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Car Insurance & Roadtax Form
Vehicle Plate Number
Owner MyKad
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Owner Full Name
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Email Address
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Contact Phone Number
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Current Address
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Postcode
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Type of Insurance
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--Select Category--
Insurance
Takaful
Car Grant Or Current coverage policy (OPTIONAL)
Additional Information (OPTIONAL)
E-Roadtax Duration
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-Select Duration-
6 months
12 months
Insurance Coverage
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-Select Coverage Type-
1st Party
3rd Party (Fire & Theft)
Additional Info
Non-Saloon Vehicle
Windscreen Vehicle
Perils Coverage
Unlimited Km Towing
Company Vehicle
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