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Vehicle Details
Vehicle Registration Number
National ID Number
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Third Party
Full Third Party
Comprehensive
Product
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Private Car
Private Trailer
Commercial Vehicle
Commercial Trailer
Private Motorcycle
Commercial Motorcycle
Commercial Commuter Omnibus
Commercial School Bus
Commercial Staff Bus
Commercial Tractors
Commercial Emergency Services
Commercial - Special Vehicles
Commercial - Agriculture
Vehicle Usage
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Personal Usage (including driving to work and back)
Personal Usage (Limitied business usage)
Personal Usage - Fleet
Personal Car (Used for Hire)
Personal Car (Used for Driving School)
Personal Usage - Trailer (including driving to work and back)
Personal Usage - Caravan
Commercial Vehicle - Own Business
Commercial Vehicle - Hire and Reward
Commercial Vehicle - Fleet - Own Business
Commercial Vehicle - Fleet - Hire and Reward
Commercial Vehicle - Driving School
Commercial Vehicle - TAXIS (eg metered taxis)
Commercial Trailers - Own Business
Commercial Trailers - Hire and Reward
Commercial Trailers - Fleet - Own Business
Commercial Trailers - Fleet - Hire and Reward
Commercial Trailers - Agriculture Usa
Motorcycle - Personal Usage (including driving to work and back)
Motorcycle - Business Usage
Motorcycle Fleet - Business Usage
Upto 30 seats
Between 31 - 60 seats
More than 60 seats
Upto 30 seats
Between 31 - 60 seats
More than 60 seats
Upto 30 seats
Between 31 - 60 seats
More than 60 seats
Tractors/Fork Lifts - Personal Use
Tractors/Fork Lifts - Hire and Reward
Tractors/Combines - Agriculture - Own use
Tractors/Combines - Agric - Hire & Reward
Ambulance, Fire Engine, Hearse
Special Types - Contractors Plant and
Equipment (Dozers, Graders and the like)
Agricultural Implements
Insurance Payment Term
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Annual-12 Months
Term-4 Months
Term-5 Months
Term-6 Months
Term-7 Months
2 Terms-8 Months
2 Terms-9 Months
2 Term-10 Months
2 Term-11 Months
Suggested Value
SumInsured
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Annual-12 Months
Term-4 Months
Term-5 Months
Term-6 Months
Term-7 Months
2 Terms-8 Months
2 Terms-9 Months
2 Term-10 Months
2 Term-11 Months
Radio License
Radio License Payment
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Annual-12 Months
Term-4 Months
Term-5 Months
Term-6 Months
Term-7 Months
2 Terms-8 Months
2 Terms-9 Months
2 Term-10 Months
2 Term-11 Months
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CUSTOMER DETAILS
Name
Surname
Email Address
DOB
Phone Number
Gender
Male
Female
City
----Select City----
Kadoma
Harare
Bulawayo
Chitungwiza
Mutare
Epworth
Gweru
Kwekwe
Masvingo
Chinhoyi
Norton
Marondera
Ruwa
Chegutu
Zvishavane
Bindura
Beitbridge
Redcliff
Victoria Falls
Rusape
Chiredzi
Kariba
Karoi
Chipinge
Gokwe
Shurugwi
Gwanda
