Request for duplicate or new certificate of insurance

This form is only available for clients of Private Lease

Contact details

First Name

Last Name

Street

Number

Postcode

Town/City

Mobile or landline number

Country

E-mail address

Vehicle registration plate

KBC aims to process your personal data in a manner that is lawful, appropriate and transparent. Further details about how we process and share your personal data are set out in our privacy statement.It explains your rights and how you can exercise them. Our privacy statement is available at www.kbcbrussels.be/en/privacy, at your branch or from your intermediary and is regularly revised.