Medium

Available on

Apple Android Windows

Family Takaful Claim Form for Individual Family Takaful Plan (Malaysia) Mobile App

Quickly complete and submit claims from any mobile device with this Family Takaful Claim Form for Individual Family Takaful Plan (Malaysia) app. Includes participant details, type of claim, claimant declaration and more.

  • Lendlease
  • The Cooperative
  • PG&E
  • oxy
  • Red Bull
  • Mirvac

Want to learn more about GoCanvas?

Request a Demo

Take a peek inside the Family Takaful Claim Form for Individual Family Takaful Plan (Malaysia) Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

  • {{data.title}}

Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    1. Takaful Certificate No / No Sijil Takaful

  • Ico textbox

    2. Name / Nama

  • Ico textbox

    3. New NRIC No / No KP Baru

  • Ico textbox

    Old IC No/Passport No/Company Registration No / No KP Lama/No Pasport/No Pendaftaran Syarikat

  • Ico textbox

    4. Correspondence Address / Alamat Surat-menyurat

  • Ico textbox

    5. Telephone / Telefon

  • Ico textbox

    Handphone / Telefon Bimbit

  • Ico textbox

    Facsimile No / No Faksimili

  • Ico textbox

    6. E-Mail Address / Alamat E-mel

  • Ico textbox

    7. Name of Member/Employee covered by this certificate / Name ahli/kakitangan yang dilindungi di ...

  • Ico textbox

    8. Selected Benefit Category, if applicable / Kategori mafaat yang disertai, sekiranya berkenaan

  • Ico checkbox

    Death / Kematian

  • Ico checkbox

    Permanent Total Disability / Keilatan Kekal Sepenuhnya

  • Ico checkbox

    Permanent Partial Disability / Keilatan Kekal Sebahagian

  • Ico checkbox

    Temporary Total Disability / Keilatan Sementara Sebahagian

  • Ico checkbox

    Temporary Partial Disability / Keilatan Sementara Sebahagian

  • Ico checkbox

    Critical Illness / Penyakit Kritikal

  • Ico checkbox

    Medical Expenses / Perbelanjaan Perubatan

  • Ico checkbox

    Hospitalisation Benefit / Manfaat Hospital

  • Ico checkbox

    Funeral Expenses / Perbelanjaan Pengkebumian

  • Ico checkbox

    Bereavement Benefit / Khairat Kematian

  • Ico checkbox

    Academic Excellence Award / Anugerah Kecemerlangan Akademik

  • Ico checkbox

    Others, please specify / Lain-Lain, sila nyatakan

  • Ico statictext

    Please complete the specified claim forms and submit supporting documents listed in the form / Si...

  • Ico statictext

    Please note that the Company may require additional supporting documents to be submitted after th...

  • Ico statictext

    Part 3 : Declaration by Participant and/or Claimant / Perakuan Peserta dan/atau Pihak Yang Menuntut

  • Ico statictext

    I/We hereby declare that, to the best of my/our knowledge, the above statements and facts are tru...

  • Ico statictext

    This for was completed by someone else, I/we hereby declare that all statements provided by them ...

  • ...and More!

Related Finance & Insurance Apps... and they're all free for GoCanvas subscribers!

App Name

Household Inventory: Special Inventor...

Use the Household Inventory: Special Inventory (Video Library) mobile app to catalog your movie collection for your record...

App Name

Repossession Guidelines Checklist

The Repossession Guidelines Checklist mobile app includes an easy use checklist for financial institutions and lenders hol...

App Name

Household Inventory: Bathroom

You just completed a remodel of your bathroom. The Household Inventory: Bathroom mobile app is a great resource for puttin...

App Name

Restoration Company Work Authorization

The convenient Restoration Company Work Authorization mobile app helps detail incremental services and materials to be use...

App Name

Health Certificate (Hong Kong)

A general purpose Health Certificate for Insurance purposes that captures all the necessary information such as the payor ...

App Name

Household Inventory: Living Room

The Household Inventory: Living Room mobile app is a fast way to catalog your household items, take photos of your valuabl...

App Name

Individual Life Outpatient & Dental B...

This app enables the claimant to file for Outpatient and Dental Claims Benefits using their mobile device. Expertly design...

App Name

Vehicle Modification Center and Track...

This is the Vehicle Modification Center and Track Release and Hold Harmless Agreement app. In this app, the User will read...

More Information