AIB Insurance Broking | Singapore Insurance Broker

Personal Information

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Name

Han Yu Pin Yin Name

NRIC Number

Gender

Date of Birth

Occupation

Driving Licence

Vehicle Information

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Vehicle Number

Vehicle Usage *

NCD *

Vehicle Number

Vehicle Usage *

NCD *

Selected Details

Vehicle Type

Vehicle Make

Vehicle Model

Vehicle Year of Manufacture

Vehicle Chassis Number

Vehicle Engine Number

Vehicle Motor Number

Vehicle Original Registration Date

Vehicle Road Tax Expiry Date

Vehicle Scheme

Vehicle Engine Capacity

Vehicle Power Rate

Vehicle Propellant

Vehicle Attachment 1

Vehicle Attachment 2

Vehicle Attachment 3

Other Information

Marital Status *

Email *

Mobile Number *

Insured Driving *

Named Driver's Name

Named Driver's NRIC/FIN

Named Driver's Gender

Named Driver's Marital Status

Named Driver's Driving Experience

Named Driver's Claims (past 3 years)

Relationship

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