Arshyan Mobile/Portable Equipment Insurance-All Risk

Name of Insured *

Date of Purchase *

Insured Mobile Number *

Insured Email ID *

Correspondence Address *

Name of Store / Outlet *

Equipment *

Name of Equipment if not in list

Equipment Brand and Model *

Equipment Serial Number / IMEI Number *

Value of Equipment *

Insurance Premium Including GST- For 1 year

Insurance Premium Including GST- For 2 year

Insurance Premium Including GST- For 3 year

Upload Aadhaar Card *

Drop your file here or click here to upload You can upload up to 1 files.

Purchase Invoice *

Drop your file here or click here to upload You can upload up to 1 files.

Insurance Payment Receipt

Drop your file here or click here to upload You can upload up to 1 files.

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