUL PERALATAN SEMUA RISIKO

EQUIPMENT ALL RISKS TAKAFUL PROPOSAL FORM / BORANG CADANGAN TAKAFUL PERALATAN SEMUA RISIKO HEAD OFFICE/ IBU PEJABAT: SYARIKAT TAKAFUL MALAYSIA BERHAD(131646-K) 26th Floor, Annexe Block, Menara Takaful Malaysia, No 4. Jalan Sultan Sulaiman, 50000 Kuala Lumpur, P.O Box 11483, 50746 Kuala Lumpur

More information

PERINTAH CUKAI KEUNTUNGAN HARTA TANAH (PENGECUALIAN) 2015 REAL PROPERTY GAINS TAX (EXEMPTION) ORDER 2015

PERINTAH CUKAI KEUNTUNGAN HARTA TANAH (PENGECUALIAN) 2015 REAL PROPERTY GAINS TAX (EXEMPTION) ORDER 2015 WARTA KERAJAAN PERSEKUTUAN 22 Disember 2015 22 December 2015 P.U. (A) 302 FEDERAL GOVERNMENT GAZETTE PERINTAH CUKAI KEUNTUNGAN HARTA TANAH (PENGECUALIAN) 2015 REAL PROPERTY GAINS TAX (EXEMPTION) ORDER

More information

BURGLARY TAKAFUL PROPOSAL FORM / BORANG CADANGAN TAKAFUL KECURIAN

BURGLARY TAKAFUL PROPOSAL FORM / BORANG CADANGAN TAKAFUL KECURIAN HEAD OFFICE/ IBU PEJABAT: SYARIKAT TAKAFUL MALAYSIA BERHAD(131646-K) 26th Floor, Annexe Block, Menara Takaful Malaysia, No 4. Jalan Sultan Sulaiman, 50000 Kuala Lumpur, P.O Box 11483, 50746 Kuala Lumpur

More information

Applicable for AmBank Credit Card b) 1.42% per month or 17% p.a. if you have promptly settled your minimum payment due for 10 consecutive months

Applicable for AmBank Credit Card b) 1.42% per month or 17% p.a. if you have promptly settled your minimum payment due for 10 consecutive months AmBank Credit Cards: Fees & Charges (Effective 1 June 2018) (Fees stated below are applicable for these cards unless stated otherwise, AmBank SIGNATURE Priority Banking World Mastercard, AmBank SIGNATURE

More information

Polisi Pemain Golf. Golfer s Policy

Polisi Pemain Golf. Golfer s Policy Polisi Pemain Golf Golfer s Policy Bahawasanya Pemegang Insurans (seterusnya dirujuk sebagai Majikan) yang dinyatakan di dalam Jadual ini, menerusi Cadangan dan Perakuan bersama surat-menyurat yang berkaitan

More information

BORANG CADANGAN IKHLAS GROUP PERSONAL ACCIDENT TAKAFUL IKHLAS GROUP PERSONAL ACCIDENT TAKAFUL PROPOSAL FORM

BORANG CADANGAN IKHLAS GROUP PERSONAL ACCIDENT TAKAFUL IKHLAS GROUP PERSONAL ACCIDENT TAKAFUL PROPOSAL FORM TAKAFUL IKHLAS BERHAD (593075 U) IKHLAS Point Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 (General Line) Fax : 03-2723 9998 (General Fax Line) Call

More information

PRODUCT DISCLOSURE SHEET

PRODUCT DISCLOSURE SHEET PRODUCT DISCLOSURE SHEET (Please read this Product Disclosure Sheet before you decide to take up the Credit Card Balance Transfer. Please be sure to also read the terms and conditions governing Balance

More information

My Auto Personal Accident Cover

My Auto Personal Accident Cover My Auto Personal Accident Cover My Auto Personal Accident Cover Coverage a. Any person who is travelling in the Insured Vehicle. Age limits in respect of each insured person: 5 to 70 Extended Coverage

