JM Insurance Proposal Form


*Person Name

*Vehicle Registration Number

*I/C Number

*Contact Number

Policy Start Date

Policy Start Date is next day of your policy expiry date,
(E.g.: Current Policy Expiry Date = 25/04/2015
Policy Start Date = 26/04/2016)

*Insurance

For New Insurance:

*Current Insurance Company

Payment Method: Bank transfer

Ford
Bank Name: MayBank (Malayan Banking Berhad)
Company Name: Syarikat Jayamas Motor
Account Number: 5573 4406 1698

Honda
Bank Name: MayBank (Malayan Banking Berhad)
Company Name: Syarikat Jayamas Motor
Account Number: 5573 4406 1698

KIA
Bank Name: MayBank (Malayan Banking Berhad)
Company Name: SJM Agency
Account Number: 5573 4406 1681

Mitsubishi
Bank Name: MayBank (Malayan Banking Berhad)
Company Name: SJM Agency
Account Number: 5573 4406 1681

Collect your Road Tax at Jayamas office with free gift.

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