CONFIRMATION OF PURCHASE OF TAKAFUL

E-C/Note No : T62703E-21000072
Issue Date & Time : 28 DEC 2021 09:27:57am
Period of Takaful : From 28 DEC 2021 To 27 DEC 2022
Vehicle Registration No. : MCY5796
Make of Vehicle : TOYOTA HILUX G VNT 1GD-FTV 6 SP AUTO SPR ECT & SQTL
Engine No. : 1GD4310911 Chassis No. : PN1BA3CD003687582
Capacity : 2755 CC Year of Make : 2017
Participant Name : WONG ING KIEW
Address : NO 3A, LORONG 17,JALAN GAMBIR,96000,SIBU,SARAWAK
NRIC/Business Reg No. : 640817-13-5862
Type of Cover : V-CO MOTOR COMPREHENSIVE
Product : PRIVATE CAR - Z-DRIVER TAKAFUL
HP Owner : PUBLIC BANK BERHAD
Sum Covered (RM) : 90,000
Transaction Type : New
Claims Excess : RM0.00
Voluntary Excess : RM 0.00

Sum Covered (RM) 90,000 Contribution (RM) 2,276.37

All Rider (Y/N) N All Rider Amt (RM) 0.00
NCD % 55.00 % NCD Amt (RM) 1,252.00
Voluntary Excess (RM) (0.00)

Basic Net (RM) 1,024.37

Tuition Load % 0% Tuition Load Amt (RM) 0.00

Extra Coverage (RM) 20.00
SST 6.00 % SST (RM) 62.66
Stamp Duty (RM) 10.00
Z-DRIVE ASSIST (RM) 89.18
TAKAFUL

Act Contribution (RM) 153.66 Payable Contribution (RM) 1,206.21

Extra Benefits Extra Covered (RM) Extra Contribution (RM)

AUTHORISED DRIVER 0 20.00
Z-DRIVE ASSIST TAKAFUL (including contribution for extra coverage whenever is 250,000.00 89.18
applicable, SST and stamp duty)

Named Drivers
ALL DRIVERS

Agent : T62703E-000 UNIQUE TAKAFUL INSURANCE AGENCY

Tel No : 086-315885 011-10525885

THIS IS A COMPUTER GENERATED FORM, SIGNATURE IS NOT REQUIRED. Page 1 of 1

Z-DRIVE ROADSIDE ASSISTANCE
24 Hours HOTLINE Number: - 1300 88 6222
These value-added benefits entitle you to Roadside Assistance program twenty -four (24) hours a day, three hundred sixty-five (365) days a year,
anywhere in Malaysia only. The services will only be rendered to the Registered Vehicle in the event of breakdown during the period of Takaful. The
Insured/driver of the Registered Vehicle must call the 24-Hour HOTLINE number 1300-88-6222 to request for the services below.
(a) Minor Roadside Breakdown
In the event that the Registered Vehicle is immobilized due to breakdown, you can contact 24-Hours Hotline for assistance. Should it be deemed
possible to repair the Registered Vehicle on the spot, We shall arrange for such minor roadside repair. In the event it is not possible to repair the car
on site, paragraph (b) shall be applicable. We shall organize and pay for labour cost for roadside repair up to a maximum labour of One hour (1) per
event. We shall not be responsible for any cost incurred for spare parts required during the Minor Roadside Repairs. We shall not be responsible to
ensure the authenticity or genuine parts are used by the workshop or repairer.
(b) 24-Hour Emergency Towing
If your car breakdown and it is not possible to repair the car on the site, we shall assist to tow the car to Your preferred workshop. Additional cost of
towing is approximately RM2.00 per km (round-trip) shall be borne and paid by the Insured /driver, and the cost of towing may vary according to the
prevailing market rates (applicable to Private Car Comprehensive only). Toll charges shall be borne by You. The twenty -four (24) hours emergency
towing services shall be made available in the event the Registered Vehicle is immobilized anywhere in Peninsular Malaysia excluding islands except
for Penang and on the Island of Langkawi. In East Malaysia, the towing service shall only be available at major towns and on the island of Labuan.
Private Car
Breakdown Towing Limits (KM)
Comprehensive Only Z Drive Assist with/without Private Car policy
New Certificate 150 KM Unlimited
Renewal Certificate 300 KM Unlimited

