TAKAFUL IKHLAS GENERAL BERHAD (1233870-A)

IKHLAS Point, Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur.
Tel: 03-2723 9999 Fax: 03-2723 9998 Website: www.takaful-ikhlas.com.my
(Licensed under Islamic Financial Services Act2013
and regulated by Bank Negara Malaysia)

CERTIFICATE OF TAKAFUL
JPJA1MY3
Road Transport Act, 1987 ( Malaysia )
Motor Vehicles (Third Party Risks) Rules, 1959 (Malaysia)
Motor Vehicles (Third Party Risks & Compensation) Act (Cap 189) Republic of Singapore
Motor Vehicles (Third Party Risks& Compensation) Rules 1960 (Republic of Singapore)
Motor Vehicles Insurance ( Third Party Risks) Act (Cap 90) Negara Brunei Darulsalam

Certificate No.:MV6468644
1.Index Mark and Vehicle Registration No. JHL6792
2.Name of Participant SYAHRIL AZMY BIN BAKAR
3.I/C No. 721129-04-5163
4.Effective date of Commencement of Takaful for the purposes of the Ordinance 28/06/2022
5.Date of Expiry of Takaful 27/06/2023
6. Persons or Classes of Person Entitled to Drive. *
(a) The Participant. (b) Any other person who is driving on the Participant's order or with their permission.
Provided that the person driving is permitted in accordance with the licensing or other laws or regulations to drive the Motor Vehicle or has been so 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 the Motor Vehicle.
7. Limitation as to Use. *
Use for social, domestic and pleasure purposes and by the Participants in person in connection with his business or profession.
The Policy does not cover :
(1) Use for hire or reward
(2) Use for racing, pace-making,reliability trial,speed-testing
(3) Use for the carriage of goods (other than samples) in connection with any trade or business
(4) Use for any purpose in connection with the Motor Trade.
*Limitation rendered inoperative by Section 95 of the Road Transport Act 1987 (Malaysia) or Section 8 of the Motor Vehicles (Third Party Risks and
Commpensation) Act (Cap 189) Republic of Singapore or Section 7 of the Motor Vehicles Insurance (Third Party Risks) Act (Cap 90) Negara Brunei
Darussalam are not included under this heading.

I/WE CERTIFY THAT THIS COVERING NOTE IS ISSUED IN ACCORDANCE WITH THE PROVISIONS OF PART IV OF THE ROAD TRANSPORT ACT,
1987 (MALAYSIA), MOTOR VEHICLES (THIRD PARTY RISKS & COMPENSATION) ACT (CAP 189) REPUBLIC OF SINGAPORE AND THE MOTOR
VEHICLES INSURANCE (THIRD PARTY RISKS) ACT (CAP 90) NEGARA BRUNEI DARUSSALAM
Untuk dan bagi pihak / For and on behalf of
TAKAFUL IKHLAS GENERAL BERHAD

-----------------------------------------------------------
Tandatangan Diberi Kuasa / Authorised Signatory
 TAKAFUL IKHLAS GENERAL BERHAD (1233870-A)
IKHLAS Point, Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur.
Tel: 03-2723 9999 Fax: 03-2723 9998 Website: www.takaful-ikhlas.com.my
(Licensed under Islamic Financial Services Act2013
and regulated by Bank Negara Malaysia)

