Car

Personal Data

Fields marked with * are required.
Note: We only insure cars with Spanish plates.
If possible, please enclose a copy of the license and your driving license.

Surname *

First name *

DNI/NIE *

Date of birth *

Address *

(Postal code, town, street)

Phone number *

E-Mail *

Date of issue of the license *

Car Data

Type of car PS/KW *

Fuel *

Diesel

Gasoline

PS or KW-number *

Year and number of the vehicle *

First Registration *

First Registration in Spain *

Discounts in recent insurances *

Kilometres driven *

Is the vehicle parked in garage or similar *

Yes

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Responsible for the data: Hainzl & Partner Versicherungen S.L.
Purpose of the data: Reply to the user based on the information provided.
Data storage: Mail manager from which we respond to the user.
Rights: At any moment you can limit, recover and delete your information.