MTR /
/
*Normal Transfer
To
: Agency Admin Unit – Head Office
Branch : ……………………………………..
From
: ………………………………………………………….
Date
: ……………………………………...
APPLICATION FOR TRANSFER OF CERTIFICATES (Normal Transfer)
Note : The Company reserves the right to reject any application for whatever reasons deemed necessary.
CERTIFICATE NO.
1)
A210134637
2)
A210133924
EFFECTIVE DATE
REASON FOR TRANSFER
3)
4)
5)
6)
7)
8)
DETAILS OF SELLING / CURRENT AGENT
Agent’s Name
Agency Status
Nabilla Najjua Binti Mamud
 WP
 AP
 AM
Code : J00396H
 CAM
Contract Date :
SIGNATURE
Date :
AM’s Name
Signature :
Code :
CAM’s Name
Signature :
Code :
DETAILS OF PROPOSED NEW SERVICING AGENT (ie New Agent)
Agent’s Name
Agency Status
Muhammad Bin Selamat
 WP
 AP
 AM
Code : J00024P
 CAM
Contract Date :
SIGNATURE
Date :
AM’s Name
Signature :
Code :
CAM’s Name
Signature :
Code :
Effective Date : Current processing month
Branch Sales Manager (BSM)
Regional Sales Manager (RSM)
 Recommended  Not Recommended
 Approved
 Declined
……………………………………..……
Name :
Date :
……………………………………………
Name :
Date :
Chief Agency Officer (CAO)
 Approved
 Declined
……………………..……………
Name :
Date :
For use of Agency Admin Unit – Head Office
 Approved
 Declined
F13-(ZT) MTR Form (v3-2021)
 KIV
Signature : ………………………………………
Date : ………………………..
Page : 1 of 2
MTR /
/
APPLICATION FOR TRANSFER OF CERTIFICATES (Normal Transfer)
Note : The Company reserves the right to reject any application for whatever reasons deemed necessary
CERTIFICATE NO.
EFFECTIVE DATE
REASON FOR TRANSFER
9)
10)
11)
12)
13)
14)
15)
16)
17)
18)
19)
20)
DETAILS OF SELLING / CURRENT AGENT
Agent’s Name
Agency Status
Code :
 WP
 AP
 AM
 CAM
SIGNATURE
Contract Date :
Date :
AM’s Name
Signature :
Code :
CAM’s Name
Signature :
Code :
DETAILS OF PROPOSED NEW SERVICING AGENT (ie New Agent)
Agent’s Name
Agency Status
Code :
 WP
 AP
 AM
 CAM
SIGNATURE
Contract Date :
Date :
AM’s Name
Signature :
Code :
CAM’s Name
Signature :
Code :
Effective Date : Current processing month
Branch Sales Manager (BSM)
Regional Sales Manager (RSM)
 Recommended  Not Recommended
 Approved
 Declined
……………………………………..……
Name :
Date :
……………………………………………
Name :
Date :
Chief Agency Officer (CAO)
 Approved
 Declined
……………………..……………
Name :
Date :
For use of Agency Admin Unit – Head Office
 Approved
 Declined
F13-(ZT) MTR Form (v3-2021)
 KIV
Signature : ………………………………………
Date : ………………………..
Page : 2 of 2