Zip code, city
Date of birth
Date of drivers license
Most frequent driver (If it is not the vehicle owner, please enter here all data according to the data of the vehicle owner above)
Eventual insurance claims and drivers license withdrawals of the last 3 years. If it is applicable, please enter here the details.
Date of first registration
Type certificate number (Format 01AB 543)
Identification nr. (Stamm nr.) (Format 111.222.333)
Catalog price in Fr.
Price of special equipment in Fr.
If you add a second vehicle to the same insurance policy, please enter here the details of the second vehicle according to the first vehicle above.
Mileage per year in km
Car is parked in a parking garage
Beginning of the contract
License plate (If existing)
Desired insurance coverage
Company, policies nr.
Please upload assisting documents here (e.g. previous insurance policies) -> it opens a new tab.