I confirm that this vehicle is only used for social, domestic and pleasure purposes and for my own or my employer's business. This excludes any carriage of fare paying passengers and any carriage of goods for a fee.

I the undersigned declare that the vehicle(s) described (is/are) in good condition and will continue to be maintained and I hereby warrant that the above statement and particulars are true and I hereby agree that declaration shall be deemed to be of a promissory nature and effect and the basis of the contract between me and the Company and that I have not withheld any important information which should be communicated to the Company and that I am willing to accept a policy subject to the terms, conditions and exceptions therein and to pay the premium agreed upon.

I/we do hereby confirm that I/we have authorized Bunna Insurance S.C. to share my/our credit information and to access my/our credit profile from Credit Reference Bureau (C.R.B)