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 JPJA1MY3

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.:MV2809627
1.Index Mark and Vehicle Registration No. 2.Name of Participant 3.I/C No. 4.Effective date of Commencement of Takaful for the purposes of the Ordinance 5.Date of Expiry of Takaful 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 their 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 for social, domestic and pleasure purposes and by the Participants in person in connection with his business or profession. The Policy does not cover : (1) Use for hire or reward (2) Use for racing, pace-making,reliability trial,speed-testing (3) Use for the carriage of goods (other than samples) in connection with any trade or business (4) Use for any purpose in connection with the Motor Trade. *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. WRY7945 FAKHRI NIZAR BIN MOHAMED 570103-08-5401 11/11/2012 10/11/2013

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)

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)

Bantuan Ikhlas Toll-Free Number : 1800 88 1186

STAMP DUTY PAID

THE SCHEDULE
Peserta : The Participant : Alamat : Address : FAKHRI NIZAR BIN MOHAMED NO 16 JALAN DATO SENU 8, TAMAN DATO SENU, 51000 SENTUL, WILAYAH PERSEKUTUAN OFFICER MOTOR CYCLE Pada : On : Kod Agensi : Agency Code : MV2809627 Tarikh tandatangan Pengakuan & borang : 11/11/2012 Tamat To 10/11/2013 Date of signature of Proposal & declaration : 07-11-2012 GW00273 NRIC : NRIC : No Pendaftaran Perniagaan : Business Registration No : 570103-08-5401

MY3

Perkerjaan atau berniaga : Profession or Business : Jenis Sijil : Class of Certificate : Dikeluarkan & ditandatangani di : Issued & signed at : Rujukan Sijil : Certificate Ref. No. : Tempoh Takaful : Period of Takaful : a) Mula From

(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 KENDERAAN THE MOTOR VEHICLE No. Pendaftaran : Registration No : Buatan & Model : Make & Type of body : WRY7945 HONDA - ANF125MR (8) SUMBANGAN SIJIL (RM) THE CERTIFICATE'S CONTRIBUTION (RM) Sumbangan Asas : Basic Contribution : All Rider (50.0%) : Tambahan : Loading (25.00%) : Keupayaan Padu : Cubic Capacity : Ruang duduk termasuk pemandu : Seating capacity including driver : Tahun di buat : Year of Manufacture : No. Enjin : Engine No : No. Casis : Chassis No : Jumlah Perlindungan : Sum Covered : Ekses : Excess : No. Pembaharuan Sijil : Renewal of Certificate No : 125CC 2 2008 NF125E-2018390 PMKJC38C08K218533 1,500.00 100.00 NIL Kelayakan NCD (0.00) : NCD (0.00) : Perlindungan Tambahan : Extra-Benefits : NIL Jumlah Kecil : Sub-Total : Rebat (10.00%): Rebate (10.00%): Cukai Kerajaan : Govt. Tax : Cukai setem : Stamp Duty : Jumlah Pembayaran : Total Payable : Sumbangan Akta : Act Contribution : Sewa beli / Syarikat menyewa / Majikan : Hire Purchase/Leasing Company/Employer : Nama Pemandu : Named Drivers : Tertakluk kepada endorsemen-endorsemen berikutnya : Subject to the following operative endorsements attached : M94 - COMPULSORY EXCESS - DAMAGE CLAIMS M96 - INTOXICATION CLAUSE M99 - INDEMNITY IN THE EVENT OF TOTAL LOSS CLAUSE Mana-mana orang yang dibenarkan memandu dan had atas kegunaan adalah termaktub dalam Sijil Takaful yang dikeluarkan sehubungan dengan Sijil ini. Person or classes of persons entitled to Drive and limitations as to use, are as Specified in the Certificate of Takaful Issued in relation to this Certificate _______________________________ Salinan Asal Telah Ditandatangani (Original Duly Sign) NIL All Rider 235.04 23.50 0.00 10.00 221.54 57.37 125.35 62.68 47.01 0.00