E-Receipt

Acknowledgement No. : AC23029441

Receipt No : 101*2023040450
Payment Date : 22 Mar 202312:13:33PM
Pay Mode : WEB FPX @ ICMS

SULAIMAN BIN IBRAHIM

NO 17, KAMPUNG BUKIT NYAMOK
MUKIM KURONG HITAM
06300 KUALA NERANG

Application/Certificate No : A230100153
Participant Name : SULAIMAN BIN IBRAHIM
Person Covered : SULWAN AL ESHAN ARFAN BIN SULAIMAN

Payment Description Due Date Amount (RM)

Contribution N/A RM 55.00

Next Due Date / Tarikh Seterusnya : N/A

Payable / Dibayar :

Agent : NURUL IZZATI IBRAHIM

Payment received by Zurich Takaful Malaysia Berhad under the application for Takaful Family
Coverage will be treated as deposit until the application is approved. When we receive the application
form with the deposit, we will issue interim coverage to the applicant applying for coverage, subject to
terms and conditions as per below:
Terms & Conditions :
a. Acceptance of payment is subject to the terms and conditions of the Takaful certificate,
application forms or any requirements or conditions set by the company.
b. Total benefits of the interim Takaful Family Coverage with effect on the applicant applying for
coverage will not exceed RM500,000.
c. If the application for Takaful coverage is not accepted as stated in paragraph (a), or the applicant
applying for coverage requests for cancellation, no Takaful coverage will take effect and the
contribution will be returned.
d. Should the Company offer Takaful coverage other than those applied at the standard contribution
rate and the applicant accepts the offered Takaful coverage within the stipulated time frame
prescribed by the company, these payments shall apply as the first contribution and the Takaful
coverage certificate will take effect.
e. When coverage for the Takaful certificate takes effect, payment for the contribution is
non-refundable, except for the further amount required to provide the maximum period of Takaful
coverage for this receipt.
f. Death of applicants applying for coverage must be caused directly and solely by accidental means
as defined in paragraph (g) below and subject to exemptions in the Takaful Coverage Plan applied
for.
g. Accidental is defined as a sudden, unintentional, unexpected, unusual and specific in time and
place identified, to be independent of any other reason, as the only reason for bodily injury.
h. Interim coverage commences from the date of this receipt and is effective for 90 days from the date
of this receipt (inclusive).
i. Notwithstanding paragraph (h), this interim coverage will terminate on the date that the company:
(i)issues a Takaful certificate (ii)declines the application for Takaful family
(iii)makes a counter offer (iv)requests for further deposit, or (v)requests for insurable
interest,whichever is earlier.
This is computer generated document. No signature required.
010638100466781172825192260125618760
 E-Receipt

Acknowledgement No. : AC23029441

Receipt No : 101*2023040449
Payment Date : 22 Mar 202312:13:33PM
Pay Mode : WEB FPX @ ICMS

SULAIMAN BIN IBRAHIM

NO 17, KAMPUNG BUKIT NYAMOK
MUKIM KURONG HITAM
06300 KUALA NERANG

Application/Certificate No : A230100122
Participant Name : SULAIMAN BIN IBRAHIM
Person Covered : SULWAN AL-ESHAN ARYAN BIN SULAIMAN

Payment Description Due Date Amount (RM)

Contribution N/A RM 85.00

Next Due Date / Tarikh Seterusnya : N/A

Payable / Dibayar :

