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Visitor Visa Insurance Details

This document is an insurance certificate for a visit visa to Saudi Arabia. It provides details of the policy such as the policy number, insured person's name, dates of issue and expiration, visa details. It also lists the premium paid in USD and SAR along with applicable VAT. Notes provide information on obtaining the insurance certificate upon payment, downloading the policy wording and medical providers list, cancelling the policy by first cancelling the visa, and contacting customer service to refund insurance fees.

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Syed Imran
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© © All Rights Reserved
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1K views2 pages

Visitor Visa Insurance Details

This document is an insurance certificate for a visit visa to Saudi Arabia. It provides details of the policy such as the policy number, insured person's name, dates of issue and expiration, visa details. It also lists the premium paid in USD and SAR along with applicable VAT. Notes provide information on obtaining the insurance certificate upon payment, downloading the policy wording and medical providers list, cancelling the policy by first cancelling the visa, and contacting customer service to refund insurance fees.

Uploaded by

Syed Imran
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

‫ﺯﻳﺎﺭﺓ‬ ‫ﺗﺄﺷﻳﺭﺓ‬ ‫ﺗﺄﻣﻳﻥ‬

Visit Visa Insurance Certificate
CUSTOMER SUPPORT Inside KSA ­ 9200­09369 CUSTOMER SUPPORT OutSide KSA ­ 9200­09369 Opening Hours ­ Son­Thu: 8AM to 4PM
Saudi Public Joint Stock Co. – Capital SR 200 Millions/ C.R. No. 1010234323/ C.C No. 182800/ Head Office: Tel: 011 2505400 Fax: 011 4631294 P.O Box 61352 Riyadh 11565

 POLICY DETAILS  VISA DETAILS
Policy Number : 1001174129 Visa Type : Single

Insurance Duration : 180 Visa Validity : 180

Issue Date : 29­11­2019 E­ Number : E248925873

Start Date : 05­12­2019 Passport Number : R1905989

Expiry Date : 02­06­2020

 CONTACT DETAILS
Mobile no : 0580967811

E­Mail ID : [Link]@[Link]

Address : 98 KULI ROAD ZAKIR NAGAR SINGHBHUM QURESHI ENTERPRISES

 INSURER DETAILS

Sl. no Name Nationality Marital Status Gender Benefciary Type Relation Type DOB


1 ROKHSAR KHAN India Married Female Main 1 05­01­1995
‫ﺍﻟﻜﺘﺮﻭﻧﻴﺔ‬ ‫ﻓﺎﺗﻮﺭﺓ‬
Electronic Invoice
Mandatory Insurance on visitors to the Kingdom of Saudi Arabia

TIN : 300057857800003 : ‫ﺍﻟﻀﺮﺑﻲ‬ ‫ﺍﻟﺘﺴﺠﻴﻞ‬ ‫ﺭﻗﻢ‬

POLICY DETAILS ‫ﺍﻟﻮﺛﻴﻘﺔ‬ ‫ﻣﻌﻠﻮﻣﺎﺕ‬

Policy Number 1001174129 1001174129 ‫ﺍﻟﻮﺛﻴﻘﺔ‬ ‫ﺭﻗﻢ‬

Name ROKHSAR KHAN ROKHSAR KHAN ‫ﺍﻻﺳﻢ‬

Issue Date (G) 29­11­2019 29­11­2019 (‫ﺍﻻﺻﺪﺍﺭ)ﻡ‬ ‫ﺗﺎﺭﻳﺦ‬

E­Number E248925873 E248925873 ‫ﺍﻹﻟﻜﺘﺮﻭﻧﻲ‬ ‫ﺍﻟﺮﻗﻢ‬

Policy Duration 180 180 ‫ﺍﻟﻮﺛﻴﻘﺔ‬ ‫ﺳﺮﻳﺎﻥ‬ ‫ﻣﺪﺓ‬

Visa Duration 180 180 ‫ﺍﻟﺘﺎﺷﻴﺮﺓ‬ ‫ﺳﺮﻳﺎﻥ‬ ‫ﻣﺪﺓ‬

PREMIUM DETAILS ‫ﺍﻟﺘﺄﻣﻴﻦ‬ ‫ﻗﺴﻂ‬ ‫ﺗﻔﺎﺻﻴﻞ‬

Premium (USD) $. 19.05 $ 19.05 (‫ﺍﻷﻣﺮﻳﻜﻲ‬ ‫)ﺑﺎﻟﺪﻭﻻﺭ‬ ‫ﺍﻟﺘﺄﻣﻴﻦ‬ ‫ﻗﺴﻂ‬

VAT USD(5%) $. 0.95 $ 0.95 (USD)(5%) ‫ﺍﻟﻤﻀﺎﻓﺔ‬ ‫ﺍﻟﻘﻴﻤﺔ‬ ‫ﺿﺮﺑﻴﺔ‬

Total Payable Amount (USD) $. 20.00 $ 20.00 (USD) (‫ﺍﻟﺴﻌﻮﺩﻱ‬ ‫)ﺑﺎﻟﺮﻳﺎﻝ‬ ‫ﺍﻟﻤﺒﻠﻎ‬ ‫ﺇﺟﻤﺎﻟﻲ‬

