Car

Car Insurance Coverage

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Car Model & Make:
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Windscreen Coverage:
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Name (As Per NRIC):
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NRIC Number:
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Mobile Number:
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Email:
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Address:
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Name (2nd Driver):
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NRIC (2nd Driver):
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Motorcycle

Motorcycle Insurance Coverage

Insurance Type:
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Plate Reg. Number:
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Motorcyle Model & Make:
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Name (As Per NRIC):
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NRIC Number:
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Mobile Number:
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Email:
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Address:
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