FPG Insurance

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I want to pay for my Insurance

INSURANCE PRODUCT *

POLICY NUMBER *

PREMIUM AMOUNT *

FIRST NAME *

MIDDLE NAME

LAST NAME *

EMAIL ADDRESS *

PHONE NO. *

MOBILE NO. *

I fully understand that for my insurance policy to be enforceable, the premium should be fully paid.

I agree that payment made, through the online facility, after a loss or beyond the agreed credit period, if a credit period has been agreed, will not be valid as to make a claim compensable.

SAM

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