zurich_logo_alt

Personal Sentinel Version 3 Plus Takaful

Personal Sentinel Version 3 Plus is a yearly renewable personal accident takaful that provides compensation in the event of bodily injuries, disablement or death caused solely and directly by an unforeseen event.

PRODUCT DISCLOSURE SHEET CERTIFICATE WORDING

Please fill in the following details.

Section 1: Certificate Holder's Name

ID Type *

Name (as per NRIC) *

Identity Card (IC) *

Date of birth *

Age *

Gender *

Mobile Number *

+60

TIN No *

Business Registration No. (if applicable)

e-Invoice *

Email *

Occupation *

Occupation class *

  • Class 1 - Person engaged in professional administrative, managerial, clerical and non-manual occupations
  • Class 2 - Person engaged in work supervisory nature but not involved in manual labour
  • Class 3 - Person engaged either occasionally or generally in manual work which involves the use of tools or machinery

Section 2: Other Information

Plan Selection *

Weekly Benefit *

Are you involved in any of the following activities? *

  • i. Cash Intensive Business or equivalent (e.g. Money lending, Money Remittance or Money Exchange)
  • ii. Gaming (4-D Number), lottery or gambling establishment
  • iii. Precious metal or jewellery trading, pawn shop or pawn brokers
  • iv. Entertainment business or equivalent (e.g. Discotheque, Pub, Bar, Massage Parlors)
  • v. Direct Selling/Multi-Level Marketing
  • vi. Recyclable Dealers/Scrap Metal Dealers

Correspondence Address

Address 1 *

Address 2 *

Address 3

Postcode *

State *

Town / City *

Country *

Nominees

Nominate person for the insurance policy.

No nominee(s) nominated for this takaful certificate.

Ouch Free Sdn Bhd (201801038678 [1300709-A])