Choose entity below to submit your application
Get ready following document:
  • NRIC (Front & Back)
  • Highest Academic Certificate – SPM/STPM/Diploma/Degree
  • MII Certificate (PCEIA General)
  • Completed PDPA Form Download
  • Completed Declaration by Agent Download
  • Statement of Bank Account
  • Full set of Suruhanjaya Syarikat Malaysia (SSM) documents
  • Photo
  • Registration Fee Transfer Slip

What is your category of business?


For Sole Proprietor & Partnership:
  • Business Registration Certificate (Borang A & D)

For Private Limited Company:
  • Business Registration Certificate (Form 9/Section 15/17, Form 49/Section 58, Form 24/Section 58)
  • Form 13 (If Change of Agency Name/Section 28)
  • Form 32A (If there is any transfer of shares/Section 51)
Registration Fee & Stamp Duty
Company Type New Agent (RM) 2nd Principal (RM)
Sole Proprietor 60.00 45.00
Partnership 90.00 60.00
Private Limited Company 90.00 60.00

***Remember to keep your transaction receipt for our reference which need to be upload below

How you can pay
You can pay via:
  • Direct Bank Transfer
  • ATM Bank In
Etiqa Account Details:
  • Etiqa General Insurance Berhad
  • Maybank
  • 514011574497
Get ready following document:
  • NRIC (Front & Back)
  • Highest Academic Certificate – SPM/STPM/Diploma/Degree
  • Takaful Basic Examination (Part A+B) rom IBFIM
  • Completed PDPA Form Download
  • Completed Code of Ethics Form Download
  • Statement of Bank Account
  • Full set of Suruhanjaya Syarikat Malaysia (SSM)
  • Photo
  • Registration Fee Transfer Slip

What is your category of business?

For Sole Proprietor & Partnership:
  • Business Registration Certificate (Borang A & D)

For Private Limited Company:
  • Business Registration Certificate (Form 9/Section 15/17, Form 49/Section 58, Form 24/Section 58)
  • Form 13 (If Change of Agency Name/Section 28)
  • Form 32A (If there is any transfer of shares/Section 51)
Registration Fee & Stamp Duty
Company Type Amount (RM)
Individual Agent 60.00
Sole Proprietor 90.00
Partnership 90.00
Private Limited Company 90.00

***Remember to keep your transaction receipt for our reference which need to be upload below

How you can pay
You can pay via:
  • Direct Bank Transfer
  • ATM Bank In
Etiqa Account Details:
  • Etiqa General Takaful Berhad
  • Maybank
  • 564016103309
Get ready following document:
  • NRIC (Front & Back)
  • Highest Academic Certificate – SPM/STPM/Diploma/Degree
  • Pre Contract Examination (PCE) & Certificate Examination Investment-Linked Life Insurance (CEILLI)
  • Completed PDPA Form Download
  • Completed Code of Ethic FormDownload
  • Completed Declaration of ConductDownload
  • Statement of Bank Account
  • Receipt of Registration Fee
  • Photo
Registration Fee & Stamp Duty
Type of Fee Amount (RM)
Individual Agent 55.00

***Remember to keep your transaction receipt for our reference which need to be upload below

How you can pay
You can pay via:
  • Direct Bank Transfer
  • ATM Bank In
Etiqa Account Details:
  • Etiqa Life Insurance Berhad
  • Maybank
  • 514253136527
Get ready following document:
  • NRIC (Front & Back)
  • Highest Academic Certificate – SPM/STPM/Diploma/Degree
  • Takaful Basic Examination (Part A+C) from IBFIM
  • Completed PDPA Form Download
  • Completed Code of Ethic Form Download
  • Completed Watakmas Membership Form Download
  • Statement of Bank Account
  • Receipt of Registration Form
  • Photo
Registration Fee & Stamp Duty
Type of Fee Amount (RM)
Individual Agent 70.00

