Car Insurance Quote Form

Car Insurance Quote

Your Vehicle Details

Full Name as per NRIC

Contact Number

Gender

NRIC/Passport No.

Date of Birth

Marital Status

How many years have you been driving? (Policyholder aka main driver of the private car.)

Have you made a claim within the past 3 years?

What's your No-Claim Discount (NCD)?

Vehicle No.

Coverage Period Start Date

Coverage Period End Date

What's your car make and model?
(If your vehicle make/model is not available in the list, you may fill in the details under Other Notes/Information and upload your existing policy.)

What's the engine capacity of your car?

Choice of Plan Coverage

Finance Company

Is your car under the Off-Peak Car scheme?

Other Notes/Information

Please upload your existing policy.

I/we hereby understand that I/we need to disclose our personal data in order for the Avant GIS team to generate a quotation for me/us. I/we have read the Privacy Policy and I/we consent to the collection and use of my/our personal data in accordance with its Privacy Policy.