Shamva
Mutoko
Murehwa
Guruve
Chivhu
Mvurwi
Chiweshe
Mount Darwin
Nyanga
Mberengwa
Mvuma
Mazowe
Mhangura
Domboshava
Nyamapanda
Goromonzi
Ngezi
Hwange
Triangle
Address
Suburb
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Risk Details
Make
Select Vehicle Make
ACTM
ADLY
ALFA ROMEO
AMBASSADOR
APRILIA
ARAGON
ARB
ARDOR
ASCA
ASHOK LEYLAND
ASTON MARTIN
AUDI
AUSTIN
AVANTI
B&L
BAJAJ
BAOTIAN
BDMC
BEDFORD
BELL
BENTLEY
BERLINGO
BIRELLI
BISAN
BLACK R
BMW
BOATIAN
BOMAG
BOXLOADER
BROOM
CABSTAR
CAGIRA
CAMEO
CASE
CATERPILLAR
CATO
CERES
CF MOTO
CHANGAN
CHERY
CHEVROLET
CHRYSLER
CHRYSLER
CITROEN
CORUS
CPI
CRANE
DAELIM
DAEWOO
DAF
DAFIER
DAIFO
DAIHATSU
DANCASTER
DATSUN
DAYTON
DELTA
DENNISON
DERBI
DFSK
DODGE
DONGFENG
DUCATI
DUNA
EICHER
ESCORT
FASAKI
FAYMONVILLE
FERRARI
FIAT
FIORI
FIRE FIGHTING
FLANDRIA
FLASH
FODEN 38
FORD
FORLAND
FOTON
FREIGHTER
FRUEHAUF
GALAXY
GARELLI
GEELY
GILPAK
GINAF
GOLDEN DRAGON
GRAU
GWM
HAMM
HAMMAR
HAOJUE
HARLEY-DAVIDSON
HERO MAJESTIC
HICOM
HILLMAN
HINO
HOLLAND
HONDA
HONLING
HOVER
HYOSUNG
HYUNDAI
INNOCENTI
ISUZU
IVECO
JAC
JAGUAR
JAILING
JCB
JEEP
JIEDA
JINBEI
JINBEI
JMC
KANZEN
KAWADA
KAWASAKI
KEEWAY
KIA
KINGLONG
KMC
KOMATSU
KTM
KUBOTA
KYMCO
LADA
LANCIA
LANDROVER
LEXMOTO
LEXUS
LEYLAND
LIFAN
LIGER
LOCAL
LOHEAC
LONDON
LONG
M & G
MAGNUM
MAHINDRA
MALAGUTI
MANITOU
MASSEY FERGUSON
MATADOR
MAXUS
MAZDA
MBK
MERCEDES-BENZ
MG
MINI
MITSUBISHI
MONDIAL
MONTEGO
MONTRACON
MORRIS
MOTOBECANE
MOTOMIA
MOTOSTAR
MOTRAC
NEW WAY
NEXUS
NISSAN
OPEL
PAUS
PERODUA
PEUGEOT
PGO
PIAGGIO
PORSCHE
PROTON
PULSAR
QUASAR
QUINGQI
QUIPAI
RAMZEY
REGAL RAPTOR
RENAULT
RIEJU
ROADSTAR
ROLLS-ROYCE
ROVER
ROYAL ENFIELD
RUIJUE
SAAB
SACHS
SAHEL
SCANIA
SENKE
SHINERAY
SINGER
SINSKI
SIONG
SMART
SSANGYONG
STEELBRO
SUBARU
SUNDIRO
SUPV
SUZUKI
SYM
TATA
TEREX
TOYOTA
TRIUMPH
TVS
UD
VAUXHALL
VOLKSWAGEN
VOLLAND
VOLVO
WOLSELEY
YADEA
YAHAMA
YANGZI
ZONGSHEN
ZX AUTO
FREIGHTLINER
M/BENZ
MERCEDES BENZ
INTERNATIONAL
MERCEDES BENZ
MERCEDES
MIBENZ
OTHER
MADZA
NIISSAN
VW
M BENZ
HOMEMADE
PAJERO
V W
M/ BENZ
UBI QUE
SINO TRUCK
FRREIGHTLINER
MOREWEAR
HMADE
HOME MADE
MERCEDES -BENZ
MITSHUBISHI
MERCEDESBENZ
MERCDES BENZ
VOLKSWAGON
FODEN
LDV
AVM
ZHONG TONG
MAN
MBENZ
TRAILER
LINCOLN
+MERCEDES BENZ
YUTONG
MERCEDES BENZ
TAWN
NMERCEDES BENZ
MITSUBISH
NISSAN MARCH
LAND ROVER
F/LINER
FAW
KING LONG
NISSAN BLUE BIRD
BENZ
M.BENZ
ITALIAN TRAILER
VOLARE MINIBUS
MARCOPOLO
NISSAN CARAVAN
MOTORCYCLE
SKM
ROCSTA
ERF
AEOLUS
MERCEDES - BENZ
CITREON
0PEL
KIA/PICANTO
SEDAN
JOURNEY BUS
BODEN
VW POLO
MODCRAFT
PEOGEOT
MAJATAME
FORDEN
RANGER ROVER
RANGE ROVER
TINDO INDUSTRIES
HOWO
V/WAGON
FORDRANGER
F0RD
PEUGEOT 607
V,W
FORD TRANSIT
HUMMER
LIFE STYLE
A.V.M
MOTORCYCLE HONDA
MECEDES BENZ
ERWEE
BAIC
SK150-10
TINDOINDUSTRIES
TNT
EDINFORD
MORE-WEAR
DIAHATSU
YAMAHA
MARIME CENTRE
SSANG YONG
TANDEM
AAD
L D V
AVECO
NISSAN SUNNY
GOLF
G W M
MITSIBISHI
MARINE CENTRE
M/BENZ VITO
MERCEDS-BENZ
RHINO
YOYOTA
FIVER
CARINA
VENTER
JIALING
POWERSTAR
M\BENZ
NICKS MOTORS
SABARU
ISUZU KB
MERCEDES BENZ
TURNER
HONDA ODYSSEY
MITISUBISHI
COLT
