Third Party Insurance | Amana Takaful PLC

Personal Information

Summary | Policy

Prefix *

Name of the Participant *

Registered Owner's Name

NIC No *

Address 01 *

Address 02 *

City

Contact No *

Email Address*

Type of Vehicle

Usage

Vehicle Make Model

Registration Number *

Manufacturing Year *

Fuel Type *

Engine Number *

Chassis Number *

Cylinder Capacity *

Registration Date *

Policy Start Date *

Policy End Date *

Absolute Ownership *

Upload Authorized Vehicle Book * Please upload scanned copies (PDF, JPG, PNG). Max 5MB.

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Is the person to be covered undergoing any treatment or suffering from any ailment/pre-existing condition or sickness?

When did the person to be covered, last visited a Doctor and for what ailment?

Date

Doctor, Ailment

Is the person to be covered undergoing any treatment or suffering from any ailment/pre-existing condition or sickness?