Fen Building 2nd Floor, Ameenee Magu, Male’, 20375, Maldives Phone: +960 301 8000 Fax: +960 331 0300 Website: www.ayady.mv Email: [email protected] Company Registration no. C-43/84 Proposal No. HAJJ AND UMRAH TAKAFUL PROPOSAL cmOf Edea cSwaclufWkwt Wrcmua/ujcawH Individual Company Policy No. National ID Card Registration Certificate (for Maldivians) (for Company’s) Work permit Passport Company/Office/Applicant’s Name: Date of Birth: D D MM PP No. Y Y YY Male Female Permanent Address (as in ID card) Nationality: Postal Address (fill below): Contact Name: Contact No: House/Building name: Road: District: Email: Postal Code: Atoll,Island: Fax: Period of Takaful: Type of Cover Required: Hajj Umrah Are you in sound physical and mental health to undertake this journey? AQAD/DECLARATION: I/We agree to participate in this general Takaful scheme based on the principle of TAKAFUL and to pay the contribution on the basis of TABARRU’ (donation) for the purpose of helping each other participants who have suffered financial loss due to any of covered event(s). Based on this contribution I/We are also entitled to the Takaful cover subject to the terms and conditions of this contract. I/We further agree that my/our contribution be credited into the PARTICIPANT RISK FUND (PRF) and to appoint AYADY TAKAFUL to manage and invest the Fund according to ISLAMIC SHARIAH. I/We also permit AYADY TAKAFUL to make payment for claims/Takaful benefits, provisions and reserves based on the guidelines and policies laid down by the authorities, and AYADY TAKAFUL to be paid a WAKALAH (Agent) fee at the rate of 30% of the contribution. I/We further agree that the money in the Participants Risk Fund (PRF) shall be invested by the AYADY TAKAFUL, if the return from the investment exceeds 1.2%, the additional return or excess shall be retained and credited to the AYADY TAKAFUL under the principle of PERFORMANCE FEE (UJRAH). Additionally, I/We authorize AYADY TAKAFUL to distribute Net Surplus of the PRF at the end of the year (if any) among the participants. I/We understand that this Takaful will not be enforced until and unless this proposal has been accepted by AYADY TAKAFUL. pg:1 Signature: Date: Office use only Rate: Contribution: Agent’s Name: Documents required with the Proposal Passport Copy THIS PROPOSAL WILL NOT BE IN FORCE UNTIL THE PROPOSAL HAS BEEN ACCEPTED BY THE TAKAFUL OPERATOR You are to disclose in the proposal form, fully and faithfully all the facts which you know or ought to know, otherwise the policy issued here under maybe void. pg: 2
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