Cars International - AIG Chartis Insurance

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Cars International GmbH
Hauptstrasse 189A
70563 Stuttgart-Vaihingen
Germany
Tel.: 0711 - 687 3080
Fax: 0711 - 687 3068

Opening hours:
Monday - Friday - 09:00 - 18:30
Saturdays - 10:00 - 15:00

Auto Insurance · Household Goods
Personal Liability

Insurance Info Request Form

First Name*

Last Name*

MI*

Date of Birth (Month/Day/Year)*

Social Security Number*

Your Email Address*

Telephone*

Pay Grade*

Married*

Description of Auto

Year*

Make*

Model*

Specifications*

VIN*

How many airbags?*

ABS Yes/No*

Anti-Theft System?*

Passive disabling?*

Do you have another AIG policy?*

How many years with AIG (Worldwide) ?*

Usage*

More/Less than 15 miles from work*

Deductibles Comprehensive*

Deductibles Collision*

Any young age drivers? (17-24)*

Accidents in past three years?*

CMR Address?*

Comments

Cars International Insurance · Tel.: (0711) 678 7835
AIG (Chartis) Insurance