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Visitor Visa Insurance Details

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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,…

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Syed Imran
  • Visa Insurance Certificate
  • Electronic Invoice

‫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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