***Remember to keep your transaction receipt for our reference which need to be upload below

How you can pay
You can pay via:
  • Direct Bank Transfer
  • ATM Bank In
Etiqa Account Details:
  • Etiqa Family Takaful Berhad
  • Maybank
  • 564016118799

Submit the following documents:

New Agent Registration

You are applying to become our Agent with Etiqa Berhad

Please submit following documents

NRIC (Front)
NRIC (Back)
Takaful Basic Examination (Part A+C) from IBFIM
MII Certificate (PCEIA General)
Completed Code of Ethic Form
Completed Watakmas Membership Form
Statement of Bank Account
Receipt of Registration Form
Copy of Your Photo
NRIC (Front)
NRIC (Back)
Highest Academic Certificate – SPM/STPM/Diploma/Degree
Pre Contract Examination (PCE) & Certificate Examination Investment-Linked Life Insurance (CEILLI)
Completed PDPA Form
Completed Code of Ethic Form
Completed Declaration of Conduct
Statement of Bank Account
Receipt of Registration Fee
Copy of Your Photo
NRIC (Front)
NRIC (Back)
Highest Academic Certificate – SPM/STPM/Diploma/Degree
Takaful Basic Examination (Part A+B) rom IBFIM
Completed PDPA Form
Completed Declaration by Agent
Statement of Bank Account
Suruhanjaya Syarikat Malaysia (SSM) Certification - Business Registration Certificate
Suruhanjaya Syarikat Malaysia (SSM) Certification - Business's Details
Suruhanjaya Syarikat Malaysia (SSM) Certification - Owner's Details
Copy of Your Photo
Business registration certificate (Form 9 - Section 15/17)
Director (Form 49 - Section 14)
Shareholder (Form 24 - Section 14)
Change of Director (Section 58) - if applicable
Change of company name (Form 13 - Section 28) - if applicable
Change of shareholder (Form 32a - section 51) - if applicable
Registration Fee Transfer Slip
NRIC (Front)
NRIC (Back)
Highest Academic Certificate – SPM/STPM/Diploma/Degree
Insurance Agent Certification (MII)
Completed PDPA Form
Completed Declaration by Agent
Statement of Bank Account
Suruhanjaya Syarikat Malaysia (SSM) Certification - Business Registration Certificate
Suruhanjaya Syarikat Malaysia (SSM) Certification - Business's Details
Suruhanjaya Syarikat Malaysia (SSM) Certification - Owner's Details
Copy of Your Photo
Business registration certificate (Form 9 - Section 15/17)
Director (Form 49 - Section 14)
Shareholder (Form 24 - Section 14)
Change of Director (Section 58) - if applicable
Change of company name (Form 13 - Section 28) - if applicable
Change of shareholder (Form 32a - section 51) - if applicable
Registration Fee Transfer Slip

Note: If you registered with an Account Manager before, you might want to check your mailbox again so you can find back the AM details.

Declaration

I have never commited an act of misappropriation of money, criminal breach of trust, fraud or forgery or collaborate or try to perform such criminal act.
Yes
I have never been found guilty of any act of cheating, dishonesty or given any mis-statement against any party or individual
Yes
I have never been charged and found guilty in any court of law in respect of any criminal act.
Yes
I have never been adjudicated as a bankrupt
Yes
I hereby give my consent to Etiqa to contact any party for purpose of seeking confirmation about myself
Yes
I hereby give my consent to Etiqa to perform credit and financial checking on me through any party appointed by Etiqa
Yes
Have you ever involved or worked directly or indirectly in any of the industries listed below?
Remittance agent
No
Money changing agency
No
Casino or any other gambling establishment
No
Night club, massage parlour or bar
No
Travel agency
No
Firearm dealers
No
Pawn shop
No
Traders in precious metals/gems
No
Antique dealers
No
Art dealers
No
Charity or society with cross border donations
No
Offshore company
No
Please provide more details such as name of company/association, years involved and your last designation if you have answered “YES” for any of the above questions:

Please read following Agent Agreement Etiqa Berhad document and acknowledge it

Agent Agreement