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Quote
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Primary Requirements
All fields with
*
are Required.
Wasel / National Address.
*
Commercial Registration Copy.
*
Select File
Official Permit Letter.
*
Select File
Upload File, Sample File
Here
.
Select Request Type.
*
Select Option...
Vehicle
Medical
Full Name.
*
Company Name.
*
Email Address.
*
Mobile No.
*
Insurance Type.
Address.
No. of Employees
Any Other Requests.
Claims Experience Report
Select File
Upload File, Sample File
Here
.
List of Members in excel sheet
Select File
Upload File, Sample File
Here
.
Any Other Attachment
Select File
Other Files you want to send.
Vehicle Owner Name.
*
Owner Mobile number.
*
Owner Email Address.
*
Owner DOB.
*
Vehicle Brand.
*
Vehicle Type.
*
Vehicle Kind.
*
Vehicle color.
*
Chassis Number.
*
Sequence no.
*
Vehicle Plate ID.
*
Registration Expiry Date.
*
List of Vehicles in excel sheet
Select File
Upload Member List, Sample File
Here
.
Car Registration Copy.
*
Select File
Upload Registration Copy
Any Other Attachment
Select File
Other Files you want to send.
Health Declaration Form for Overage Members (Above 64yrs age)
Contact Us
Jeddah Branch
Get In Touch
Jeddah Branch
Jeddah Branch
966 92000 2570
966 12 610 5423
info@applus.com.sa
Jeddah, Saudi Arabia
2091 AlTahlia St. Jameel Square office 811
Jeddah 23326 - 8909