Basic Cover Application Form
Basic Policy Only
Yes (tick)
No (tick)
Amount: €40
Basic Policy & Second Home
Yes (tick)
No (tick)
Amount: €55
Personal Details:
Spanish Address:
Address (if different):
Name:
Telephone:
Payment information:
Credit Card details: Debit my card with
Euros
Credit Card number and expiry date:
/
* Note cover is not in force until payment has been received and the risk accepted by the underwriters *
Rightway Insurance & Finance SL, CC Las Postas, Local 9,
Sitio de Calahonda, 29649 Mijas Costa, Málaga. Tel: (+34) 952 934 963 Fax: (+34) 952 939 097
Email:
info@rightwaysl.com