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TAKAFUL IKHLAS SDN BHD (593075 U) 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 (A subsidiary of Malaysian National Reinsurance Berhad) CERTIFICATE OF TAKAFUL JPJ A1 MX1 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.: ML1000892 1. Index Mark and Vehicle Registration No. PDJ5951 2. Name of Participant MUKHLIS BIN MAT ISA @ YAHYA 3. I/C No. 810120-06-5365 4. Effective date of Commencement of Takaful for the purposes of the Ordinance 07/10/2011 5. Date of Expiry of Takaful 06/10/2012 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 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. 7. Limitation as to Use. * Use only for social, domestic and pleasure purposes and for the Policyholder's business. The Policy does not cover use for hire or reward, racing, pacemaking, reliability trial speed-testing,the carriage of goods other than samples in connection with any trade or business. *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 ----------------------------------------------------------- Salinan Asal Telah Ditandatangani (Original Duly Sign)

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  • TAKAFUL IKHLAS SDN BHD(593075 U)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

    (A subsidiary of Malaysian National Reinsurance Berhad)

    CERTIFICATE OF TAKAFULJPJA1MX1

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

    Certificate No.:ML10008921.Index Mark and Vehicle Registration No. PDJ59512.Name of Participant MUKHLIS BIN MAT ISA @ YAHYA3.I/C No. 810120-06-53654.Effective date of Commencement of Takaful for the purposes of the Ordinance 07/10/20115.Date of Expiry of Takaful 06/10/2012

    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 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 permittedand 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 only for social, domestic and pleasure purposes and for the Policyholder's business.The Policy does not cover use for hire or reward, racing, pacemaking, reliability trial speed-testing,the carriage of goods other than samples in connection withany trade or business.*Limitation rendered inoperative by Section 95 of the Road Transport Act 1987 (Malaysia) or Section 8 of the Motor Vehicles (Third Party Risks andCommpensation) Act (Cap 189) Republic of Singapore or Section 7 of the Motor Vehicles Insurance (Third Party Risks) Act (Cap 90) Negara BruneiDarussalam 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 MOTORVEHICLES INSURANCE (THIRD PARTY RISKS) ACT (CAP 90) NEGARA BRUNEI DARUSSALAM

    -----------------------------------------------------------

    Salinan Asal Telah Ditandatangani(Original Duly Sign)

  • TAKAFUL IKHLAS SDN BHD(593075 U)IKHLAS Point, Tower 11A, Avenue 5, Bangsar South, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur.tel:03-2723 9999fax:03-2723 9998website:www.takaful-ikhlas.com.my

    (A subsidiary of MNRB Holdings Berhad)

    STAMP DUTY PAID

    THE SCHEDULE MX1Peserta :The Participant :

    MUKHLIS BIN MAT ISA @YAHYA

    NRIC :NRIC :

    810120-06-5365

    Alamat :Address :

    61, TAMAN PERMAI,09300 KUALA KETIL,KEDAH

    No Pendaftaran Perniagaan :Business Registration No :

    Perkerjaan atau berniaga :Profession or Business :

    GOVERNMENT SERVANT

    Jenis Sijil :Class of Certificate :

    PRIVATE CAR Pada :On :

    27-09-2011

    Dikeluarkan & ditandatangani di :Issued & signed at :

    Kod Agensi :Agency Code :

    GI00026

    Rujukan Sijil :Certificate Ref. No. :

    ML1000892

    Tempoh Takaful :Period of Takaful :

    Tarikh tandatanganPengakuan &borang :

    a) MulaFrom

    07/10/2011 TamatTo

    06/10/2012 Date of signature ofProposal & 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 KENDERAANTHE MOTOR VEHICLE

    SUMBANGAN SIJIL (RM)THE CERTIFICATE'S CONTRIBUTION (RM)

    No. Pendaftaran :Registration No :

    PDJ5951 Sumbangan Asas :Basic Contribution :

    667.90

    Buatan & Model :Make & Type of body :

    318I(A) Tambahan :Loading :

    0.00

    Keupayaan Padu :Cubic Capacity :

    1796CC Kelayakan NCD (55.00) :NCD (55.00) :

    367.35

    Ruang duduk termasuk pemandu :Seating capacity including driver :

    5 Perlindungan Tambahan :Extra-Benefits :

    Tahun di buat :Year of Manufacture :

    1996 NIL

    No. Enjin :Engine No :

    8082M659 Jumlah Kecil :Sub-Total :

    300.55

    No. Casis :Chassis No :

    AC80825 Rebate :Rebate :

    30.06

    Jumlah Perlindungan :Sum Covered :

    16,000.00 Cukai Kerajaan :Govt. Tax :

    0.00

    Ekses :Excess :

    160.00 Cukai setem :Stamp Duty :

    10.00

    No. Pembaharuan Sijil :Renewal of Certificate No :

    NIL Jumlah Pembayaran :Total Payable :

    280.49

    Sumbangan Akta :Act Contribution :

    34.42

    Sewa beli / Syarikat menyewa / Majikan :Hire Purchase/Leasing Company/Employer :

    MAYBAN FINANCE BERHAD

    Nama Pemandu :Named Drivers :

    NIL

    Tertakluk kepada endorsemen-endorsemen berikutnya :Subject to the following operative endorsements attached :M02 - EXCESS DAMAGE CLAIMM2(f) - COMPULSORY EXCESSM30 - REPLACEMENT PARTSM106 - INSURER'S AUTHORISED WORKSHOPMana-mana orang yang dibenarkan memandu dan had atas kegunaan adalah termaktub dalam SijilTakaful yang dikeluarkan sehubungan dengan Sijil ini.Person or classes of persons entitled to Drive and limitations as to use, are as Specified in theCertificate of Takaful Issued in relation to this Certificate

    _______________________________

    Salinan Asal Telah Ditandatangani(Original Duly Sign)