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Copyright 2010. All Rights Reserved. This website last modified on Friday, August 20, 2010

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Vehicle Number*

Please make sure you read the following before you hit 'Submit'

1. We will send the Proposal Form for your completion
2. The purchase is not complete until you have signed on the Proposal Form and return the Proposal Form to us
2. Motor is a Premium-Before-Cover policy, hence the insurance cover will not commence unless payment is made
3. By submitting your purchase over Westing Agency's e-portal platform, it is no indication that the proposal has been accepted by the 
    insurance company
4. A Certificate of Insurance or Cover Note will be issued upon acceptance of risk by the insurance company
5. Insurance companies normally takes about 2-3 days to upload insurance details to Land Transport Authority (LTA)

Contact Number*
Premium Quoted*
Quoted By*
Customer Name*
Insurer*

Address

Block Number*

Street Name*

Unit Number

Building Name

Postal Code*

Comments

Address

Payment*

Quotation Date*

inclusive of 7% GST

MOTOR QUOTATION PURCHASE FORM

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