Bajaj | Allianz - Agency Portal:Pre Inspection Request

Pre Inspection Request

I-Track No.*

Partner Type*

Institutional Name*

Address Line 1*

Address Line 2

Landmark*

Client First Name*

Pincode*

State*

City*

Area

Telephone

Mobile No.

Email ID

Inspection Type*

Vehicle Classification*

Make*

Model*

Registration No.*

Year of Mfg*

IMD Code*

Sub-IMD Code*

IMD Name*

Sub-IMD Code*

RM Code*

Check to change RM Code*

Other RM Code*

IMD Contact No.*

Inspection Plan Date*

Send SMS to IMD

Agency Type

Remarks