ASSICURAZIONE RC AUTO/MOTO

COMPILA IL FORM PER OTTENERE IL PREVENTIVO PER LA TUA ASSICURAZIONE, SARAI SUCCESSIVAMENTE CONTATTATO PER L’INVIO DEL PREVENTIVO.

RC AUTO / MOTO / FURGONE

CHE TIPO DI VEICOLO DEVI ASSICURARE ?

CHE TIPO DI ASSICURAZIONE ( PRIMA IMMATRICOLAZIONE ? / POLIZZA IN SCADENZA / VOLTURA /ALTRO.. )

INSERISCI LA TARGA

NOME E COGNOME INTESTATRIO AUTO E CODICE FISCALE

RESIDENZA INTESTATARIO

DOCUMENTI INTESTATARIO ( DOCUMENTO D'IENTITA , COMPRESO DI CODICE FISCALE ) Choose a file

Max. size: 128,0 MB

LIBRETTO AUTO/ MOTO/ FURGONE ( FRONTE RETRO ) Choose a file

Max. size: 128,0 MB

CELLULARE INTESTATARIO MEZZO

MAIL DOVE RICEVERE IL PREVENTIVO ?

DATA SCADENZA POLIZZA

CHE PREMIO VUOI PAGARE ? ( ANNUALE / SEMESTRALE ?)

CHE GARANZIE VUOI ? ( SOLO RC / ANCHE INCENDIO E FURTO / CARRO ATTREZZI / CASKO / ALTRO.. )

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