More information

NOMINATION FORM / BORANG PENAMAAN

NOMINATION FORM / BORANG PENAMAAN Policy Number / Nombor Polisi NOMINATION FORM / BORANG PENAMAAN Name of Policy Owner / Nama Pemegang Polisi NRIC/Birth Certificate/Passport No. / No K.P/Sijil Kelahiran/Paspot Name of Life Assured / Nama

More information

Course Title Date Venue. Name (as in NRIC/Passport) NRIC/Passport No. Designation Company & Address

Course Title Date Venue. Name (as in NRIC/Passport) NRIC/Passport No.  Designation Company & Address Capital Market Director Programme (CMDP) REGISTRATION FORM A. PROGRAMME MODULES Please tick ( ) Course Title Date Venue Fee (RM) GST (6%) Total Fee (RM) Module 1: Directors as gatekeepers of market participants

More information

TAKAFUL myhome CONTENT PROPOSAL FORM / BORANG CADANGAN TAKAFUL myhome CONTENT

TAKAFUL myhome CONTENT PROPOSAL FORM / BORANG CADANGAN TAKAFUL myhome CONTENT HEAD OFFICE/ IBU PEJABAT: Syarikat Takaful Malaysia Am Berhad (1246486-D) 26th Floor, Annexe Block, Menara Takaful Malaysia No. 4, Jalan Sultan Sulaiman, 50000 Kuala Lumpur P.O. Box 11483, 50746 Kuala

More information

As charged in accordance to 2 Hospital Supplies & Services

As charged in accordance to 2 Hospital Supplies & Services FOREIGN WORKERS HOSPITALIZATION & SURGICAL (FWHS/SKHPPA) Product Disclosure Sheet (Please read this Product Disclosure Sheet before you decide to take out this insurance. Be sure to also read the general

More information

PRODUCT DISCLOSURE SHEET

PRODUCT DISCLOSURE SHEET PRODUCT DISCLOSURE SHEET Read this Product Disclosure Sheet before you decide to apply for the Trade Services Facility. Please be sure to also read the Terms and Conditions as stated in the Agreement.

More information

- - No. icert / icert No.

- - No. icert / icert No. BORANG PERMOHONAN PENAMAAN BARU / PENUKARAN PENAMAAN (HIBAH TAKAFUL / WASI TAKAFUL) REQUEST FOR NEW NOMINATION / CHANGE OF NOMINATION FORM (TAKAFUL HIBAH / TAKAFUL WASI) No. icert / icert No. Nombor Sijil/Certificate

More information

ABSOLUTE DEED OF ASSIGNMENT

ABSOLUTE DEED OF ASSIGNMENT ABSOLUTE DEED OF ASSIGNMENT RM10.00 Stamping Fee I, whose name and particulars are set out in Part 1 of the Schedule, (hereinafter called the Participant) for the consideration set out in Part 2 of the

More information

i-am PROTECT PROPOSAL FORM / BORANG CADANGAN i-am PROTECT

i-am PROTECT PROPOSAL FORM / BORANG CADANGAN i-am PROTECT i-am PROTECT PROPOSAL FORM / BORANG CADANGAN i-am PROTECT Proposal No. / No. Cadangan IMPORTANT NOTICE / NOTIS PENTING: You are responsible to disclose in this proposal form fully and faithfully all the

More information

FOR INTERNAL USE ONLY Account No. Date Opened D D M M Y Y Y Y Resident/External Ac. (R/E)

FOR INTERNAL USE ONLY Account No. Date Opened D D M M Y Y Y Y Resident/External Ac. (R/E) FOR INTERNAL USE ONLY Account No. Date Opened D D M M Y Y Y Y Resident/External Ac. (R/E) ACCOUNT OPENING APPLICATION FORM (INDIVIDUAL / JOINT) / BORANG PERMOHONAN MEMBUKA AKAUN (INDIVIDU / BERSAMA) Applicant

