Motor Insurance Quotation

Insured’s Particulars

Your Name (required)
NRIC/Passport no/Fin no
License Pass Date
Date of Birth (ddmmyy)
Marital Status
 Single Married
Contact No.
Gender
 Male Female
Nationality
 Singaporean PR Foreigner
If Civil Servant / foreigner please provide details:

Vehicle Particulars

Vehicle Reg.
Agent/PI Model
 Normal OPC
Finance Company
Make and Model
Reg Date
CC

Previous Vehicle Particulars

Claim Details:
NCD%
Insurance Co.