Limitations and Exclusion of Service

We shall not be liable or to provide the services under paragraph (a) and (b) above under the following circumstances:
1. Services which are not organized or pre-approved directly by Us.
2. Towing in the event of an accident.
3. If the Registered Vehicle is or has been modified for participation in legitimate or illegitimate rally and racing or modified against government regulations .
4. Service provision outside the territorial limits stated.
5. Failure of the Insured/driver and/or passenger(s) of the Registered Vehicle to take reasonable precautions or to follow warnings of any intended strike , riot or civil
commotion via the mass media.
6. Any commercial vehicle or vehicles not registered to receive this Services.
7. If your vehicle is registered as A and C Permit vehicle .
8. When the car keys are not available or locked inside the Registered Vehicle .
9. When there is no mechanical part in the Registered Vehicle , such as no engine or transmission.
10. Towing of a Registered Vehicle for the purpose of disposing the vehicle .
11. Towing of a Registered Vehicle for the purpose of transferring the vehicle from one workshop to another .
12. No valid road tax disc displayed on the Registered Vehicle .
13. Towing a stolen Registered Vehicle which has been discovered , abandoned or due to vandalism.
14. Registered Vehicle that has been dismantled fully or partly in a workshop with or without the consent of the Insured / driver.
15. Towing a Registered Vehicle that is greater weight than for which it was designed as stated in the manufacturer 's specifications.
16. Towing a Registered Vehicle which registration number does not match with the number registered with Us .
17. Towing a Registered Vehicle due to catastrophe events or Act of God such as earthquake , landslip, landslide or other convulsion of nature is involved.
18. If the Registered Vehicle suffers a mechanical breakdown and is immobilized on an unpaved road surface or on a road that is not a gazette road .
19. If the Registered Vehicle requires the use of special equipment during the roadside repair or towing process .
20. Transportation for the Registered Vehicle's driver to the vehicle for service or from the vehicle to another destination after service has been rendered.
21. Towing at the direction of a law enforcement office related to traffic obstruction , impoundment, abandonment, illegal parking or other violations of the law.
22. Any cost on parts and cost of repair at the workshop or service centre.

We shall not be responsible to render the service or to bear any costs and expenses in respect of or under the following circumstances:
1. Services not organized directly by the Us.
2. Service outside the territorial limits stated.
3. Cost of repair or replacement of parts.
4. Petrol, parking fees, accommodation and telephone charges.
5. When the car keys are not available or locked inside Your Car .
6. When Your Car do not have an engine or mechanical parts .
7. When towing is for the reason to dispose Your Car .
8. Towing for discovered stolen of Your Car or abandoned vehicle .
9. When towing is for a reason of transferring Your Car from one workshop to another workshop .
10. When there is no valid road tax disc displayed on Your Car .
11. Tow Your Car after it has been sent for a spray job .
12. If Your Car is or has been modified for participation in rally or racing , or if the Your Car has been modified against government regulations .
13. Failure of the Insured to take reasonable precautions or to follow warnings of any intended strike, riot or civil commotion via the mass media.
14. Any illegal or unlawful act by You or the use of Your Car for any unlawful or illegal purposes .
15. Towing or repair of any motorcycles and commercial Named Vehicles such as but not limited to lorries , trucks, wagons, taxis etc.
We reserve the right to refuse assisting and towing of such vehicles .
16. When special towing and/or special equipment is required during the course of providing the towing services for Your Car which , in the sole opinion
of the Company, are considered high risk and/or reasonably impracticable. For example, when the car or car tyre fall into the drain or river.
17. When Your Car is on an unpaved road surface or on a road that is not a gazette road of the road systems of Malaysia .
18. When Your Car can still be driven.
19. When the breakdown of Your Car is due to forget to fill up fuel or pumped in wrong fuel to Your Car .
20. When second towing of Your Car is requested for one same incident .
 PRIVATE CAR
KERETA PERSENDIRIAN
THE SCHEDULE JADUAL
ORIGINAL COPY SALINAN ASAL

Agent Code (Kod Ejen) : T62703E-000 (BINTULU) Date (Tarikh) 28 DEC 2021
UNIQUE TAKAFUL INSURANCE AGENCY Receipt No.
(No. Resit)
Replacing Cover Note No. : T62703E-21000072
(Menggantikan Nota Lindung No.) ACT (ACT) : RM 153.66
Certificate No. (No. Sijil) : 652150000694-00 Basic Contribution : RM 2,276.37
The Participant : WONG ING KIEW
(Peserta)

