Motor Insurance Quote – ParsonsAuto

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Name 姓名

Email 电子邮件

NRIC 身份证号码 / Company UEN 公司统一编号

Date of Birth 出生日期 DDMMYYYY

Gender

Marital Status

Contact Number 联系电话

Residential Address 居住地址

Occupation 职业

Date of Issue of Licence 执照颁发日期 DDMMYYYY

Type Of Cover 保险类型

Renewal 续约

Vehicle Registration Number 车辆登记号码

Make & Model 制造商/型号

Year 年份

Present Insurer 现行保险公司

NCD (%) 无索赔折扣

Claims (State if any) 索赔（如有)

Data Consent Agreement

By ticking and submitting this form, I confirm that the information provided is either my personal data or that I have obtained consent from the owner of such personal data to provide it. By supplying this information, I consent to the disclosure of my personal data to your employees, agents, or insurers for the purpose of obtaining insurance premium quotations for motor vehicle insurance policies via various communication channels such as telephone calls, SMS messages, facsimile, email, mail, and others. Additionally, I consent to the insurers collecting, using, disclosing, and/or processing my personal data for the purpose of processing my request for quotations and providing underwriting and insurance products and services.

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