Jubilee General Insurance Company Limited

(formerly New Jubilee Insurance Company Limited)

Jubilee Insurance House, 2nd Floor, I.I.Chundrigar Road, Karachi 74000
UAN: 111 654 111, Tel: (021) 32416022-26, Fax: (021) 32438738, 32416728
Email: info@jubileegeneral.com.pk, Website: www.jubileegeneral.com.pk

MOTOR VEHICLE INSPECTION REPORT

POLICY NO.

OWNER OF THE VEHICLE

ADDRESS

Examination of the Registration book should be done to confirm the above at the time of inspection and
renewal. NO vehicle should be insured on open transfer letter.

PARTICULARS OF THE VEHICLE:

REGISTRATION NO. MILEAGE.

MAKE. MODEL.
ENGINE NO. CHASSIS NO.
C. C: COLOUR

VALUE TO BE INSURED RS.

CONDITION OF THE VEHICLE AT THE TIME OF INSPECTION :

DETAILS OF EXISTING DAMAGES (IF ANY):

CONDITION OF COLOUR: GOOD / FAIR / FADED.

BONUS/LOADING POSITION :

( PLEASE ATTACH COPY OF RENEWAL NOTICE )

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ACCESSORIES FITTED IN THE VEHICLE:
RADIO

MAKE MODEL VALUE (Rs).

CASSETTE PLAYER:

MAKE MODEL VALUE (Rs).

AIR CONDITIONER:

MAKE MODEL VALUE (Rs).

ANY OTHER ITEM:

If the Vehicle has factory fitted accessories they should be specifically mentioned.

Date:___________ Signature of the Authorized Officer:________________________

Date:___________ Signature of the person presenting

the vehicle for inspection :________________________

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