Insurance Form
Effective from - Jan 30 2025
To view other versions open the versions tab on the right
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) | ||