Address (Alamat) : NO 3A, LORONG 17,JALAN GAMBIR, 96000 SIBU, SARAWAK

NCD:55.00% : RM 1,252.00
Voluntary Excess : RM 0.00
Business Reg. No. (No. Sykt.) : Extra Cover : RM 20.00
I/C No. New (No. K/P Baru) : 640817-13-5862 Old I/C No.(No. K/P Lama) :
Gross Contribution : RM 1,044.37
Business / Profession (Perniagaan / Pekerjaan) : OTHERS
Hire Purchase Owners (Pemilik Sewa Beli ) : PUBLIC BANK BERHAD SST: 6.00% : RM 62.66
Employer / Lessors (Majikan / Pemajak) : Stamp Duty : RM 10.00
(DUTI SETEM)
Period of Coverage (a) From (Dari) : 28 DEC 2021 To (Hingga) : 27 DEC 2022
(Tempoh Perlindungan)
: 09:27AM Total Contribution : RM 1,117.03
Time To Midnight : 11:59:59 pm (JUMLAH)
(b) Any subsequent period for which you shall pay and we shall
agree to accept a renewal contribution
Sebarang tempoh selanjutnya untuk mana anda membayar dan kami bersetuju
menerima caruman pembaharuan
The Motor Vehicle Any of the following (Mana - mana daripada yang berikut): Kenderaan Motor
Registration No. Make Type of Body Cubic Capacity Year of Seating Capacity Your Estimate of Value
Manufacture Including Driver Including Accessories
No. Pendaftaran Buatan Jenis Badan Keupayaan Enjin Tahun Diperbuat Muatan Tempat Duduk Nilai Anggaran Anda
termasuk Pemandu termasuk Aksesori
MCY5796 TOYOTA 4D 2755 CC 2017 5 RM90,000.00
HILUX G DOUBLE
CAB
Date of Signature of Proposal and Declaration Claims Excess : RM 0.00 Engine (Enjin) : 1GD4310911
Tarikh Cadangan dan Perakuan Ditandatangan (Ekses Tuntutan) Chassis (Casis) : PN1BA3CD003687582
Subject to the terms and conditions of the Certificate and endorsement as numbered below :
Tertakluk kepada peraturan - peraturan dan syarat - syarat Sijil dan pengendorsan seperti disenaraikan di bawah :
Named Driver : 1) ALL DRIVERS
Include Endorsement No :15,30,100,W1
Additional Extra Coverage/Endorsements :-
Code Description Sum Covered Contribution
01A AUTHORISED DRIVER 0 20.00

Excess(Ekses)
Excess is the first amount that you are required to pay towards a claim you make on your vehicle. Claims excess is the amount of excess determined
by Company based on your risk profile. Voluntary Excess is the amount of excess that is chosen by you in return for a lower contribution. In addition ,
Compulsory Excess may apply depending on the circumstances defined in the certificate.

Ekses adalah amaun pertama yang Anda perlu tanggung bagi setiap tuntutan yang dibuat. Ekses Tuntutan adalah ekses yang ditentukan oleh
Syarikat berdasarkan profil risiko Anda. Ekses Sukarela adalah ekses amaun yang dipilih oleh Anda sebagai balasan caruman sijil dikurangkan.
Di samping itu, terdapat Ekses Wajib di mana Anda perlu tanggung seperti yang dinyatakan di dalam sijil ini.

LEGISLATION:-
Road Transport Act, 1987 (Malaysia) Motor Vehicles (Third Party Risks and Compensation) Act (Cap 189) Republic of Singapore Motor Vehicles (Third Party Risks and
Compensation) Rules (Republic of Singapore) Motor Vehicles Takaful (Third Party Risks) Act (Cap 90) Negara Brunei Darussalam (the reference to legislation under the
heading "Avoidance of Certain Terms and Right of Recovery" is limited to Section 94, 95 and 96 of the Road Transport Act 1987 (Malaysia) Section 7, 8 and 9 of the Motor
Vehicles (Third Party Risks and Compensation) Act (Cap 189) Republic of Singapore and Section 7 of the Motor Vehicles Takaful (Third Party Risks) Act (Cap 90) Negara
Brunei Darussalam.
UNDANG - UNDANG:-
Akta Pengangkutan Jalan Raya, 1987 Malaysia, Akta Kenderaan Motor (Risiko Dan Pampasan Pihak Ketiga) (Cap 189) Republik Singapore, Peraturan Kenderaan Motor
(Risiko Dan Pampasan Pihak Ketiga) 1960 Republik Singapura, Akta Takaful Kenderaan Motor (Risiko Pihak Ketiga) (Cap 90) Negara Brunei Darussalam (rujukan kepada
undang - undang di bawah tajuk "Pengelakan Peraturan - Peraturan Dan Hak Tuntutan Tertentu" adalah terhad kepada Seksyen 94, 95 dan 96 Akta Pengangkutan Jalan
Raya, 1987 Malaysia. Seksyen 7, 8 dan 9 Akta Kenderaan Motor (Risiko Dan Pampasan Pihak Ketiga) (Cap 189) Republik Singapura, dan Seksyen 7 Akta Takaful
Kenderaan Motor (Risiko Pihak Ketiga) (Cap 90) Negara Brunei Darussalam).
Limits of Liability:-
Had Tanggungan: For and on behalf of / Untuk dan bagi pihak
Limit of the amount of Our Liability under Section B-1(a) .......... Unlimited ZURICH GENERAL TAKAFUL MALAYSIA
Had jumlah tanggungan Kami di bawah Seksyen B-1(a) ..........
BERHAD
Limit of the amount of Our Liability under Section B-1(b) .......... RM3,000,000.00
Had jumlah tanggungan Kami di bawah Seksyen B-1(b) ..........
Limitation as to Use : As shown in the Certificate of Takaful
Had Penggunaan
: Seperti ditunjukkan dalam Sijil Takaful
Geographical Area : Malaysia, Republic of Singapore and Negara Brunei Darussalam
Had Wilayah
: Malaysia, Republik Singapura dan Negara Brunei Darussalam
Authorised Driver : As shown in the Certificate of Takaful
Nazrul Hisham Abdul Hamid
Pemandu Yang Dibenarkan
: Seperti ditunjukkan dalam Sijil Takaful

