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Untuk kegunaan pejabat / For office use only No. Siri. / Serial No. : Kod Agen / Agent Code: (A subsidiary of Malaysian National Reinsurance Berhad) BORANG CADANGAN TAKAFUL MOTOR / MOTOR TAKAFUL PROPOSAL FORM KENYATAAN MENGIKUT SEKSYEN 28 AKTA TAKAFUL 1984. Anda hendaklah memberitahu di dalam borang cadangan ini secara penuh dan jujur, segala fakta yang anda tahu atau yang anda patut tahu, jika tidak Sijil yang dikeluarkan boleh menjadi tidak sah STATEMENT PURSUANT TO SECTION 28 of THE TAKAF.

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