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Debit Note

This document is an invoice from Malath Cooperative Insurance Co. It details an insurance policy for Sufi Khan Mohammed Yahya. The policy number is 97240451 and covers the period from May 8, 2021 to April 8, 2022. The total amount due is 1,577.11 Saudi Riyals which includes a 15% VAT amount of 205.71 Riyals.

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413 views1 page

Debit Note

This document is an invoice from Malath Cooperative Insurance Co. It details an insurance policy for Sufi Khan Mohammed Yahya. The policy number is 97240451 and covers the period from May 8, 2021 to April 8, 2022. The total amount due is 1,577.11 Saudi Riyals which includes a 15% VAT amount of 205.71 Riyals.

Uploaded by

tala ham
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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VAT CERTIFICATE NO 300001626800003 :‫ﺭﻗﻢ ﺷﻬﺎﺩﺓ ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ‬

INVOICE

SUFI KHAN MOHAMMED YAHYA :‫ﺭﻗﻢ ﺍﻟﻔﺎﺗﻮﺭﺓ‬


Name of Client: :‫ﺍﺳﻢ ﺍﻟﻌﻤﻴﻞ‬
Invoice No. DNU65-700/91829
:‫ﺗﺎﺭﻳﺦ ﺍﻟﻔﺎﺗﻮﺭﺓ‬
Address: - :‫ﺍﻟﻌﻨﻮﺍﻥ‬
Invoice Date . 04/08/2021

VAT Certificate : - :‫ﺷﻬﺎﺩﺓ ﺍﻟﻘﻴﻤﻪ‬ Policy No. 97240451 :‫ﺭﻗﻢ ﺍﻟﻮﺛﻴﻘﺔ‬


‫ﺍﻟﻤﻀﺎﻓﺔ‬

Account No : 154100-005000410 :‫ﺭﻗﻢ ﺍﻟﺤﺴﺎﺏ‬ Endorsement No. 0 :‫ﺭﻗﻢ ﺍﻟﻤﻠﺤﻖ‬

Product Name Comprehensive :‫ﺍﺳﻢ ﺍﻟﻤﻨﺘﺞ‬

Please note that we have DEBITED your account as follows:

Amount in
Description
Saudi Riyal
Being policy premium amount for policy ‫ﻗﻴﻤﺔ ﻗﺴﻂ ﺍﻟﺘﺄﻣﻴﻦ ﻟﻠﻮﺛﻴﻘﺔ ﺭﻗﻢ‬
97240451 1,371.40

Admin Charges For Policy .00


97240451 :‫ﺍﻟﺮﺳﻮﻡ ﺍﻻﺩﺍﺭﻳﺔ ﻟﻮﺛﻴﻘﺔ ﺭﻗﻢ‬

Period from: 05/08/2021 :‫ﺍﻟﻔﺘﺮﺓ ﻣﻦ‬

Period To : 04/08/2022 :‫ﺍﻟﻔﺘﺮﺓ ﺍﻟﻰ‬

Insured Name : SUFI KHAN MOHAMMED YAHYA :‫ﺍﺳﻢ ﺍﻟﻤﺆﻣﻦ ﻟﻪ‬

Insured Code : 3870067 :‫ﺭﻗﻢ ﺍﻟﻤﺆﻣﻦ ﻟﻪ‬

1371.4
Total Amount Due In Saudi Riyal ‫ﺍﻟﻤﺠﻤﻮﻉ ﺑﺎﻟﺮﻳﺎﻝ‬
(% 15 ) ‫ﻗﻴﻤﺔ ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ ﺑﻨﺴﺒﺔ‬ 205.71
‫ﺍﺟﻤﺎﻟﻲ ﺍﻟﻤﺒﻠﻎ ﺍﻟﻤﺴﺘﺤﻖ ﻋﻠﻲ ﺍﻟﻌﻤﻴﻞ ﺷﺎﻣﻞ ﺿﺮﻳﺒﺔ ﺍﻟﻘﻴﻤﺔ ﺍﻟﻤﻀﺎﻓﺔ‬ 1577.11
ONE THOUSAND FIVE HUNDRED SEVENTY-SEVEN &ELEVEN ONLY
.‫ﺃﻟﻒ ﻭﺧﻤﺴﺔ ﻣﺎﺋﺔ ﻭﺳﺒﻌﺔ ﻭﺳﺒﻌﻮﻥ ﺭﻳﺎﻝ ﺳﻌﻮﺩﻯ ﻭﺇﺣﺪﻯﻋﺸﺮﺓ ﻫﻠﻠﻪ ﻓﻘﻂ ﻻ ﻏﻴﺮ‬

For and behalf of


Malath Cooperative Insurance Co.

Prepared By APPSUSER ----------------------------------------


MOTOR_DR_NOTE_RETAIL_ALL V25

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