More information

ACCIDENT CLAIM FORM / BORANG TUNTUTAN KEMALANGAN

ACCIDENT CLAIM FORM / BORANG TUNTUTAN KEMALANGAN AmMetLife Insurance Berhad (15743-P) (Formerly known as AmLife Insurance Berhad) Licensed Insurer Level 19, Menara AmMetLife,. 1, Jalan Lumut, 50400 Kuala Lumpur 1300 88 8800 +603 2171 3000 customercare@ammetlife.com

More information

BIMB HOLDINGS BERHAD (Company No X) (Incorporated in Malaysia under the Companies Act, 1965)

BIMB HOLDINGS BERHAD (Company No X) (Incorporated in Malaysia under the Companies Act, 1965) NOTICE OF ELECTION THIS NOTICE OF ELECTION IS IMPORTANT AND REQUIRES YOUR IMMEDIATE ATTENTION AND IS TO BE READ IN CONJUNCTION WITH THE DIVIDEND REINVESTMENT PLAN ( DRP ) STATEMENT ( DRP STATEMENT ). TERMS

More information

FOREIGN WORKER INSURANCE GUARANTEE PROPOSAL FORM BORANG CADANGAN JAMINAN INSURANS PEKERJA ASING

FOREIGN WORKER INSURANCE GUARANTEE PROPOSAL FORM BORANG CADANGAN JAMINAN INSURANS PEKERJA ASING MSIG Insurance (Malaysia) Bhd (46983-W) Head Office: Customer Service Centre, Level 15, Menara Hap Seng 2, Plaza Hap Seng, No. 1, Jalan P. Ramlee, 50250 Kuala Lumpur Tel +603 2050 8228, Fax +603 2026 8086,

More information

THE ESSENTIAL PROTECTIONS

THE ESSENTIAL PROTECTIONS Allianz MISC Combo THE ESSENTIAL PROTECTIONS FOR SMALL MANUFACTURERS AND INDEPENDENT RETAILERS PERLINDUNGAN ASAS UNTUK PENGILANG KECIL DAN PERUNCIT BEBAS Allianz General Insurance Company (Malaysia) Berhad

More information

BORANG CADANGAN IKHLAS RETAIL NIAGA IKHLAS NIAGA TAKAFUL (RETAIL NIAGA) PROPOSAL FORM

BORANG CADANGAN IKHLAS RETAIL NIAGA IKHLAS NIAGA TAKAFUL (RETAIL NIAGA) PROPOSAL FORM A. IKHLAS Point, Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur Tel : 03-2723 9999 Fax : 03-2723 9998 Call Centre No : 03-2723 9696 Website : www.takaful-ikhlas.com.my PENCADANG

More information

DEATH CLAIM FORM (CREDIT LIFE) BORANG TUNTUTAN KEMATIAN (TAKAFUL HAYAT KREDIT)

DEATH CLAIM FORM (CREDIT LIFE) BORANG TUNTUTAN KEMATIAN (TAKAFUL HAYAT KREDIT) AIA PUBLIC Takaful Bhd. (935955-M) Collection Station Stesen Kutipan DEATH CLAIM FORM (CREDIT LIFE) BORANG TUNTUTAN KEMATIAN (TAKAFUL HAYAT KREDIT) PART 1 : INFORMATION ON THE MASTER CERTIFICATE HOLDER

More information

LONG TERM HOUSEOWNER S TAKAFUL PROPOSAL FORM / BORANG CADANGAN TAKAFUL PEMILIK RUMAH KEDIAMAN JANGKA PANJANG

LONG TERM HOUSEOWNER S TAKAFUL PROPOSAL FORM / BORANG CADANGAN TAKAFUL PEMILIK RUMAH KEDIAMAN JANGKA PANJANG HEAD OFFICE/ IBU PEJABAT: SYARIKAT TAKAFUL MALAYSIA BERHAD(131646-K) 26th Floor, Annexe Block, Menara Takaful Malaysia, No 4. Jalan Sultan Sulaiman, 50000 Kuala Lumpur, P.O Box 11483, 50746 Kuala Lumpur

More information