Let’s get started… Let’s get you the perfect price to cover your motorcycle. Let’s get started with you telling us who you are and how we can get hold of you? rather call me back First Name *Last NameEmail Address *Phone *ID Number *0 / 13Marital StatusSingleMarriedCan we do an ITC check?YesNoEmployment StatusGovernmentPrivateSelf EmployedResidential AddressStreet AddressComplex/BuildingSuburbCity/TownPostal CodeProvinceSelectEastern CapeFree StateGautengKwaZulu-NatalLimpopoMpumalangaNorthern CapeNorth WestWestern CapeYear, Make & Model of Bike:MakeModelYearRetail ValueEngine CapcityColourAre you the regular rider of the motorcycle? *YesNoIf no, please provide the regular riders detailsFirst NameLast NameEmail AddressPhoneID Number *0 / 13Where is your motorcycle parked during the day?In the streetBehind a locked gateInside a garageWhere is your motorcycle parked during at night?In the streetBehind a locked gateInside a garageDo you use the motorcycle for business use?YesNoIs your bike for on-road or off-road use?On-roadOff-roadDo you use the motorcycle to commute daily to your place of work?YesNoIs the motorcycle financed?YesNoAre there any extras fitted to the motorcycle that you would like insured?DescriptionValueDescriptionValueDescriptionValueDo you have any riding gear that you would like insured?DescriptionValueDescriptionValueDescriptionValueDrivers License NumberSelectCodeA1ADate of issueUpload Photo of Drivers LicenseChoose FileNo file chosenDelete uploaded fileUpload Photo of License DiskChoose FileNo file chosenDelete uploaded fileYears continuous motor vehicle insuranceYears riding experience:Any claims/losses in the last 5 years: If so, please complete the below:Date of lossValue of lossDescription of lossLoad anotherDate of lossValue of lossDescription of lossGet My Quote CALL ME BACK Name *Phone *Call Me Back
