1. Personal Details
Full Name As Per Id

Tim Huang

Agent Code

73119

Agency Code

T453D

Agency Name

Jetsky and Safeco Marvard Harvesly Group Sdn. Bhd.

Marital Status*
Spouse Details
Full Name As Per ID*
Identification Type*
Identification No.*
Nationality*
Passport Expiry Date*
Please enter a valid Passport Expiry Date.

2. Licence
Documents*

      Documents*

          Documents*


              3. Upload Document

              Please upload all mandatory documents below and ensure your details are correct before submitting your application. Please select the file and tap on the upload button. Supported file types: .jpg, .png, .pdf up to 10MB

              COPY OF ID (FRONT)*

                  COPY OF ID (BACK)*

                      Passport Sized Photo*

                          1. Copy of ID (Front)*

                          Front copy of your Identity Card (e.g. IC)

                          2. Copy of ID (Back)*

                          Back copy of your Identity Card (e.g: IC)

                          3. Passport Sized Photo*

                          Please refer to Guidelines for photo requirements.

                          MOVEMENT OF AGENT

                              RESIGNATION LETTER

                                  4. Movement of Agent

                                  Applicable if candidate is attached with other insurer company

                                  5. Resignation Letter

                                  Applicable if candidate is attached with other insurer company


                                  4. Contract

                                  Please select licence(s) before proceeding.

                                  LIFE-CEILI does not require a contract.


                                  5. Declaration

                                  Please select licence(s) before proceeding.