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WalletName: MALI4182

Email: [email protected]

Name: MOHD AZIZZUDIN BIN ZAINAL RASHID

IC Number: 840406-08-6417

Occupation: MARKETING EXECUTIVE

Address: 418, Menara Cenderawasih, AU3 , Lembah Keramat

Phone Number (Mobile): 01120203003

Phone Number (Office): 03-92130687

Phone Number (House):

Vechicle Reg. No/ Trailer No : WQM7995

Make: HONDA - ACCORD

Model: 2997CC

Year Of Manufactured: 2004

Hire Purchase Company: NIL

Previous Insurer Particulars: TAKAFUL IKHLAS

Second Driver Name: MALIK BIN MIZAM

Identification Number: 590509-01-6113

ADDTIONAL COVERAGE

STRIKE, RIOT AND CIVIL COMMOTION : NO

FLOOD, WINDSTORM & TYPHOON : YES

L.L.O.P. FOR ACTS OF NEGLIGEN: YES

WINDSCREEN : NO

LEGAL LIABILITY TO PASSENGER : YES

PRIVATE HIRE CAR ENDORSEMENT: NO

ADDTIONAL DRIVER

Additional Driver Name:

Additional Driver Identification Card Number:

DOCUMENTS

Vehicle Registration Certificate : FILE

Identification Card (IC): FILE

Previous Insurer Policy: FILE

FOR ADMIN TO FILL IN

Quotation: 0

Remark:

QUOTATION: NO FILE

Approved by:

Approved Date:

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