IM PRIORITY Car Full Form Test Name: Let us know how we should address you Last Name: Let us know how we should address you Email: Alfred likes to email too, how can we reach you? Phone: What number would you like us to ring you on? Please enter numbers only and do not start with '+'. Nationality: Choose a NationalityAfghanAlbanianAlgerianAmericanAndorranAngolanAntiguansArgentineanArmenianAustralianAustrianAzerbaijaniBahamianBahrainiBangladeshiBarbadianBarbudansBatswanaBelarusianBelgianBelizeanBenineseBhutaneseBolivianBosnianBrazilianBritishBruneianBulgarianBurkinabeBurmeseBurundianCambodianCameroonianCanadianCape VerdeanCentral AfricanChadianChileanChineseColombianComoranCongoleseCosta RicanCroatianCubanCypriotCzechDanishDjiboutiDominicanDutchEast TimoreseEcuadoreanEgyptianEmiratiEquatorial GuineanEritreanEstonianEthiopianFijianFilipinoFinnishFrenchGaboneseGambianGeorgianGermanGhanaianGreekGrenadianGuatemalanGuinea-BissauanGuineanGuyaneseHaitianHerzegovinianHonduranHungarianI-KiribatiIcelanderIndianIndonesianIranianIraqiIrishIsraeliItalianIvorianJamaicanJapaneseJordanianKazakhstaniKenyanKittian andKuwaitiKyrgyzLaotianLatvianLebaneseLiberianLibyanLiechtensteinerLithuanianLuxembourgerMacedonianMalagasyMalawianMalaysianMaldivanMalianMalteseMarshalleseMauritanianMauritianMexicanMicronesianMoldovanMonacanMongolianMoroccanMosothoMotswanaMozambicanNamibianNauruanNepaleseNew ZealanderNi-vanuatuNicaraguanNigerienNorth KoreanNorthern IrishNorwegianOmaniPakistaniPalestinianPalauanPanamanianPapua New GuineanParaguayanPeruvianPolishPortugueseQatariRomanianRussianRwandanSaint LucianSalvadoranSamoanSan MarineseSao TomeanSaudiScottishSenegaleseSerbianSeychelloisSierra LeoneanSingaporeanSlovakianSlovenianSolomon IslanderSomaliSouth AfricanSouth KoreanSpanishSri LankanSudaneseSurinamerSwaziSwedishSwissSyrianTaiwaneseTajikTanzanianThaiTogoleseTonganTrinidadian or TobagonianTunisianTurkishTuvaluanUgandanUkrainianUruguayanUzbekistaniVenezuelanVietnameseWelshYemeniteZambianZimbabwean(other) What nationality are you? If you hold multiple passports, just choose the country you learned to drive in. Date of Birth: Day12345678910111213141516171819202122232425262728293031 MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Year20152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915 UAE licence held for: Please Chooseless than 6 monthsless than 1 year1 year2 years3 years4 years5 years6 years7 years8 years9 years10 years11 years12 years13 years14 years15 years16 years17 years18 years19 years20 years + How many years have you had a UAE driving licence for? Car Make & Model: Model Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998 or older What year was the car manufactured? (please note, if different, please tell us when the car was first registered) Emirate of Registration: Please ChooseDubaiAbu DhabiSharjahRas Al KhaimahAjmanFujairahUmm Al Quwain Where will your car be registered i.e. which authority will you get your Mulkiya from? This is usually the same Emirate that your visa is from. Car value: How much is your car worth? If you're not sure, do you remember how much it was worth last year? If you don't know, just put down a '?' and we'll recommend a FREE insurance valuation for your car. Type of Insurance: SelectComprehensive (full insurance)Third Party Only Would you like to insure your own car as well as people and property outside your vehicle? If so, select Comprehensive. If you would just like to insure your liability i.e. people and property that you may collide into while driving your vehicle, then please select Third Party Only. Claims history: Please ChooseNo claims in the past yearNo claims for 2 yearsNo claims for 3 yearsNo claims for 4 yearsNo claims for 5+ yearsI claimed last yearThis is my very first car ever! Have you claimed recently? If not, you may be eligible for a discount. Sometimes, you may need to get a certificate from your old insurance company, but not always. If this is your first car in the UAE but you've owned cars before, let us know your claims history anyway. Currently with: If you are renewing your insurance, please tell us which insurance company your car is currently insured with.This way we can see whether it would be more beneficial to stick with your current insurer. If you are buying a car, please let us know here by saying 'buying'. Senior Manager (IM PRIORITY) : SM Code : Additional Notes : We'll email a comparison table, help you choose and email your policy!