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New Insurance

Thank you for your interest in Optima Werkz’s Services, we shall get back to you within 24 hours:

Vehicle details

Vehicle no:

Year:

Make:

Model:

Personal Details

Name:

Gender:

FemaleMale

I.C No. / International Passport:

Driving License No.:

License Pass Date:

Date of Birth:

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Address:

Postal Code:

Country:

I have read & agree to the T&C and PDPA

I would like to receive updates from Optima Werkz

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Renew Insurance

Thank you for your interest in Optima Werkz’s Services, we shall get back to you within 24 hours:

Vehicle details

Vehicle no:

Year:

Make:

Model:

Insurance details

Insurance coverage:

Commencement date:

Offence Free:

YesNo

NCD Upon Renewal:

Current Insurer:

Other (please fill in)

Current Renew Premium:

Number of Claims Mode:

Occupation:

Personal Details

Name:

Gender:

FemaleMale

I.C No. / International Passport:

Driving Licence No.:

Date of Birth:

Mobile:

Email:

Address:

Postal Code:

Country:

I have read & agree to the T&C and PDPA

I would like to receive updates from Optima Werkz

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