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Motor Insurance Quotation
Insured Name
ROC/NRIC No
Contact No
Email
Address
Vehicle No.
Vehicle Details
Make
Select
Nissan
Toyota
Renewal NCD
Model
Select
Nissan2010
Toyota2018
Exisiting Insurer
Year of Manufacture
Previuos Registration No
Original Reg. Date
Yr Made / Date of Reg
Type of Cover
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Remarks
Distributor’s Workshop
Any Workshop
Authorised Workshop
Remarks
China Taiping
Excess
NTUC
Excess
Lonpac
Excess
ETIQA
Excess
ERGO
Excess
ECICS
Excess
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