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.:MV4959542
1.Index Mark and Vehicle Registration No. CDY958
2.Name of Participant MOHD EHSAN BIN ABU HASSAN
3.I/C No. 880706-56-5117
4.Effective date of Commencement of Takaful for the purposes of the Ordinance 22/02/2019
5.Date of Expiry of Takaful 21/02/2020
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 : MOHD EHSAN BIN ABU HASSAN NRIC : 880706-56-5117
The Participant : NRIC :
Alamat : BLOK 41-01-08 FLAT SRI PERAK, No Pendaftaran Perniagaan :
Address : BANDAR BARU SENTUL, Business Registration No :
51000 KUALA LUMPUR,
W.P. KUALA LUMPUR
Perkerjaan atau berniaga : OTHERS
Profession or Business :
Jenis Sijil : MOTOR CYCLE Pada : 22-02-2019
Class of Certificate : On :
Dikeluarkan & ditandatangani di : Kod Agensi : GW00217
Issued & signed at : Agency Code :
Rujukan Sijil : MV4959542
Certificate Ref. No. :
Tempoh Takaful : Tarikh tandatangan
Period of Takaful : Pengakuan &
borang :
a) Mula 22/02/2019 Tamat 21/02/2020 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 : CDY958 Sumbangan Asas : 179.69
Registration No : Basic Contribution :
Buatan & Model : SYM - BX110
Make & Type of body :
Keupayaan Padu : 110CC Kelayakan NCD (15.00) : 26.95
Cubic Capacity : NCD (15.00) :
Ruang duduk termasuk pemandu : 2 Perlindungan Tambahan :
Seating capacity including driver : Extra-Benefits :
Tahun di buat : 2018 NIL
Year of Manufacture :
No. Enjin : VMVX3S4H115351 Jumlah Kecil : 152.74
Engine No : Sub-Total :
No. Casis : RLGSC11VHHH115355 Rebat (10.00%): 15.27
Chassis No : Rebate (10.00%):
Jumlah Perlindungan : 1,000.00 Cukai Perkhidmatan (6.00%): 8.25
Sum Covered : Service Tax (6.00%):
Ekses : 100.00 Cukai setem : 10.00
Excess : Stamp Duty :
No. Pembaharuan Sijil : NIL Jumlah Pembayaran : 155.71
Renewal of Certificate No : Total Payable :
Sumbangan Akta : 49.67
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 :
M94 - COMPULSORY EXCESS - DAMAGE CLAIMS
M96 - INTOXICATION CLAUSE
M99 - INDEMNITY IN THE EVENT OF TOTAL LOSS CLAUSE
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