ALC Rubber Stamp CERTIFICATE TRANSFER REQUEST

TO : Agency Administration, FWD Takaful

Kindly transfer* the below certificates to the rightful servicing agent as they are unable to be contracted timely due to movement
issue from previous Company (Add/Delete rows based on number of records).

No Certificate NO Current Servicing Agent (Code) Signature New Servicing Agent Signature

I approve the above transfer ALC Leader Name: (Signature)

Code:
Date:

____________________________________________________________________________________________
FOR FWD USE: Verified By : Transfer Processed By :
Date : Completion Date :
Note: Policy cannot be transferred twice.