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Applicant & Policy Details
Applicant Name Buying Policy for: Renew Policy Existing Car:
Previous Policy Issued By Date of First Purchase/Registration: Previous Policy Expiry Date:
Policy Type: Package Policy        
Vehicle Details
Manufacturer Name Model Variant
City Of Registration Fuel Type Cubic/Seat Capacity /
Suggested Ex-Show Room Price(in Rs.) Own Ex-Show Room Price(in Rs.) Suggested IDV(in Rs.)
Your own IDV(in Rs.) Claims made in expiring policy? No Claim Bonus(NCB) in previous policy (or) earlier vehicle sold(in %): Not Applicable
NCB Rate Eligible(in %): Not Applicable Vehicle Registered in the Name of a/an: Company    
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