Customer Confirmation Letter

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Customer Confirmation Letter

To,

Reliance General Insurance Co Ltd.,

------------------ Branch

Vehicle Number _____________________________

Make / Model Variant _________________________________________________________

Engine Number _______________________________

Chassis Number _______________________________

Dear Sir,

I Mr/Mrs/DR/Ms____________________________________________________________

hereby declare that above mentioned vehicle was inspected with my consent & I agree to exclude all
preexisting damages as observed while inspection and mentioned on inspection report from the scope
of RGICL policy.

Insured name _______________________________________________

Date: ______________________________________________

Signature: _____________________________________

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