FORD RANGER
LANDCRUISER
TOTOTA
BOAT
BASSET
CRANE FREUHARF
DATSUN/NISSAN
MASTERBODY
HIGER
MITSUBHISHI
LIFESTYLE
BUS
LEYLAND DAF
L/ROVER
TMUK
CAM
PERFECTION
TOYOTA HILUX
H/MADE
ALFA
NISSAN DIESEL
NISSSAN
V.W
NISSAN CHAMP
DACIA
SEDDON
BAW
DASTUN
FREHAUF
ISUZU ELF
VN
AVEO
HORSE
FLAT
FREIGHLINER
VOKSWAGEN
INTEERNATIONAL
DUTSUN
HERO
TRUCK
BMW MINI
AUDI/A4SE
JINBEI GEM
INTERLINK
TOWLITE
SEAT
GMC
HONDA
DIAMOND
TT TRAIL
BLUEBIRD
JIALIANG
G.DRAGON
CHANA
LS125TITAN
CORSA
TIPPER
CHALLENGER
HOMEMADE TRAILER
ATA
RIGIED
DATSUN NISSAN
PEUGEOUT
FORD BANTAM
PETERBILT
VW GOLF
DATSUN-NISSAN
NISAN
PORCHE
GYPSEY
NEW HOLLAND
RANGE
BOAT TRAILER
BURG
INDALE
ATLAS
TOYOTA COROLLA
KARET
ROLLS ROYCE
MOBILE
HENRED
TOYOTA FORTU
GRW
MK 111
HEIL
TRIAXLE
CHEVEROLET
ASHOCK
ZAMBEZI
SHACMAN
INT
SIDE DROP
TOYOTA COROL
VOLVO MACK T
BOX TRAILER
NISSAN VANET
SKM SK125D
TORSION
HARLEY
FREITGHTLINER
NORTHMEC CSE
TOYOTA DYNA
ALITRANS
RSA
SCANIA R420
SCANIA P380
UNCERTAIN
ISUZU FTR850
HENRED TRAIL
JETTA
DONG FENG
NISSAN NAVAR
FREIGHRLINER
HUNDAI
BDJ
NISSAN CARAV
HONDA CRV
VAUXHAULL
INYATHI
TANK CLINIC
SKODA
HENRED FRUE
FREIGHT LINER
AUMARK
SINO
SINOTRUCK
TANKER
HONDA TORNEO
NISSAN-DIESEL
NISSAN TERRANO
YUEJIN
GRD
BUMI
INTERNATONAL
ASIAWING
TOMPSON
SA TRUCK
HOMEBUILD
ISUZU N75.19
FUEL
MERCEDES BEN
DEVEN ENGINEERING
YAXING
ISUZU KB220
RANGEROVER
HONDA FIT
TOYOTA AURIS
AUDI A4
ATECO
LEYLAND DAF
GREAT WALL MOTOR
NISSANSUNNY
MUSSO
ISUZU RODEO
TINTO IND
AFRIT
RENAULT PREM
HASTT
MOTOR CYCLE
NISSAN BLUE BIRD
FRIGHTLINER
ROADHOG
BMW 320I
L.D.V.
FLATDECK
AG
MAN TGX
ARGOSY
MAN DROPSIDE
BEIQI
TRINITY
LAND ROVER V
LAYLAND
TINTO INDUSTRIES
FRONT LINK
FREUHAUF
MOTOR CYCLE
TINTO
MERC BENZ
PERFECTION ENGINEERING
TRIDEM
ROYCE
ASHOK
MORE WEAR
TOYOTA ALLEX
MECCEDES BENZ
ZHANQI
MAGIRUS
FREHEUF
MERCEDESS BENZ
MAN BOX TRUC
NISSAN X TRA
KTM790
PEREIRA
IRIZAR
RIAAN`S
HONDA JAZZ
WARRIOR
H2 HAMMER
MAIDS
NOOTEBOOM
HOME- MADE
TINTO INDISTRIES
WANQIANG
DAF LF45.150
PRO3015JCBC
SCHMITZ
FUEL TRAILER
DISCOVERY
DAF LF
DAF FALF55
SINGABANTO
CHALLANGER
VOLVO FH1346
BRS
CHRYSTLER
TRI-AXLE
HONDA FIT HY
CARTWRIGHT
MAZDA B2500
DEVEN
COBO
COMET
HONDA AIRWAV
SOR
BUGATTI
RHOTEC
TOYOTA LANDCRUISER
TRI AXLE
HINO RANGER
WNGRUN
GRAND
MERC BENZ
INTERCEPTOR
AEDUS
NISSA
SAFARI
HASIT ZIMBABWE
CLARSON
MECRCEDES
BUICK
SOYAT
MORESTEEL
BRAKHAH TRAILER
HENDRED
KEARNEY
NISSAN ATLAS
KABOTS
ZHONGTONG
GOMOTO
SWARAJ
POWERSTAR VX
YUTONGBUS
FIBRE CRAFT
SK 125D
VENTER TRAIL
SEADYKE/ TIPPER
ITALIAN
FUWA
HANRED
THOMPSON
KORANDO
HINO 1626 XL
CHANGAN CHAN
TIRSAN
TOYOTA VITZ
INTER
KEN WORTH
CHRSLER
URSUS
CHRYSIER
MODCRAAFT
M&G
VOLVO FH
MUSSO SSANG YONG
KENGINEERING
MITSUBISHI P
VAUXHAL
CADILLAC
MADZA`
MITUBISHI
DAF FACF65 E
DAHATSU
TANDAM
CURTAINSIDER
NISSAN HARDBODY
TOYOTA TOYOA
MECEDE BENZ
VOLVO FH 480
VOLVO TRUCK
MCLAREN
INFINITI
SDC
MADZABT5042
TT TRAIL STR
SINOTRUK
FRAIGHTLINER
MAZDA B18
MECCEDESBENZ
NISSAN CABSTAR
MERCEDECES
TOYOTA AXIO
RAV 4
TOYOTA LANDC
MAZDA BONGO
ZHAQI
MORDAN
HYNDAI
STICKER
ARMADA BUS
MAN BOX VAN