Bantuan Ikhlas Toll-Free Number : 1800 88 1186

STAMP DUTY PAID

THE SCHEDULE MY3

Peserta : SYAHRIL AZMY BIN BAKAR NRIC : 721129-04-5163
The Participant : NRIC :
Alamat : NO 21 JALAN NIBONG 52, No Pendaftaran Perniagaan :
Address : TAMAN DAYA, Business Registration No :
81100 JOHOR BAHRU,
JOHOR
Perkerjaan atau berniaga : OTHERS
Profession or Business :
Jenis Sijil : MOTOR CYCLE Pada : 28-06-2022
Class of Certificate : On :
Dikeluarkan & ditandatangani di : Kod Agensi : GO09489
Issued & signed at : Agency Code :
Rujukan Sijil : MV6468644
Certificate Ref. No. :
Tempoh Takaful : Tarikh tandatangan
Period of Takaful : Pengakuan &
borang :
a) Mula 28/06/2022 Tamat 27/06/2023 Date of signature of
From To Proposal & declaration :
(Termasuk kedua-dua tarikh ) (both dates inclusive )
b)Mana-mana tempoh selanjutnya Peserta membayar dan Syarikat bersetuju menerima sumbangan pembaharuan.
Any subsequent period for which the participant shall pay and the Companyshall agree to accept a renewal contribution.
BUTIR KENDERAAN SUMBANGAN SIJIL (RM)
THE MOTOR VEHICLE THE CERTIFICATE'S CONTRIBUTION (RM)
No. Pendaftaran : JHL6792 Sumbangan Asas : 195.69
Registration No : Basic Contribution :
Buatan & Model : MODENAS - KRIS
Make & Type of body :
Keupayaan Padu : 111CC Kelayakan NCD (25.00) : 48.92
Cubic Capacity : NCD (25.00) :
Ruang duduk termasuk pemandu : 5 Perlindungan Tambahan :
Seating capacity including driver : Extra-Benefits :
Tahun di buat : 2004 NIL
Year of Manufacture :
No. Enjin : AN110FELP2886 Jumlah Kecil : 146.77
Engine No : Sub-Total :
No. Casis : PMNAN110F4MLN2896 Rebat (0.00%): 0.00
Chassis No : Rebate (0.00%):
Jumlah Perlindungan : 1,000.00 Cukai Perkhidmatan (6.00%): 8.81
Sum Covered : Service Tax (6.00%):
Ekses : 100.00 Cukai setem : 10.00
Excess : Stamp Duty :
No. Pembaharuan Sijil : NIL Jumlah Pembayaran : 165.58
Renewal of Certificate No : Total Payable :
Sumbangan Akta : 131.88
Act Contribution :
Sewa beli / Syarikat menyewa / Majikan : NIL
Hire Purchase/Leasing Company/Employer :
Nama Pemandu : All Rider
Named Drivers :
Tertakluk kepada endorsemen-endorsemen berikutnya :
Subject to the following operative endorsements attached :
M113 - REFERENCE TO MOTOR VEHICLE MARKET VALUATION SYSTEM
P65 - WAQAF / ENDOWMENT
Mana-mana orang yang dibenarkan memandu dan had atas kegunaan adalah termaktub dalam Sijil Untuk dan bagi pihak / For and on behalf of
Takaful yang dikeluarkan sehubungan dengan Sijil ini. TAKAFUL IKHLAS GENERAL BERHAD
Person or classes of persons entitled to Drive and limitations as to use, are as Specified in the
Certificate of Takaful Issued in relation to this Certificate

_______________________________
Tandatangan Diberi Kuasa / Authorised Signatory
 TAKAFUL IKHLAS GENERAL BERHAD (1233870-A)
IKHLAS Point, Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur.
T: +603-27239696 F : +603-27239998 Website : http://www.takaful-ikhlas.com.my
(Licensed under Islamic Financial Services Act 2013 and regulated by Bank Negara Malaysia)

Encik/Cik/Puan SYAHRIL AZMY BIN BAKAR

NO 21 JALAN NIBONG 52,
TAMAN DAYA,
81100 JOHOR BAHRU JOHOR

IKHLAS Waqf & Endowment (IWE)

Tahniah dan Terima Kasih kerana memilih Takaful IKHLAS sebagai pengendali Takaful pilihan anda bagi
Motor MOTOR CYCLE Comprehensive dengan Sijil bernombor MV6468644.

Sebagai tanda penghargaan, sukacita dimaklumkan anda layak mendapat IKHLAS Waqf & Endowment
(IWE) bernilai RM1,000.00 secara PERCUMA*.

Layari laman web www.takaful-ikhlas.com.my untuk maklumat lanjut atau hubungi kami di talian 03-
27239696/emel ikhlascare@takaful-ikhlas.com.my

Yang IKHLAS,

Tandatangan Diberi Kuasa

* tertakluk kepada terma dan syarat