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Auto asistence

Policy details
Invoicing details
Payment confirmation
Vehicle data
License plate
Motor vehicle category
Power(kw)
Roadside assistance validity start date
Chassis series
Vehicle brand
Manufacturing year
Gross weight allowed
Period
6 months 12 months
Registration type
Vehicle model
Cylindric capacity (cm3)
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Owner data
Type:
Natural person     Legal person
Last name
CNP
First name
Purpose of the vehicle
Address recorded in the registration certificate
County
Number
Floor
City
Block
Apartment
Street
Entrance
ZIP Code
I have read and agree to the processing of my personal data for the purpose of being made an offer according to the Information on the processing of personal data

SC Piconet SRL, for the purpose of insurance distribution activities, is registered in the Register of Insurance and/or Reinsurance Intermediaries under number RAJ-407174 as a Brokerage Assistant of Renomia Insurance Reinsurance Broker S.R.L., Broker Register registration number: RBK-009/2003

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