Page 2 of 6
 PRIVATE CAR
KERETA PERSENDIRIAN
THE SCHEDULE JADUAL
FINANCIAL COPY SALINAN KEWANGAN

Agent Code (Kod Ejen) : T62703E-000 (BINTULU) Date (Tarikh) 28 DEC 2021
UNIQUE TAKAFUL INSURANCE AGENCY Receipt No.
(No. Resit)
Replacing Cover Note No. : T62703E-21000072
(Menggantikan Nota Lindung No.) ACT (ACT) : RM 153.66
Certificate No. (No. Sijil) : 652150000694-00 Basic Contribution : RM 2,276.37
The Participant : WONG ING KIEW
(Peserta)

Address (Alamat) : NO 3A, LORONG 17,JALAN GAMBIR, 96000 SIBU, SARAWAK

NCD:55.00% : RM 1,252.00
Voluntary Excess : RM 0.00
Business Reg. No. (No. Sykt.) : Extra Cover : RM 20.00
I/C No. New (No. K/P Baru) : 640817-13-5862 Old I/C No.(No. K/P Lama) :
Gross Contribution : RM 1,044.37
Business / Profession (Perniagaan / Pekerjaan) : OTHERS
Hire Purchase Owners (Pemilik Sewa Beli ) : PUBLIC BANK BERHAD SST: 6.00% : RM 62.66
Employer / Lessors (Majikan / Pemajak) : Stamp Duty : RM 10.00
(DUTI SETEM)
Period of Coverage (a) From (Dari) : 28 DEC 2021 To (Hingga) : 27 DEC 2022
(Tempoh Perlindungan)
: 09:27AM Total Contribution : RM 1,117.03
Time To Midnight : 11:59:59 pm (JUMLAH)
(b) Any subsequent period for which you shall pay and we shall
agree to accept a renewal contribution
Sebarang tempoh selanjutnya untuk mana anda membayar dan kami bersetuju
menerima caruman pembaharuan
The Motor Vehicle Any of the following (Mana - mana daripada yang berikut): Kenderaan Motor
Registration No. Make Type of Body Cubic Capacity Year of Seating Capacity Your Estimate of Value
Manufacture Including Driver Including Accessories
No. Pendaftaran Buatan Jenis Badan Keupayaan Enjin Tahun Diperbuat Muatan Tempat Duduk Nilai Anggaran Anda
termasuk Pemandu termasuk Aksesori
MCY5796 TOYOTA 4D 2755 CC 2017 5 RM90,000.00
HILUX G DOUBLE
CAB
Date of Signature of Proposal and Declaration Claims Excess : RM 0.00 Engine (Enjin) : 1GD4310911
Tarikh Cadangan dan Perakuan Ditandatangan (Ekses Tuntutan) Chassis (Casis) : PN1BA3CD003687582
Subject to the terms and conditions of the Certificate and endorsement as numbered below :
Tertakluk kepada peraturan - peraturan dan syarat - syarat Sijil dan pengendorsan seperti disenaraikan di bawah :
Named Driver : 1) ALL DRIVERS
Include Endorsement No :15,30,100,W1
Additional Extra Coverage/Endorsements :-
Code Description Sum Covered Contribution
01A AUTHORISED DRIVER 0 20.00

Excess(Ekses)
Excess is the first amount that you are required to pay towards a claim you make on your vehicle. Claims excess is the amount of excess determined
by Company based on your risk profile. Voluntary Excess is the amount of excess that is chosen by you in return for a lower contribution. In addition ,
Compulsory Excess may apply depending on the circumstances defined in the certificate.

