IFA-SINGAPORE

IFA-Singapore Motor Car Quotation Request


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Title: Ms Miss Mrs Mdm Mr
Vehicle Owner Name:
Date of Birth (dd-mm-yyyy):
Marital Status: Married Divorced Single Others
Residential Status: Singaporean Singapore PR Employment Pass Others
Occupation (Please explain if self employed):
Work Location: Indoor Outdoor
Passing Date of Class 3 DL (dd-mm-yyyy):
Years of Driving Exp. outside Singapore (if any):
NCD upon renewal (%):
Safe Driver Discount by Traffic Police: No Yes Please click here to check the status at Traffic Police Website
NCD Protector (for 50% NCD): No Yes Optional
Vehicle Registration No.:
Fuel Source:
Off-Peak Vehicle?: No Yes
Parallel Import Vehicle?: No Yes
Coverage Type:
Claim Experience (past 3 years):
Excess Preference:
Current / Last Insurance Company:
Contact No.:
Email Address:

Named Driver 1 (if any):
Name:
Date of Birth (dd-mm-yyyy):
Passing Date of Class 3 DL (dd-mm-yyyy):
Years of Driving Exp. outside Singapore (if any):
Occupation:
Work Location: Indoor Outdoor
Relationship to owner (spouse, etc.):

Named Driver 2 (if any):
Name:
Date of Birth (dd-mm-yyyy):
Passing Date of Class 3 DL (dd-mm-yyyy):
Years of Driving Exp. outside Singapore (if any):
Occupation:
Work Location: Indoor Outdoor
Relationship to owner (spouse, etc.):
Remarks: