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Vehicle Reg. No.: Policy No.: Customer Name:

IDV (₹): MFG Year: Zone: Zone A Zone B Zone C GVW (kg): Discount on OD (%): Electrical Accessories (₹): CNG/LPG Kit: NoYes CNG Kit Value (₹): IMT23: NoYes NCB (%): 02025354550 Geo Extension: ₹0₹400 Anti-Theft: NoYes Zero Dep (%): RSA (₹): PA Owner (₹): LL Paid: ₹0₹50 LL Emp: ₹0₹50₹100 ₹150₹200₹250 ₹300₹350 Restricted TPPD: NoYes

Remarks/Notes:

Final Policy Details

Insurer Name Select Insurance Company New India Assurance United India Insurance National Insurance ICICI Lombard Bajaj Allianz

Intermediary Name

Vehicle Model