Ekses adalah amaun pertama yang Anda perlu tanggung bagi setiap tuntutan yang dibuat. Ekses Tuntutan adalah ekses yang ditentukan oleh
Syarikat berdasarkan profil risiko Anda. Ekses Sukarela adalah ekses amaun yang dipilih oleh Anda sebagai balasan caruman sijil dikurangkan.
Di samping itu, terdapat Ekses Wajib di mana Anda perlu tanggung seperti yang dinyatakan di dalam sijil ini.

LEGISLATION:-
Road Transport Act, 1987 (Malaysia) Motor Vehicles (Third Party Risks and Compensation) Act (Cap 189) Republic of Singapore Motor Vehicles (Third Party Risks and
Compensation) Rules (Republic of Singapore) Motor Vehicles Takaful (Third Party Risks) Act (Cap 90) Negara Brunei Darussalam (the reference to legislation under the
heading "Avoidance of Certain Terms and Right of Recovery" is limited to Section 94, 95 and 96 of the Road Transport Act 1987 (Malaysia) Section 7, 8 and 9 of the Motor
Vehicles (Third Party Risks and Compensation) Act (Cap 189) Republic of Singapore and Section 7 of the Motor Vehicles Takaful (Third Party Risks) Act (Cap 90) Negara
Brunei Darussalam.
UNDANG - UNDANG:-
Akta Pengangkutan Jalan Raya, 1987 Malaysia, Akta Kenderaan Motor (Risiko Dan Pampasan Pihak Ketiga) (Cap 189) Republik Singapore, Peraturan Kenderaan Motor
(Risiko Dan Pampasan Pihak Ketiga) 1960 Republik Singapura, Akta Takaful Kenderaan Motor (Risiko Pihak Ketiga) (Cap 90) Negara Brunei Darussalam (rujukan kepada
undang - undang di bawah tajuk "Pengelakan Peraturan - Peraturan Dan Hak Tuntutan Tertentu" adalah terhad kepada Seksyen 94, 95 dan 96 Akta Pengangkutan Jalan
Raya, 1987 Malaysia. Seksyen 7, 8 dan 9 Akta Kenderaan Motor (Risiko Dan Pampasan Pihak Ketiga) (Cap 189) Republik Singapura, dan Seksyen 7 Akta Takaful
Kenderaan Motor (Risiko Pihak Ketiga) (Cap 90) Negara Brunei Darussalam).
Limits of Liability:-
Had Tanggungan: For and on behalf of / Untuk dan bagi pihak
Limit of the amount of Our Liability under Section B-1(a) .......... Unlimited ZURICH GENERAL TAKAFUL MALAYSIA
Had jumlah tanggungan Kami di bawah Seksyen B-1(a) ..........
BERHAD
Limit of the amount of Our Liability under Section B-1(b) .......... RM3,000,000.00
Had jumlah tanggungan Kami di bawah Seksyen B-1(b) ..........
Limitation as to Use : As shown in the Certificate of Takaful
Had Penggunaan
: Seperti ditunjukkan dalam Sijil Takaful
Geographical Area : Malaysia, Republic of Singapore and Negara Brunei Darussalam
Had Wilayah
: Malaysia, Republik Singapura dan Negara Brunei Darussalam
Authorised Driver : As shown in the Certificate of Takaful
Nazrul Hisham Abdul Hamid
Pemandu Yang Dibenarkan
: Seperti ditunjukkan dalam Sijil Takaful

Page 4 of 6
 PRIVATE CAR - Z-DRIVER TAKAFUL Code / Kod 18 MX1
CERTIFICATE OF TAKAFUL SIJIL TAKAFUL
ROAD TRANSPORT ACT, 1987 (MALAYSIA) AKTA PENGANGKUTAN JALAN RAYA, 1987 (MALAYSIA)
THE MOTOR VEHICLES (THIRD PARTY RISKS, RULES 1959 (MALAYSIA) PERATURAN KENDERAAN MOTOR (RISIKO PIHAK KETIGA) 1959 (MALAYSIA)
THE MOTOR VEHICLES (THIRD PARTY RISKS AND COMPENSATION) ACT AKTA KENDERAAN MOTOR (RISIKO DAN PAMPASAN PIHAK KETIGA) (CAP 189) (REPUBLIK SINGAPURA)
(CAP 189) (REPUBLIC OF SINGAPORE) PERATURAN KENDERAAN MOTOR (RISIKO DAN PAMPASAN PIHAK KETIGA) 1960 (REPUBLIK SINGAPURA),
THE MOTOR VEHICLES (THIRD PARTY RISKS AND COMPENSATION) RULES 1960 (REPUBLIC OF SINGAPORE) AKTA TAKAFUL KENDERAAN MOTOR (RISIKO PIHAK KETIGA) (CAP 90) NEGARA BRUNEI DARUSSALAM
THE MOTOR VEHICLES TAKAFUL (THIRD PARTY RISKS) ACT (CAP 90) NEGARA BRUNEI DARUSSALAM

