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Vehicle Registration Number :
e.g. ABC123
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Company Vehicle
E-Hailing Vehicle
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Package Option
Insurance Only
Insurance Only
Insurance & Road Tax
Road Tax Only
Package
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Owner Name :
Name
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Owner MyKad / Passport / Army / Police :
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Owner E-Mail Address :
E-mail Address
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Owner Contact Number :
Phone Number
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Insurance Type :
1st Party (Comprehensive)
3rd Party (Fire & Theft)
3rd Party
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Extra Protection :
Peril Coverage (Natural Disaster Protection)
Windscreen Coverage
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Windscreen Amount (RM)
[{"field":"{extra}","logic":"contains","value":"Windscreen Coverage","and_method":"","field_and":"","logic_and":"","value_and":""}]
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2nd Driver Name :
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2nd Driver MyKad / Passport / Army / Police :
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