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New/Renewal Insurance
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Vehicle Owner
*
Vehicle Number
*
Year
*
Make
*
Model
*
Engine Number
*
Chassis Number
*
mentioned the details
*
1. Your date of birth/firm's incorporation date(as mentioned in PAN) 2. PAN number 3. Aadhar Number 4. Nominee Name 5. Nominee date of birth
Previous Policy Number
*
Expiry date
*
Previous Insurer
*
NCB
*
% of Non-Claimed bonus appeared in your last policy
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