Date 09.04.2015

Ahmad Yusri Bin Ismail,Lot 3545 Jalan Tokey Kiang,Kg. Banggol Katong,20050 Kuala Terengganu.Terengganu.

Syarikat Takaful Malaysia Berhad,26th Floor, Annexe Block, Menara Takaful Malaysia,No. 4 Jalan Sultan Sulaiman, 50000 Kuala Lumpur.P.O. Box 11483,50746 Kuala Lumpur.

Attention : Third Party Claim Department (Loss Of Use)

Dear Sir,

VEHICLE NO : TBB 6765 (NISSAN G.LIVINA) ACCIDENT ON :16.07.2014OUR INSURED : Ahmad Yusri Bin Ismail COVER NOTE NO : TVP-K5304424-T1YOUR INSURED VEHICLE NO : WQL 9397_____________________________________I would like to inform you that the above third party vehicle was insured with you at the material time when the accident occured. The accident was caused by negligence of your insured.

I’m is now making a third party claim against your insured for the sum of RM 2423.64 and I’m enclosed herewith the following documents to substantiate the claim.

1. Photocopy of my claim form2. Photocopy of my police report No : 003580/143. Photocopy of my cover note insurance4. Photocopy of my registration card5. Photocopy of my road tax6. Photocopy of my driving 7. licence and NRIC8. Photocopy of (Driver) driving licence and NRIC9. Photographs Scene Of Accident10. Photocopy of Discharge Voucer11. Photocopy of police investigation result, your insured cover note and police report, sketch plan &

key of the said vehicle

The amount of the claim as follows :

1. Loss Of Uses (21 days X RM50.00 per day) RM 1050.002. Excess 2F RM 1373.64

TOTAL CLAIM RM 2423.64

Please forward the Letter Of Offer and Discharge Voucer to me as soon as possible. Kindly acknowledge receipt of this letter. Your kind co-operation in this matter is most appreciated.Thank you.

Your Sincerly,

.....................................Ahmad Yusri Bin Ismail