Certificate No. (No. Sijil) : 652150000694-00 T62703E-000

1. Index Mark and Registration Number of Vehicle : MCY5796 NCD : 55.00 %

(Tanda Indeks dan Nombor Pendaftaran Kenderaan) : TOYOTA HILUX G VNT 1GD-FTV 6 SP AUTO SPR ECT & SQTL
2. Name of Certificate Holder (Nama Pemegang Sijil) : WONG ING KIEW
3. Effective date of the Commencement of Covered for the purposes of the Regulations, Ordinance of Enactment : 28 DEC 2021
(Tarikh Perlindungan Mula Berkuatkuasa bagi tujuan Peraturan - Peraturan, Ordinan atau Enakmen)
4. Date of Expiry of the Takaful (Tarikh Perlindungan Tamat) : 27 DEC 2022
5. Persons or Classes of Persons entitled to drive* (Orang atau Kelas Orang yang berhak memandu*) :

a) Policyholder b) Any other person who is driving on the Policyholder'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 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.

Limitation on Usage
Use only for social, domestic and pleasure purposes and for the participant's business or profession. The
certificate does not cover :- Use for hire or reward, racing, pace-making, reliability trial, speed- testing,
or the carriage of goods (other than samples) in connection with any trade or business or use for any purpose
in connection with Motor Trade.

* Limitations rendered inoperative by Section 95 of the Road Transport Act 1987 (Malaysia) or Section 8 of the Motor Vehicles (Third Party Risks and Compensation) Act (Cap 189) Republic of Singapore or Section 7
of the Motor Vehicles Takaful (Third Party Risks) Act (Cap 90) Negara Brunei Darussalam are not to be included under these heading.

* Had - had yang tidak lagi berkuatkuasa kerana Seksyen 95 Akta Pengangkutan Jalan Raya, 1987 (Malaysia) atau Sekyen 8 Akta Kenderaan Motor (Risiko Dan Pampasan Pihak Ketiga) (Cap 189)
Republik Singapura atau Seksyen 7 Akta Takaful Kenderaan Motor (Risiko Pihak Ketiga) (Cap 90) Negara Brunei Darussalam tidak boleh dimasukkan di bawah tajuk ini.

Covered in pursuance to cover Note No : T62703E-21000072

Dikeluarkan mengikut Nota lindungan No :

I / We hereby certify that the Certificate of Takaful to which the Certificate is issued
For and on behalf of / Untuk dan bagi pihak
in accordance with the provisions of Part IV of the Road Transport Act, 1987
ZURICH GENERAL TAKAFUL MALAYSIA
(Malaysia), Motor Vehicles (Third Party Risks & Compensation) Act (Cap 189)
BERHAD
Republic of Singapore and the Motor Vehicles Takaful (Third Party Risks) Act (Cap
90) Negara Brunei Darussalam.

Saya / Kami dengan ini mengesahkan bahawa Sijil Takaful yang berkaitan
dengan Sijil ini dikeluarkan selaras dengan peruntukan - peruntukan Bahagian IV Nazrul Hisham Abdul Hamid
Akta Pengankutan Jalan Raya, 1987 (Malaysia), Akta Kenderaan Motor (Risiko
Dan Pampasan Pihak Ketiga) (Cap 189) Republik Singapura dan Akta Takaful
Kenderaan Motor (Risiko Pihak Ketiga) (Cap 90) Negara Brunei Darussalam

Page 5 of 6
CERTIFICATE OF TAKAFUL

This Certificate is not transferable to a new owner of the Vehicle .

If for any reason the Coverage is terminated during its currency this Certificate must be returned to the Takaful Operator or if this Certificate has
been lost or destroyed a Statutory Declaration to that Effect must be made . Failure to comply with this obligation is an offence under the
compulsory Takaful Legislation.
This Certificate must be returned if the Coverage is suspended during its currency.

SIJIL TAKAFUL

Sijil ini tidak boleh dipindahkan kepada pemilik baru Kenderaan.

