CTPL Application

To begin your application, kindly fill out all the required fields in the application form below.

Where did you hear about us?

Client Information

Type

Individual

Corporate without assignee

Corporate with assignee

Corporate Name

Name

Contact Information

Address

Mobile Number

+63

Email Address

*Your quotation and payment information will be sent to this email address.

Car and Driving Information

Type of Vehicle

Private car

Commercial vehicle

Motorcycle

Year Model

Vehicle Make

Vehicle Model

Vehicle Trim

Registration Type

Previously Registered

First Year Registration

We will send a confirmation email on this email address. Please make sure this email address is correct.

I understand that the CTPL policy will be issued based on the statements that I disclosed in the application form, which I represent as true and complete with all material information related to my application. I hereby authorize Paramount Life & General Insurance Corporation (PLGIC), its employees, officers and directors, to keep, record, use, and process my personal information, including the disclosure of the same to such other employees, officers, directors, affiliates, partners, contractors and/or sub-contractors of PLGIC, for the evaluation and assessment of my application for insurance and other insurance-related services. I further understand that PLGIC will dispose, delete and/or modify the said personal information upon my express request.