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AFTER HOURS EMERGENCY? We’re here for you. Call 078 451 4284
/
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/ Motor Accident Claim Form
Please attached a schetch of the accident:
Please attached a copy of the drivers license:
Please attached a copy of the drivers ID:
We herby declare the foregoing particulars to be true in every respect
Ons verklaar hiermee dat die voorafgaande besonderhed in elke opsig waar is
Insured's VAT registartion number if applicable:
I Accept that the information I have provided is true
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