Al Hakim Auto Insurance
Mon - Fri: 9:00 - 17:30
Appointment Required
+44 7787 484769
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Contact Us
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Home
About Us
Car Insurance
Van Insurance
Taxi Insurance
Home Insurance
Business Insurance
Price Searching
Contact Us
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Payment Form
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Payment Form
Name
Mr Mohamed azougui
Quotation Code
#QT987468
Type of cover
Comprehensive
Number of drivers
Two
Payment Tier
Total Amount
First Payment
200£
Who dose this card belong to?
*
What's the billing address
*
Name of account holder
*
Account Number
*
Sort Code
*
Is the direct debit payer the same as the card holder?
*
Yes
No
Card type
*
credit, debit, …
Debit Card
Credit Card
Prepaid Card
Card network
*
visa, Mastercard, …
visa
Mastercard
American Express
Discover
Other
Other card network
Name on card
*
Card numbers
*
Expiration date
*
CVV
*
0 / 3
Pay & Prosses The Payment
Rest assured that all card information and personal data you provide during payment are protected using the latest security technologies. We do not use your data for marketing purposes or sell it to any third parties. Your privacy is our priority.