Allcare Insurance

Allcare Insurance Agency Ltd University Roundabout
Msida MSD 1751 Malta

Tel: (356) 21 330011
Fax: (356) 21 347947/8

RENEWALS FORM

Name of Insured		*
Address
Postcode
E-Mail Address		*
Tel. No. / Mobile No.		*
Type of Policy to be Renewed	Motor Home Others
Policy Number to be Renewed		*
Renewal Date

Would you like to effect any changes to the present cover?	Yes No
(If yes, please provide details)

Would you like to effect any changes to the present sum/s to be insured?	Yes No
(If yes, please provide details)

Would you like to receive your renewal documentation?	By Mail By collecting them from our offices
Please let us have any comments you wish to make in the following space

APPLICABLE ONLY TO MOTOR RENEWALS

Would you like us to renew the road licence on your behalf?

Yes
No

Is your vehicle subject to VRT ?	Yes No
(This information is stated on your road licence disc)

DATA PROTECTION

Insofar as the information that you provide us with in this form constitutes personal data for the purposes of the Data Protection Act 2001, Allcare Insurance Agency Limited will only process this information in the manner and for the purposes laid down in its Privacy Policy. By completing this form and clicking on the ‘Submit’ button below, you consent to Allcare Insurance Agency Limited processing this information in accordance with this Policy. Please view our Privacy Policy before submitting this form.

Please note that underwriters will not be on risk until a confirmation of renewal acceptance in writing is received from Allcare Insurance Agency Ltd.

Renewal Premium Due