Motor Third Party Liability Proposal Form Step 1 of 3 33% Cover OptionsFrom:* DD slash MM slash YYYY To:* DD slash MM slash YYYY Type of plan*SelectRegalRulerAdditional CoverOption 1 Third Party liability for driving other private vehicles Option 2 Windscreen cover (€200) If more please give the sum insured Option 3 Cover for Trailer If yes, please give details Option 4 Cover for driving beyond the limits of a public road Option 5 Road Assistance and Accident Care Option 6 Personal Accident of the Insured of €10,000 Option 7 Personal Accident of the Insured's spouse €10,000 Option 8 Loss of or damage to vehicle due to fire or theft If yes, give value of Vehicle Proposer's DetailsName* Postal Address* Telephone* Email* Οccupation statusSelectEmployedSelf-EmployedRetiredUnemployedStudentHousehold DutiesDate of Birth* DD slash MM slash YYYY Identity Card No* Present Insurer Second Driver DetailsName Date of Birth MM slash DD slash YYYY Year driving test passed Occupation StatusSelectEmployedSelf-EmployedRetiredUnemployedStudentHousehold DutiesAny person over 25 up to 70 and holder of driver's license for more than two years. YES Vehicle DetailsRegistration No* Vehicle Year Vehicle Make Vehicle Model* Number of passengers including driver Date of Purchase* MM slash DD slash YYYY Use of Vehicle Social,Domestic and pleasure and for the Insured's business For Data Protection Company Policy Click Here. * I have read the Data Protection Company Policy posted on this website I herewith provide Royal Insurance Company Ltd (and any successors and assignees thereof), my express and unconditional consent regarding the processing and creation of data records in electronic and physical form, of all my relevant personal data, that may include sensitive data which I have declared and submitted
