Follow the steps to accurately complete your form.

1. Click ‘Get Form’ button to access the 60801026 Auto Debit - Prudential BSN Takaful form.
2. Enter the date, proposal or certificate number, and application date in the specified fields.
3. In Section A, provide your particulars as the account holder. This includes your name, identification number, date of birth, mobile phone number, occupation, and correspondence address.
4. If applicable, provide details for a joint account holder in the appendix and attach it to your form. Fill in the relevant fields for nationalities and various contact numbers.
5. Select your bank from the options provided and insert your account number.
6. In Section B, provide particulars of payment. Include the name of the person covered and select the payment frequency (monthly, quarterly, half-yearly, or yearly). Specify the effective month for the contributions.
7. Indicate your relationship to the account holder by ticking the appropriate box.
8. Review the important notes and ensure that you meet the requirements, such as providing a copy of identification for verification.
9. In Section C, authorize the bank to debit your account, confirming your understanding of the related terms and conditions.
10. Provide your signature and the date, along with the signature of any joint account holder if applicable.
11. Submit the completed form as instructed, ensuring you have all necessary attachments and checks in place.

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