Questionario de Moto | Dareli Seguros

Is the vehicle brand new? (If the answer is "YES", please specify (I don't have the license plate):

Yes

No

Enter the LICENSE PLATE (type aplaca without a hyphen)

DDD0000 or DDD00

Make and Model of your vehicle

Ducati Multistrada V4 S

Is the vehicle from an auction?

Yes

No

Motorcycle Usage:

Particular

Deliveries

Ride-hailing app

Insured's Name:

CPF or CNPJ (enter the numbers without hyphens)

Date of birth

Month

Day

Year

RG (enter the numbers without hyphens)

0000000000

Your best email

WhatsApp phone number (add area code):

00000000000

Residential address:

Residential and Overnight Zip Code (enter the numbers without hyphens)

00000000

Where do you live?

Apartment

Home

Condominium

Driver profile

Main Driver Profile (*if there is more than one driver, *specify the newest one*):

Date of birth:

DD/MM/YYYY

CPF (enter the numbers without hyphens)

000000000000

There are people between 18 and 25 years old:

Yes, and he drives.

Yes, and he doesn't drive.

Does not live with person(s) of that age group.

Profession:

Single choice

Yes, it's a garage with a manual gate.

Yes, it has an automatic gate in the garage.

No, it's on the street.

Does your workplace have a garage?

Yes

No

Are you going to college/school/course?

Yes

No

It is not used for that purpose.

If this is a referral from a friend, what is their full name?

Do you have a valid insurance policy with any insurance company?

No, it's a new insurance policy.

Yes, it's a renovation.

If it's a renewal and the answer is YES, has this policy had a claim?:

There was no accident.

Yes, it contains 1 incident.

Yes, it contains more than one incident.

If it's a renewal and the answer is YES, has this policy had a claim?:

Which insurance company?

Example: PORTO SEGURO

How is my data used?

We use this information to activate, simulate, or quote products.

Your data is protected!

The information you provide is safe and protected in accordance with the General Data Protection Law (LGPD - Law 13.709/2018). Check our Privacy Policy .

There's still time! Get your insurance quote now and take advantage of the last days of the discount.

Driver profile