Date : 26 Dec 2018

MOHD FAIZAL BIN MOHD ZIN

LOT 764 HADAPAN SEK KEB KOR
16010 KOTA BHARU

Dear Sir/Madam

RE: APPLICATION NO. : Z184612753

PERSON COVERED'S NAME : AMIR SUFI BIN MOHD FAIZAL
PARTICIPANT'S NAME : MOHD FAIZAL BIN MOHD ZIN

We thank you for your application for a family Takaful Coverage with our Company. For the consideration of issuing
you a certificate, we require additional tests/reports/investigations/forms as indicated in the attached Outstanding
Requirement Advice.

Please be advised that any initial/subsequent contribution paid shall be deemed invalid null and void and the
Company shall not be liable in any manner whatsoever for any claims made there from unless and until the
requirements indicate in the attached Outstanding Requirement Advice have been attended to, application has been
duly approved and certificate contract has been duly issued.

By copy of this letter, we are also requesting our agent to assist you in this matter.

Thank you.

ZURICH TAKAFUL MALAYSIA BERHAD

ztmb.underwriting@zurich.com.my

From Family Underwriting

(Computer generated advice - no signature is required)
cc - CONSULTANT : W102-08-T10795P FARALIZA BINTI KHALID
C.M.C : AGENSI ERA BUMI SDN BHD

eCOPY
 Outstanding Requirement Advice

Application No. : Z184612753 Date :26 Dec 2018

Person Covered's Name : AMIR SUFI BIN MOHD FAIZAL
Applicant's Name : MOHD FAIZAL BIN MOHD ZIN

Please accomplish the requirement(s) indicated below for assessment of the above numbered application:

1)PLEASE REFER REMARKS BELOW

Remarks :
Same requirement for applicant, please refer Z184612741.

eCOPY