汽车保险投保书.PDFVIP

汽車保險投保書 MOTOR VEHICLE INSURANCE PROPOSAL FORM 投保人姓名 先生 女士 公司 電話 職業 Proposer full name Mr. Ms Company Telephone Number Occupation 地址 Address 保險生效日期 由 至 保 月 Period of Insurance From To For Months 投保類別 綜合保險 第三者保險 Type of Cover Comprehensive Third Party Only 投保汽車資料PARTICULARS OF VEHICLE TO BE INSURED 汽車登記號碼 汽車牌子 型號 座位數目(司機除外) 汽車容量(c.c.) 車輛總重量 Registration number Make Model Seating Capacity (excluding Driver) Cylinder Capacity Gross Vehicle Weight 引擎號碼 底盤號碼 車身類型 製造年份 車門數量 購買日期 Engine Number Chassis Number Type of Body Year of Manufacture No. of Door Date when purchased 投保汽車通常停泊處 汽車市值估計，包括附件及備件 Usual parking places of the Motor Vehicle Estimated Vehicle Value incl. accessories and spare parts whilst thereon HK$ 除固定零件外如有加裝附件，請列明價值 Please list all additional accessories and provide breakdown of the cost 加裝附件 Additional Accessories 價值 Value (HK$) 閣下的汽車有否裝置任何防盜設備? 如 “有” 請注明牌子及型號 Has a theft alarm system been installed in the vehicle? If Yes please state make and model 投保汽車有否曾作任何形式的改裝或修飾? 如 “有” 請詳述之 Has the vehicle been modified in any way? If Ye