Insurance Form
| No: 441/191 | Date(g): 22/7/2020 | Date(h): 2/12/1441 | Status: In-Force |
Insurance Form (to be filled by the Lessor and the Lessee at the beginning of the Finance agreement) | ||
Lessor and Lessee Information | ||
| (Lessor) | (Lessee) |
National ID number for Saudi nationals Commercial Registration No. | ||
Name of Lessee and Lessor | ||
Phone number | ||
National Address | |||||
Vehicle Details | |||||
| Chassis No. | Registration Plate No. | |||
| Vehicle Registration Expiry Date | Vehicle Color | |||
| Customs Card No. | Type of Chassis | |||
| Year of Manufacture | Vehicle Make | |||
| Names of Authorized Drivers | Vehicle Model | |||
| Annual Depreciation Percentage of Motor Vehicle | Actual Value of Motor Vehicle | |||
The approximate value of the Motor Vehicle for the next years from the Motor Vehicles Financially Leased Contract. | |||||
First Year: (actual value of Motor Vehicle selling price) | |||||
Second Year: (Motor Vehicle value based on depreciation percentage) | |||||
Third Year: (Motor Vehicle value based on depreciation percentage) | |||||
Forth Year: (Motor Vehicle value based on depreciation percentage) | |||||
Fifth Year: (Motor Vehicle value based on depreciation percentage) | |||||
Deductible | |||||
Additional Benefits | |||||
Repair Method (dealerships or certified auto repair shops) | |||||