Sun Life Malaysia Takaful Berhad

As I have settled the housing loan with CIMB Bank/CIMB Islamic Bank (“the Bank” ), I hereby request to surrender my MRTA/MRTT certificate with the fol...

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Sun Life Malaysia Assurance Berhad (197499-U) Sun Life Malaysia Takaful Berhad (689263-M) Level 11, 338 Jalan Tuanku Abdul Rahman, 50100 Kuala Lumpur Telephone (603) 2612 3600 Facsimile (603) 2698 7035 Customer Careline 1300-88-5055 sunlifemalaysia.com

To

: Policy Services Department (Level 8) MORTGAGE REDUCING TERM ASSURANCE/TAKAFUL (MRTA/MRTT) SURRENDER REQUEST FORM

As I have settled the housing loan with CIMB Bank/CIMB Islamic Bank (“the Bank”), I hereby request to surrender my MRTA/MRTT certificate with the following details. I further understand that this surrender application is subject to the final approval from Credit Support Administration (CSA) department from the Bank, and the surrender effective date will be based on the date Sun Life Malaysia receives my complete documents. Housing loan account no. / CA no. MRTA/MRTT certificate no.

Name of life assured/person covered NRIC no. of life assured/person covered Contact no. (mobile/home/office) Email address Refund via e-payment (please provide your bank account details) Notes: • This bank account number is used for payout purposes (if any). The account number must belong to the life assured/ person covered. • Please provide a copy of the bank passbook/statement for our verification purposes.

Bank account no.

Bank name

Correspondence address

I declare that the information given is true and accurate to the best of my knowledge and record. I shall indemnify Sun Life Malaysia Assurance Berhad/Sun Life Malaysia Takaful Berhad for any loss arising from the reliance on the above information. Authorised by:

___________________________________ Signature of life assured/person covered Name

:

NRIC no.

:

Date

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MRTA/MRTT Surrender Request Form Oct 2015