VOLVO FH460
MARUTI
M/CYCLE
OPEL CORSA
MAILSTONE
AE0LUS
TOYOTA PIXIS
IVECO IVECO
MINIBUS
BMW X1
SA TRUCK BODIES
HINO DUTRO
LAMBORGHINI
FLATBED
AXLE
BMW X5
ENTWISTLE
TOYOTA AQUA
SITRUC
PARAMOUNT
MAN HGV
JEEP CORPORATION
INTERNATIONA
NISSAN NP200
Model
Select Vehicle Model
MONTELIMAR
TaxClass
Select Tax Class
LIGHT MOTOR VEHICLE (1-2300KG) - CLASS 1
HEAVY VEHICLE (2301-4600KG) - CLASS 2/1
HEAVY VEHICLE (4601-9000KG) - CLASS 2/2
HEAVY VEHICLE (> 9000KG) - CLASS 2/3
TRAILERS SMALL (1-500KG) - CLASS 4/1
TRAILERS BIG (> 500KG) - CLASS 4/2
MOTOR BIKES, TRACTORS - CLASS 3
LIGHT MOTOR VEHICLE (1-2300KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
LIGHT MOTOR VEHICLE (1-2300KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
LIGHT MOTOR VEHICLE (1-2300KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
LIGHT MOTOR VEHICLE (1-2300KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
TRAILERS BIG (> 500KG)
TRAILERS SMALL (1-500KG)
TRAILERS BIG (> 500KG)
LIGHT MOTOR VEHICLE (1-2300KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
LIGHT MOTOR VEHICLE (1-2300KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
LIGHT MOTOR VEHICLE (1-2300KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
LIGHT MOTOR VEHICLE (1-2300KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
MOTOR BIKES, TRACTORS
MOTOR BIKES, TRACTORS
MOTOR BIKES, TRACTORS
MOTOR BIKES, TRACTORS
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
TRAILERS SMALL (1-500KG)
TRAILERS BIG (> 500KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
LIGHT MOTOR VEHICLE (1-2300KG)
LIGHT MOTOR VEHICLE (1-2300KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
LIGHT MOTOR VEHICLE (1-2300KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
TRAILERS SMALL (1-500KG)
TRAILERS BIG (> 500KG)
TRAILERS SMALL (1-500KG)
TRAILERS BIG (> 500KG)
TRAILERS SMALL (1-500KG)
TRAILERS BIG (> 500KG)
TRAILERS SMALL (1-500KG)
TRAILERS BIG (> 500KG)
TRAILERS SMALL (1-500KG)
TRAILERS BIG (> 500KG)
MOTOR BIKES, TRACTORS
MOTOR BIKES, TRACTORS
MOTOR BIKES, TRACTORS
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
HEAVY VEHICLE (2301-4600KG)
HEAVY VEHICLE (4601-9000KG)
HEAVY VEHICLE (> 9000KG)
HEAVY VEHICLE (2301-4600KG)
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Payment Details
Insurance Premium
Basic Premium
Total Stamp Duty
Total ZTSCLevy
Discount
License Amount
Zinara Amount
Penalites
Radio License
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Client self collect
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Payment Type
Total Amount
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License Delivery Address
Address1
Address2
City
----Select City----
Harare
Bulawayo
Chitungwiza
Mutare
Epworth
Gweru
Kwekwe
Kadoma
Masvingo
Chinhoyi
Norton
Marondera
Ruwa
Chegutu
Zvishavane
Bindura
Beitbridge
Redcliff
Victoria Falls
Rusape
Chiredzi
Kariba
Karoi
Chipinge
Gokwe
Shurugwi
Gwanda
Same As Permanent Address
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