Contact Us:

Motorance Enterprise

1004 Eunos Avenue 8, #01-05

Singapore 409499

Tel:

+65-6693-1365

Fax:

+65-6744-8641





 

Work Injury Compensation / Workmen Compensation

 

Company Name:
ROC No. :  
Address :
Coverage Period:    to     
Business Nature:   
Any Claims? :  Yes  No
If yes, claims details :
Company's ACRA :

Employees Information:

Category :  
No of Workers: 

Total Annual Wages :

Category :  
No of Workers: 

Total Annual Wages :

Category :  
No of Workers: 

Total Annual Wages :

Category :  
No of Workers: 

Total Annual Wages :

Category :  
No of Workers: 

Total Annual Wages :

Any Additional Information :

 

Contact Person:
Contact No. :
Email  :

Prefer to contact via :Phone Call  E-Mail  SMS

 

By submitting this request, I understand that all information provided above are correct and Motorance is given the permission to use my information. I acknowledge having read through the Privacy Policy and consent to use my information for the purpose of obtaining insurance quotes and to be contacted for quotation updates. Where the data provided is not mine, I confirm that I have the consent of the owner to provide such data. 

 


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