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Warning:
Items marked with
are mandatory.
"I, in the capacity as the injured party, or, as the case may be, the legal representative of the damaged party, do declare that I was injured during a traffic accident caused by the vehicle specified hereunder, and do also declare that the information entered is truthful."
Vehicle Reg.No:
Only alphanumerical characters without spaces and punctuation
Vehicle VIN:
Only alphanumerical characters without spaces and punctuation
MTPL Insurance on the date:
Format DD.MM.YY or DD.MM.YYYY
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