Mutual Benefits Assurance Plc.

Aret Adams House, 233 Ikorodu Road, Ilupeju - Lagos. P.O.Box 70986, Victoria Island, Lagos. RC 269837
Tel: 09054644444, 09054744444 Fax:
Email: info@mutualng.com Website: http://www.mutualng.com

MOTOR VEHICLES (THIRD PARTY INSURANCE) ORDINANCE, ACT, 1945 (NIGERIA)

CERTIFICATE OF INSURANCE W.A.X.1

Certificate No. 647689ID

Policy No. PRM/15/4/00032/17

1. Index mark and registration

number of vehicle KJA978AZ Veh. Make: TOYOTA COROLLA
2. Name of Policy holder SANNI SULIYAT AMOKE
3. Effective date of the commencement of insurance for the
purpose of the Ordinance(s)
07-May-2021
4. Date of Expiry of insurance 06-May-2022
5. Persons or classes of persons entitled to drive*
(a) The Policy Holder. The Policy Holder may also drive a Motor Car not belonging to him and not hired to him under a hire-purchase
agreement.
(b) Any other person who is driving on the Policy holder\'s order or with his permission. Provided that the person driving is permitted in
accordance with the licensing or other laws or regulations to drive the Motor Car or has been permitted and is not disqualified by order
of a Court of Law or by reason of any enactment or regulation in that behalf from driving such Motor Car.

6. Limitations as to use* THIRD PARTY ONLY

Use only for social domestic and pleasure purposes and for the Policy holder\'s business
The Policy does not cover use for hire or reward or for racing Pace-Making reliability trial speed-testing or use for purpose in
connection with the Motor Trade.

* Limitations rendered inoperative by the provisions of the Motor Vehicles (Third Party Insurance) Ordinance, 1945 (Nigeria), the
Motor vehicles (Third Party Insurance) Act, 1958 (Ghana), the Motor Vehicles (Third Party Insurance) Ordinance, 1948 (Gambia)
and the Motor Vehicles (Third Party Insurance) Ordinance, 1949 (Sierra Leone) are not to be included under this heading

I/WE HEREBY CERTIFY that the policy to which this certificate relates is issued in accordance with the provisions of the Motor Vehicles
(Third Party Insurance) Ordinance, 1945 (Nigeria), the Motor vehicles (Third Party Insurance) Act, 1958 (Ghana), the Motor Vehicles (Third
Party Insurance) Ordinance, 1948 (Gambia), and the Motor Vehicles (Third Party Insurance) Ordinance, 1949 (Sierra Leone).

Mutual Benefits Assurance Plc.

(Approved Insurers) RC 269837

PRM/15/4/00032/17-647689ID http://www.askniid.org Managing Director

 Mutual Benefits Assurance Plc.
Aret Adams House, 233 Ikorodu Road, Ilupeju - Lagos. P.O.Box 70986, Victoria Island, Lagos. RC 269837
Tel: 09054644444, 09054744444 Fax:
Email: info@mutualng.com Website: http://www.mutualng.com

CASH R21039176ID 07/05/2021

Received from: SANNI SULIYAT AMOKE

The Sum of: Five Thousand Naira Only

In Respect of: PREMIUM DUE ON POLICY PRM/15/4/00032/17 - DN2021036062ID ...

Total Amount: NGN 5,000.00

Cheque Particulars: 314289889054[ 314289889054 ]

Payment Type: NEW BUSINESS Payment Status: GROSS

Officer: USER@ONLINE
Print Date: Friday, 7th May, 2021 For: Mutual

P o w e r e d b y T C P D F ( w w w . t c p d f . o r g )