Embedded Insurance Application

General information

Applicant and driver details

Vehicle details

Finance application

Please upload the completed and signed finance application.

Disclosure form (download here)

Please upload the completed and signed disclosure form.

By pressing submit the client agrees that the above information is true and correct.

Dotsure Limited (Registration number 2006/000723/06) is a licensed non-life insurer and authorised financial services provider (FSP39925). Ts & Cs and possible exclusions may apply and can be obtained by emailing u2us@dotsure.co.za.