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EZYRENEW FORM
Please fill up the form, we will send you car insurance quotation shortly
*Require
Car Owner Name / Company Registered Name *
IC / Company Reg. No *
Car Plate No *
Phone Number (For WhatsApp Quotation) *
Type of Coverage *
Comprehensive
Third Party, Fire & Theft
Third Party
Cover Front Screen
Yes
Grab's e-Hailing service
Yes
Do you agree our
Privacy & Policy
*
Yes
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