Jika atas sebarang sebab Perlindungan Takaful ini ditamatkan semasa ia masih berkuatkuasa Sijil ini mesti dipulangkan kepada Pengendali
Takaful atau jika Sijil ini telah hilang atau dimusnahkan , satu Pengakuan Berkanun menyatakan demikian mesti dibuat. Kegagalan untuk
mematuhi kewajipan ini adalah satu kesalahan di bawah Undang - Undang Takaful wajib.

Sijil ini mesti dipulangkan jika Perlindungan digantung semasa ia masih berkuatkuasa.

IMPORTANT NOTICE
If you are involved in an accident causing injury to any person or damage to any property or other vehicle you must :
(a) Try to obtain names and address of any witness to the accident.
(b) Report to the Takaful Operator immediately.
(c) Refer to the Takaful Operator immediately all communications received from the Police Authorities.
(d) Send to the Takaful Operator immediately all letters from Third Parties unanswered.
(e) Not to pay money to any Party involved in the accident without the Takaful Operator's written permission.

NOTIS PENTING
Sekiranya anda terlibat di dalam sebarang kemalangan yang menyebabkan kecacatan kepada sesiapa atau kerosakan
kepada sebarang harta benda atau sebarang kereta anda mesti :
(a) Cuba mendapatkan saksi-saksi kepada kemalangan itu.
(b) Melaporkan kepada Pengendali Takaful dengan segera.
(c) Merujuk kepada Pengendali Takaful dengan segera segala perhubungan yang diterima daripada pihak berkuasa Polis.
(d) Mengirimkan kepada Pengendali Takaful dengan segera semua surat - surat yang diterima dari pihak - pihak lain tanpa
berjawab.
(e) Jangan membayar wang kepada sebarang pihak yang terlibat di dalam kemalangan itu tanpa mendapat kebenaran

I / We hereby certify that the Certificate of Takaful to which the Certificate is issued For and on behalf of / Untuk dan bagi pihak
in accordance with the provisions of Part IV of the Road Transport Act, 1987 ZURICH GENERAL TAKAFUL MALAYSIA
(Malaysia), Motor Vehicles (Third Party Risks & Compensation) Act (Cap 189) BERHAD
Republic of Singapore and the Motor Vehicles Takaful (Third Party Risks) Act (Cap
90) Negara Brunei Darussalam.

Saya / Kami dengan ini mengesahkan bahawa Sijil Takaful yang berkaitan
dengan Sijil ini dikeluarkan selaras dengan peruntukan - peruntukan Bahagian IV
Nazrul Hisham Abdul Hamid
Akta Pengankutan Jalan Raya, 1987 (Malaysia), Akta Kenderaan Motor (Risiko
Dan Pampasan Pihak Ketiga) (Cap 189) Republik Singapura dan Akta Takaful
Kenderaan Motor (Risiko Pihak Ketiga) (Cap 90) Negara Brunei Darussalam

Page 6 of 6
 Z-DRIVE ASSIST TAKAFUL

THE SCHEDULE(JADUAL)

Certificate No(No Sijil) : 652150000695-00 Basic Contribution : (RM) 83.00

(Caruman Asas)
The Participant(Peserta) : WONG ING KIEW Extra Cover Contribution : (RM) 0.00
(Caruman Perlindungan Tambahan)

Multi-Product Discount : (RM) (10.00)

(Diskaun Pelbagai Produk)

Stamp Duty(Duti Setem) : (RM) 10.00

SST (6.00%) (SST) : (RM) 4.48
Address(Alamat) : NO 3A, LORONG 17,JALAN GAMBIR Total Contribution(Jumlah Caruman) : (RM) 89.18
96000 SIBU SARAWAK
SARAWAK
NRIC/ Company No : 640817-13-5862
(NRIC/No. Sykt)

Vehicle Details
Vehicle Regn. No Year of Make Make/Model Seating capacity
(No Pendaftaran Kenderaaan) (Tahun dibuat) (Buatan) (Muatan Tempat
Duduk termasuk Pemandu)

MCY5796 2017 TOYOTA HILUX G VNT 1GD-FTV 6 SP AUTO SPR ECT & SQT 5

Period of Takaful(Tempoh Perlindungan Takaful) :

(a) From(Dari) 28 Dec 2021 to(Hingga) 27 Dec 2022 (both dates inclusive - termasuk kedua-dua tarikh)
(b) Any subsequent period for which the Participant person shall pay and the Company shall agree to accept a renewal
contribution.
(Sebarang tempoh selanjutnya untuk mana anda membayar dan kami bersetuju menerima caruman pembaharuan).

