保险专业资源下载网站

(I) Insured 投保人

Name Occupation

姓名 职业

Policy / Certificate No. Period of Insurance

保险单号码 承保日期

Residential Address Tel.

住宅地址 电话

Office Address Tel.

办事处地址 电话

(II) Insured Vehicle 承保车辆

Registration Marks. Make

车牌号码 厂名

Model Year of Manufacture

款式 製造年份

Engine No. Chassis No. Date of Purchase

引擎号码 车身底盘号码 购入日期

Hire Purchase Owner No. of passengers being carried 

at the time of the accident excluding driver

所属财务公司 意外时所载乘客人数 (不包括司机)

Nature of goods being carried at the time of the accident

意外时所载货物种类