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FORMULIR KLAIM KENDARAAN BERMOTOR MOTOR VEHICLE CLAIM FORM 1. Nama Tertanggung : Insured 's Name 2. No. Polis : Policy No. 3. Alamat / Telpon : Address / Phone Masa Pertanggungan : Dari Insurance.

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How to fill out the Kbinsure online

Filling out the Kbinsure online can seem daunting, but with clear guidance and attention to detail, you can complete the process efficiently. This guide will provide step-by-step instructions to ensure you fill out the form correctly.

Follow the steps to complete the Kbinsure form accurately

  1. Click ‘Get Form’ button to obtain the Kbinsure form and open it in the editor.
  2. Enter the insured's name in the 'Nama Tertanggung' field. This should be the name of the individual or entity covered by the insurance policy.
  3. Provide the policy number in the 'No. Polis' field. Ensure that you enter the exact number as it appears on your insurance documents.
  4. Fill in your contact information under 'Alamat / Telepon,' which includes your address and phone number for follow-up.
  5. Input the insurance period by indicating the start date under 'Masa Pertanggungan : Dari' and the end date under 'Sampai.' Select the relevant dates.
  6. In 'Kendaraan yang dipertanggungkan,' detail the vehicle that is insured. This includes make and year of manufacture in 'Kendaraan – Merk & Thn Pembuatan.'
  7. Indicate the vehicle's license validity under 'STNK berlaku hingga,' providing the expiration date.
  8. Enter the chassis and engine number in 'No. Rangka/mesin' and the vehicle registration number in 'No. Polisi.' Ensure the accuracy of these numbers.
  9. Specify the name of the individual driving the vehicle at the time of the accident in the field 'Pengemudi kendaraan ketika terjadi kecelakaan.'
  10. Fill in the driver's occupation under 'Pekerjaan' and detail their relationship to the insured in 'Hubungan dengan tertanggung.'
  11. Describe the accident in detail in 'Keterangan tentang kejadian.' Include the place and date of the accident.
  12. Document the speed of the vehicle at the time of the accident under 'Kecepatan kendaraan waktu terjadi kecelakaan.' Enter the speed in kilometers per hour.
  13. If there was a third party involved in the accident, indicate their involvement and your opinion on fault in the appropriate section.
  14. List the police station handling the case under 'Kantor polisi yang menangani kasus ini.'
  15. Provide details of any witnesses in the 'Saksi – saksi' section.
  16. Thoroughly explain the accident's circumstances in 'Terangkan lebih jauh terjadinya kecelakaan' and draw a sketch if required.
  17. Itemize the damage to the insured vehicle and any third party vehicles in 'Perincian kerusakan kendaraan milik tertanggung dan/atau pihak ketiga.'
  18. Confirm the truthfulness of the information provided by signing and dating the form in the final section.
  19. Once you have filled out all sections, you can save changes, download, print, or share the form as necessary.

Complete the Kbinsure document online today for efficient processing.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232