Travel - store - Tawuniya

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Yes No, I`m travelling alone

ID/IQAMA Number *

Date of Birth *

I hereby give Tawuniya advance consent to obtain my and/or my dependents information from the National Information Center

Name as in passport *

Occupation *

Gender Male Female

Contact number * OTP will be sent to this mobile number

Email Address *

Are you politically exposed person (PEP) *

No Yes Yes, Family or Close Associate

Country *

Nationality *

Region *

City *

Place of Birth *

Mailing address Use my home address as a mailing address P.O.Box

Employer *

Source of Income *

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Do you confirm the Declaration on behalf of all persons to be insured?

Declaration by Applicant on behalf of all Persons to be Insured

To the best of my knowledge and belief, the above statements and particulars are complete and true and that I have not misstated or suppressed any material facts. (A material fact is one which is likely to influence Tawuniya's acceptance or assessment of this proposal.If in any doubt whether facts are material, they shouldbe disclosed).
To the best of my knowledge and belief there are no reasons which would give rise to cancel or curtail our trip, and I will notify Tawuniya in the event of any such reason arising between the policy being issued and the commencement date of insurance.
None of us will be traveling against medical advice.
It is agreed that this proposal shall be the basis of the contract between me and Tawuniya.
Tawuniya reserves the right to decline any application.
I hereby declare that I am the policy holder andI entered all fields by my self.
I hereby declare that I/We are not involved in any criminal or money laundering activity and that the premiums paid are out of my legitimate source of income and are not derived from any illegal activities.
In case of policy cancelation the amount will be refund to the policy holder and in case of credit card payment the amount will be refund to the same used card during the purchasing process.
I declare that the documents submitted for identification are original and all particulars given are true and correct. I/We further declare that I/We do not have any other names or identification particulars, apart from the ones submitted above. The information supplied by me/us as regards to identification particulars are true and correct and any wrong information given can render insurance contract void at the option of the insurer. It is also understood that the insurer reserves the right to request any document to proof the information that I entered, also the right to cancel the policy and forfeit the premiums paid in case identification particulars are not found correct.