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Accident Date
Driver Date of Birth (at the time of accident)
Police Report Date
Police Report Number
Accident Remarks
Mobile Number
Accident Fault
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Not my fault
My fault
Cause Of Accident
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Collision
Hit and Run Away
Rain Water Damage
Theft
Windscreen Broken
Fire
Others
Preference of Garage
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INTERNATIONAL MOTOR TRADING AGENCY W.L.L
BEHBEHANI BROTHERS W.L.L.
MONTREAL MOTORS CO. S.P.C
AUTOOS
KARAWAN GARAGE
YOUSIF KHALIL ALMOAYYED & SONS CO.
AHMED ALZAYYANI & SONS CO W.L.L
NATIONAL MOTOR COMPANY W.L.L.
MOHAMMED JALAL & SONS COMPANY LIMITED W.L.L
ALHADDAD MOTORS
EURO MOTORS CO S P C
ATLAS GARAGE
NABEEL GARAGE
AIR PORT GARAGE
ALAMADI AUTO SERVICES W L L
ALREJENSI AUTO GARAGE
SENGER GARAGE
FAKHROO GARAGE
PAKISTAN GARAGE
YOUSIF TALEB GARAGE
Preferred Survey Date
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Dear customer, please ensure that below full details of the employer (in case of domestic helper) or policy holder in general must be entered correctly during registration.
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