COMPULSORY THIRD PARTY LIABILITY (CTPL) - SAGITARIES INSURANCE SERVICES

CAR INFORMATION

IS YOUR VEHICLE BRAND NEW?

CTPL COVERAGE :

1 year - for not brand new

3 year - for brand new

CTPL COVERAGE

VEHICLE TYPE

TRANSMISSION TYPE

MANUFACTURED YEAR

BRAND

MODEL

CONDUCTION STICKER

PLATE NO.

Engine No. should be at least 5 digits/characters in length

ENGINE NUMBER

Chassis No. should be at least 5 digits/characters in length

CHASSIS NUMBER

MV FILE NO.

COLOR

PERIOD OF INSURANCE

INCEPTION

EXPIRY

Personal Information

TITLE*

FIRST NAME*

MIDDLE NAME*

LAST NAME*

MOBILE NUMBER*

EMAIL*

IDENTIFICATION NUMBER*

DATE OF BIRTH*

DATE OF BIRTH

ADDRESS*