Agent : NURUL IZZATI IBRAHIM

Payment received by Zurich Takaful Malaysia Berhad under the application for Takaful Family
Coverage will be treated as deposit until the application is approved. When we receive the application
form with the deposit, we will issue interim coverage to the applicant applying for coverage, subject to
terms and conditions as per below:
Terms & Conditions :
a. Acceptance of payment is subject to the terms and conditions of the Takaful certificate,
application forms or any requirements or conditions set by the company.
b. Total benefits of the interim Takaful Family Coverage with effect on the applicant applying for
coverage will not exceed RM500,000.
c. If the application for Takaful coverage is not accepted as stated in paragraph (a), or the applicant
applying for coverage requests for cancellation, no Takaful coverage will take effect and the
contribution will be returned.
d. Should the Company offer Takaful coverage other than those applied at the standard contribution
rate and the applicant accepts the offered Takaful coverage within the stipulated time frame
prescribed by the company, these payments shall apply as the first contribution and the Takaful
coverage certificate will take effect.
e. When coverage for the Takaful certificate takes effect, payment for the contribution is
non-refundable, except for the further amount required to provide the maximum period of Takaful
coverage for this receipt.
f. Death of applicants applying for coverage must be caused directly and solely by accidental means
as defined in paragraph (g) below and subject to exemptions in the Takaful Coverage Plan applied
for.
g. Accidental is defined as a sudden, unintentional, unexpected, unusual and specific in time and
place identified, to be independent of any other reason, as the only reason for bodily injury.
h. Interim coverage commences from the date of this receipt and is effective for 90 days from the date
of this receipt (inclusive).
i. Notwithstanding paragraph (h), this interim coverage will terminate on the date that the company:
(i)issues a Takaful certificate (ii)declines the application for Takaful family
(iii)makes a counter offer (iv)requests for further deposit, or (v)requests for insurable
interest,whichever is earlier.
This is computer generated document. No signature required.
010635000466771472825186032125618760
 E-Receipt

Acknowledgement No. : AC23029441

Receipt No : 101*2023040448
Payment Date : 22 Mar 202312:13:33PM
Pay Mode : WEB FPX @ ICMS

SULAIMAN BIN IBRAHIM

NO 17, KAMPUNG BUKIT NYAMOK
MUKIM KURONG HITAM
06300 KUALA NERANG

Application/Certificate No : A230100031
Participant Name : SULAIMAN BIN IBRAHIM
Person Covered : SULAIMAN BIN IBRAHIM

Payment Description Due Date Amount (RM)

Contribution N/A RM 93.12

Next Due Date / Tarikh Seterusnya : N/A

Payable / Dibayar :

Agent : NURUL IZZATI IBRAHIM

Payment received by Zurich Takaful Malaysia Berhad under the application for Takaful Family
Coverage will be treated as deposit until the application is approved. When we receive the application
form with the deposit, we will issue interim coverage to the applicant applying for coverage, subject to
terms and conditions as per below:
Terms & Conditions :
a. Acceptance of payment is subject to the terms and conditions of the Takaful certificate,
application forms or any requirements or conditions set by the company.
b. Total benefits of the interim Takaful Family Coverage with effect on the applicant applying for
coverage will not exceed RM500,000.
c. If the application for Takaful coverage is not accepted as stated in paragraph (a), or the applicant
applying for coverage requests for cancellation, no Takaful coverage will take effect and the
contribution will be returned.
d. Should the Company offer Takaful coverage other than those applied at the standard contribution
rate and the applicant accepts the offered Takaful coverage within the stipulated time frame
prescribed by the company, these payments shall apply as the first contribution and the Takaful
coverage certificate will take effect.
e. When coverage for the Takaful certificate takes effect, payment for the contribution is
non-refundable, except for the further amount required to provide the maximum period of Takaful
coverage for this receipt.
f. Death of applicants applying for coverage must be caused directly and solely by accidental means
as defined in paragraph (g) below and subject to exemptions in the Takaful Coverage Plan applied
for.
g. Accidental is defined as a sudden, unintentional, unexpected, unusual and specific in time and
place identified, to be independent of any other reason, as the only reason for bodily injury.
h. Interim coverage commences from the date of this receipt and is effective for 90 days from the date
of this receipt (inclusive).
i. Notwithstanding paragraph (h), this interim coverage will terminate on the date that the company:
(i)issues a Takaful certificate (ii)declines the application for Takaful family
(iii)makes a counter offer (iv)requests for further deposit, or (v)requests for insurable
interest,whichever is earlier.
This is computer generated document. No signature required.
010625900466761554025186032125618760