Date: ‘Zurich General Takaful Malaysia Berhad / Zurich General Insurance Malaysia Berhad Attn: Motor Claims Department Dear Sir/Madam, Letter of Betterment Contribution Vehicle No: Accident Date: Insured’s Name: Thave been advised by the repairer that my car bearing registration no. is more than 5 years old. The workshop explained to me the options available. | agree with the option below (marked ‘with a tick) to repair my motor vehicle. A. [/_] 1 do not want to contribute to betterment, Agreed to utilize non-franchise parts. B, [_] agreed to contribute to betterment. To utilize Franchise parts and for parts recommended for replacement, C.[7] Regarding SRS AIRBAG SYSTEM. | am not agreeable to contribute towards the betterment. | hereby acknowledged and am agreeable for the use of used or non-franchise parts and | hereby indemnify the repairer, for any legal responsibility/legal liability towards the above mentioned repaired vehicle from any parties. 1 shall be fully responsible for this repaired vehicle, especially the SRS Airbag System. And using it at my own risk and not otherwise. x Sig 1g Some Franchise parts for others non-franchise D.[_] Lagree to repair my motor vehicle utili partsto make good the damages. List of Franchise parts which I agreed to contribute to betterment at_% a) ») Lo __NRIC. __hereby confirm that 1 have exercised option___and agreeable to the terms and conditions herein, Seale of betterment approved by ‘Bank Negara & PIAM: ‘Age of Vehicles/Voats ‘ese than 5 years Rate of Sattermant 5 15% 6 20% 7 25% 8 30% 8 233% 108 above 40% INTERNAL USE ONLY