Plan Type : BASIC PLAN

(Jenis Pelan : Pelan Asas)

BASIC COVERAGE(Perlindungan Asas)

Benefits (Manfaat) Benefits Description (Keterangan Manfaat) Sum Covered (Jumlah Perlindungan)
A Accidental Death (Kematian akibat Kemalangan) RM50,000 per person (setiap orang)

B Accidental Permanent Disablement RM50,000 per person (setiap orang)

(Hilang Upaya Kekal akibat Kemalangan)

C Medical Expenses (Perbelanjaan Perubatan akibat Kemalangan) RM3,000 per person (setiap orang)

D Daily Hospital Income RM50 per day(setiap hari)

(Pendapatan Harian Hospital) up to maximum of 30 days
(maksimum sehingga 30 hari)

E Towing & Roadside Assistance Benefit Unlimited

(Penundaan Kereta dan Bantuan Tepi Jalan) (Tiada Limit)

F Courtesy Car (Bantuan Ihsan Kereta) NA (Tiada)

G Inconvenience Allowance due to Flood(covered events):-
(Elaun Kesukaran akibat Banjir - Kejadian yang dilindungi)

Cost of Cleaning - Cost of Cleaning of the interior parts of Car RM1,000

(excluding engine)
(Kos Pembersihan - kos membersihkan bahagian dalaman kenderaan- tidak temasuk enjin)

Accidental Medical Expenses - Medically Necessary expenses RM1,000

within twelve (12) consecutive months from the date of the flood
(Perbelanjaan yang perlu dari segi perubatan dalam dua belas (12) bulan yang berturut-turut dari tarikh banjir)

Compassionate Allowance - Accidental death RM1,000

(Elaun Ihsan - Kematian akibat Kemalangan)
Agent Code (Kod Agensi) : T62703E-000
Date of Issue : 28 Dec 2021
(Tarikh Dikeluarkan)

Signed For and On Behalf Of The Company

(Untuk dan bagi pihak Syarikat)

Nazrul Hisham Abdul Hamid

Chief Executive Officer
Zurich General Takaful Malaysia Berhad

Page 2 of 2
 Participant's Copy

INVOICE
SST REG. NO. : W10-1808-31038416
INVOICE NO : GI2122658352
INVOICE DATE : 25 DEC 2021
CLIENT CODE : 0001306523
ACCOUNT CODE : T62703E-000

WONG ING KIEW

NO 3A, LORONG 17,JALAN GAMBIR
96000 SIBU
SARAWAK MALAYSIA

SST REG NO : 001838395392

CLASS : PRIVATE CAR - Z-DRIVER TAKAFUL

TAKAFUL CONTRIBUTION

VEHICLE NO : MCY5796
VEHICLE BODY : 4D DOUBLE CAB PICK UP
SEATING CAPACITY : 5
CERTIFICATE NO : 652150000694-00
PERIOD OF TAKAFUL : 28 DEC 2021 TO 27 DEC 2022

Description Amount SST Rate SST Amount Total (RM)

Contribution 1,044.37 6.00 62.66 1,107.03
Total Before Disbursement 1,044.37 62.66 1,107.03
Stamp Duty (Disbursement) 10.00 0.00 10.00

Total After Disbursement 1,054.37 62.66 1,117.03

Total Amount Payable 1,117.03

A Cashier’s Receipt will be given on payment of this account

E. & O.E.
THIS IS A COMPUTER GENERATED FORM AND DOES NOT REQUIRE A SIGNATURE Page 1 of 1
 Participant's Copy
INVOICE
SST REG. NO. : 001838395392
INVOICE NO : GI2121124398
INVOICE DATE : 28 DEC 2021
CLIENT CODE : 0001306523
ACCOUNT CODE : T62703E-000

WONG ING KIEW

NO 3A, LORONG 17,JALAN GAMBIR
96000 SIBU
SARAWAK MALAYSIA

CLASS : Z-DRIVE ASSIST TAKAFUL

TAKAFUL CONTRIBUTION

CERTIFICATE NO : 652150000695-00
PERIOD OF TAKAFUL : 28 DEC 2021 TO 27 DEC 2022

No. Description Amount SST Rate SST Amount Total (RM)

1 Contribution 74.70 6.00 4.48 79.18
Total Before Disbursement 74.70 4.48 79.18

Stamp Duty (Disbursement) 10.00 0.00 10.00

Total After Disbursement 84.70 4.48 89.18

Total Amount Payable 89.18

A Cashier’s Receipt will be given on payment of this account

E. & O.E.
THIS IS A COMPUTER GENERATED FORM AND DOES NOT REQUIRE A SIGNATURE Page 1 of 1