Premium (SAR) SAR. 71.44 71.44 ‫﷼‬ (‫ﺍﻟﺴﻌﻮﺩﻱ‬ ‫)ﺑﺎﻟﺮﻳﺎﻝ‬ ‫ﺍﻟﺘﺄﻣﻴﻦ‬ ‫ﻗﺴﻂ‬

VAT (5%) SAR. 3.57 3.57 ‫﷼‬ (5%) ‫ﺍﻟﻤﻀﺎﻓﺔ‬ ‫ﺍﻟﻘﻴﻤﺔ‬ ‫ﺿﺮﺑﻴﺔ‬

Total Payable Amount SAR.75.01 75.01 ‫﷼‬ (‫ﺍﻟﺴﻌﻮﺩﻱ‬ ‫)ﺑﺎﻟﺮﻳﺎﻝ‬ ‫ﺍﻟﻤﺒﻠﻎ‬ ‫ﺇﺟﻤﺎﻟﻲ‬

NOTES ‫ﻣﻼﺣﻈﺎﺕ‬
You will be able to obtain an insurance certificate upon payment
‫ﺍﻟﻤﺮﺍﻓﻖ‬ ‫ﻓﻲ‬ ‫ﻗﺒﻮﻟﻬﺎ‬ ‫ﻳﺘﻢ‬ ‫ﻭﺳﻮﻑ‬ ‫ﺍﻟﺪﻓﻊ‬ ‫ﺇﺗﻤﺎﻡ‬ ‫ﻓﻮﺭ‬ ‫ﺍﻟﺘﺄﻣﻴﻦ‬ ‫ﺷﻬﺎﺩﺓ‬ ‫ﻋﻠﻰ‬ ‫ﺍﻟﺤﺼﻮﻝ‬ ‫ﻳﻤﻜﻨﻜﻢ‬
which will be accepted in the medical providers (with no need for a
‫ﺍﻟﻤﻌﺘﻤﺪﺓ‬ ‫ﺍﻟﻄﺒﻴﺔ‬ ‫ﺍﻟﻤﺮﺍﻓﻖ‬ ‫ﻓﻲ‬ ‫ﺍﺳﺘﺨﺪﺍﻣﻬﺎ‬ ‫ﺷﺮﻳﻄﺔ‬ (‫ﺑﻼﺳﺘﻴﻜﻴﺔ‬ ‫ﻟﺒﻄﺎﻗﺔ‬ ‫ﺍﻟﺤﺎﺟﺔ‬ ‫)ﺩﻭﻥ‬ ‫ﺍﻟﻄﺒﻴﺔ‬
plastic card) provided that it is used only in your appointed medical
.‫ﻓﻘﻂ‬ ‫ﻟﻜﻢ‬
providers.
You can download a copy of the insurance “Policy Wording” and
the “Appointed Medical Providers’ Network” by clicking on the ‫ﻋﻠﻰ‬ ‫ﺑﺎﻟﻀﻐﻂ‬ ‫ﺍﻟﻤﻌﺘﻤﺪﺓ‬ ‫ﺍﻟﻄﺒﻴﺔ‬ ‫ﺍﻟﻤﺮﺍﻓﻖ‬ ‫ﻭﺷﺒﻜﺔ‬ ‫ﺍﻟﺘﺄﻣﻴﻦ‬ ‫ﺑﻮﻟﻴﺼﺔ‬ ‫ﻣﻦ‬ ‫ﻧﺴﺨﺔ‬ ‫ﺗﻨﺰﻳﻞ‬ ‫ﻳﻤﻜﻨﻜﻢ‬
icons at the end of the insurance certificate page issued by )Enjaz) .‫ﺻﺪﻭﺭﻫﺎ‬ ‫ﺣﺎﻝ‬ ‫ﺇﻧﺠﺎﺯ‬ ‫ﻣﻮﻗﻊ‬ ‫ﻣﻦ‬ ‫ﺍﻟﺼﺎﺩﺭﺓ‬ ‫ﺍﻟﺘﺄﻣﻴﻦ‬ ‫ﺷﻬﺎﺩﺓ‬ ‫ﺻﻔﺤﺔ‬ ‫ﺃﺳﻔﻞ‬ ‫ﺍﻷﻳﻘﻮﻧﺘﻴﻦ‬
website.
To cancel insurance policy, visa must be cancelled first. .‫ﺃﻭﻻ‬ ‫ﺍﻟﺘﺄﺷﻴﺮﺓ‬ ‫ﺇﻟﻐﺎء‬ ‫ﻳﺠﺐ‬ ،‫ﺍﻟﺘﺄﻣﻴﻦ‬ ‫ﺑﻮﻟﻴﺼﺔ‬ ‫ﻹﻟﻐﺎء‬
To refund the insurance fees, please contact customer service
920009369 ‫ﻋﻠﻰ‬ ‫ﺍﻟﻌﻤﻼء‬ ‫ﺧﺪﻣﺔ‬ ‫ﺑﻤﺮﻛﺰ‬ ‫ﺍﻻﺗﺼﺎﻝ‬ ‫ﻳﺮﺟﻰ‬ ،‫ﺍﻟﺘﺄﻣﻴﻦ‬ ‫ﺭﺳﻮﻡ‬ ‫ﻻﺳﺘﺮﺩﺍﺩ‬
center at 9200 0 9369.

Mobile no : 0580967811 E­Mail ID : imran.jharkhand@gmail.com Address : 98 KULI ROAD ZAKIR NAGAR SINGHBHUM QURESHI ENTERPRISES
POLICY DETAILSﻣﻌﻠﻮﻣﺎﺕ ﺍﻟﻮﺛﻴﻘﺔ Policy Number 1001174129 1001174129ﺭﻗﻢ ﺍﻟﻮﺛﻴﻘﺔ Name ROKHSAR KHAN ROKHSAR KHANﺍﻻﺳﻢ Issue Date (G

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