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POLICY DETAILS

PRIVATE CAR COMPREHENSIVE

Cover Note No. : EG105583 Account No. : KL3011280

MR MOHD HELMI BIN ABD GHANI

TIANG LETRIK 68/7 KG KEMENGKANG,KESANG TUA
77000 JASIN
MELAKA

Business / Occupation :
IC/Business Registration : 670401-04-5393

Period of Insurance : 30/08/2018 to 29/08/2019

Premium : Annual Premium RM 771.03

Loading RM 0.00

(**NCB Disclaimer) Less NCB 55.00 % RM 424.07

Extra Benefit RM 0.00

Premium Due RM 346.96

Service Tax RM 0.00
Goods And Services Tax @ 0% RM 0.00
Stamp Duty RM 10.00
Total Due RM 356.96

Geographical Area : West Malaysia

Authorised Driver :
As printed in item (5) - Certificate of Insurance attached to policy
Limitations as to use :
As printed in item (6) - Certificate of Insurance attached to policy

Vehicle : Make : NAZA CITRA

Engine No. : G4GC5H305030 Regn No. : MBE2824
Chassis No. : PNAKB3L035G001704 Capacity : 1975 CC/TN
Sum Insured : RM 12000.00 Year Make : 2005
Excess : RM 0.00 No of Seats :7
Hire Purchase :
Authorised Driver : THE INSURED
NURSYAZWANI BINTI MOHD HELMI, MUHAMMAD IRFAN BIN MOHD HELMI, NURUL
HIDAYAH BINTI MOHD HELMI, ZAWIYAH BTE AHMAD

Extra Benefit: Description Premium SumInsured

THIS IS A COMPUTER GENERATED DOCUMENT. NO SIGNATURE IS REQUIRED.

**NCD Entitlement
1. Your NCD percentage selected will be confirmed with your existing insurer.
2. Please declare accurately so that you are not being prejudice in the event of a claim.
3. If the NCD is incorrect, you are undertake to pay the difference of premium within 14 working days, failing which your policy may be
cancelled by the company.

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MX1
PRIVATE CAR

CERTIFICATE OF INSURANCE

ROAD TRANSPORT ACT 1987 (MALAYSIA)

THE MOTOR VEH. (T/P RISKS) RULES, 1959 (MALAYSIA)
THE MOTOR VEH. (T/P AND COMPENSATION) ORDINANCE 1960 (NO. 1 OF 1960)
(REP. OF S'PORE)

THE MOTOR VEH. (T/P AND COMPENSATION) RULES, 1960 (REP. OF S'PORE)
THE MOTOR VEH. INSURANCE *T/P RISKS) ENACTMENT 1950 (NEGARA BRUNEI DARUSSALAM)

CERTIFICATE NO. : EG105583

1. Index Mark and Registration MBE2824 1975 CC/TN

Number of Vehicle NAZA CITRA

2. Name of Policyholder MR MOHD HELMI BIN ABD GHANI

3. Effective date of the Commencement of Insurance 30/08/2018

for the purposed of the Ordinance

4. Date of Expiry of Insurance 29/08/2019

5. Persons or Classes of Persons entitled to drive*

(a) The Policyholder
(b) Any other person who is driving on the Policyholder's order or with his/her 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.

6. 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 or use for any purpose in connection with the Motor Trade.

* Limitations rendered inoperative by Section 95 of the Road Transport Act, 1987 (Malaysia) or Section 7 of the Motor Vehicles
(Third-Party Risks and Compensation) Ordinance 1960 (Republic of Singapore) or Section 7 of the Negara Brunei
Darussalam Enactment are not to be included under this heading.

I/WE HEREBY CERTIFY that the policy to which this certificate relates is issued in accordance with the provisions of Part IV of the
Road Transport Act 1987 (Malaysia), the Motor Vehicles (Third-Party Risks and Compensation) Ordinance 1960 (Republic of
Singapore) and the Motor Vehicles Insurance (Third Party Risks) Enactment 1950 (Negara Brunei Darussalam).

THIS IS A COMPUTER GENERATED DOCUMENT. NO SIGNATURE IS REQUIRED.

**NCD Entitlement
1. Your NCD percentage selected will be confirmed with your existing insurer.
2. Please declare accurately so that you are not being prejudice in the event of a claim.
3. If the NCD is incorrect, you are undertake to pay the difference of premium within 14 working days, failing which your policy may be
cancelled by the company.

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(GST Reg No: 002092072960)

TAX INVOICE
Invoice No. : MTX20180805583

Invoice Date : 2018-08-29

MR MOHD HELMI BIN ABD GHANI

TIANG LETRIK 68/7
KG KEMENGKANG,KESANG TUA

GST Reg No. :

Type of Policy :PRIVATE CAR

Policy No. :EG105583
Renewal No. :-
Period of Cover :30/08/2018 to 29/08/2019
Sum Insured :RM 12000.00
Insured Name :MR MOHD HELMI BIN ABD GHANI

Address :TIANG LETRIK 68/7

KG KEMENGKANG,KESANG TUA

Intermedlary Acct No :
Name :
GST Reg No :
Address :

RINGGIT MALAYSIA : RM

Premium Due : 346.96

Less 10% Discount : 0.00
______________
Total Premium Amount : 346.96
Add Stamp Duty : 10.00
______________
Total Payable Amount Before GST: 356.96
Add GST : 0.00
______________
Net Amount Due : 356.96
______________

Thank You

THIS IS A COMPUTER GENERATED DOCUMENT. NO SIGNATURE IS REQUIRED.

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