INSURED
full name
address
mobile No
Relationship to the owner of the car
VEHICLE DETAILS
make
model
chassis No
color
insurance period
from
to
insurance policy NO
Does the car have insurance from another company?
If the answer is yes, attach a copy of the insurance certificate
Max. size: 100.0 MB
DETAILS
date of the accident
time
location
The type of glass damaged
The driver's name at the time of the accident
age
address
Was the glass changed during the insurance?
Payment of insurance premiums
The remaining amount of money
Documents
polic report
Max. size: 100.0 MB
copy of insured's driving license
Max. size: 100.0 MB
copy of updated registration card
Max. size: 100.0 MB
copy of driver's driving license
Max. size: 100.0 MB
scene of accident photographs
Max. size: 100.0 MB
copy of driver's driving license
Max. size: 100.0 MB