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Commercial Vehicles Motor Insurance Quotation

Kindly fill up form & submit by clicking on the submit button. Fields marked with * must be filled.

3 Easy Steps :   1.Submit   2.Confirmation   3.Make Payment  You're covered !

about yourself
Name*
Email*
NRIC / FIN No.*
Address*
Singapore* (postal code)
Phone*
Date of Birth* (ddmmyyyy)
Gender*
Marital status*
Occupation*
Nationality*
Driving Experience* (number of years)
Safe Driver Discount (Traffic Police)* 
about your vehicle
Registration Number*
Type of Coverage* Detail ?
Engine capacity (cc)*
Unladen Wt*
Max Laden Wt*
Seating capacity*
Year manufactured*
Year of registration*
Class* e.g. Goods (Closed)
Make*
Model*
Vehicle Type*
Vehicle Usage*
Parallel Imported?*
Company Registered Car ?*
about your insurance history
No Claim Discount at Next Renewal*
Current/previous motor insurer*
Total no of claims in last 3 years*
Total claim amount in last 3 years*
Current Finance Company   
about your named drivers
Named Driver 1  
Date of Birth   (ddmmyyyy)
Driving Experience  
Relationship to Insured  
Named Driver 2  
Date of Birth   (ddmmyyyy)
Driving Experience  
Relationship to Insured  
about your new policy
Next Commencement Date* (ddmmyyyy)
Expiry Date* (ddmmyyyy)
about your renewal notice
Already received your renewal notice?*
If yes, what was the quote received?* Premium $
Excess   $

Important Notice:
Statement Pursuant to Section 25(5) of the Insurance Act (Cap. 142) - You are to disclose in this form fully and faithfully all the facts which you know or ought to know, otherwise the policy issued hereunder may be void.

The insurance will not be in force until the application and premium have been received and accepted by the company.