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Change Of Membership/Request For Replacement Card
First Name
Middle Name
Last name
Membership No.
Vehicle Registration
Request for:
Replacement Card
Change of Membership Details
Change of Contact Details
If you require a replacement card send to Auto Assured offices the amount of Kshs. 290 within 48 hours of this request, as payment for the new card.
Membership Type
Auto Assured Lady
Blue Membership
AON Rescue
Lion Auto Assured
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Ultimate Motor Policy
Jubilee Drive 24/7
Car Insurance with Rescue
Change of vehicle applies only to Auto Assured Lady and Blue Membership
Change of vehicle
Previous vehicle Reg.
New vehicle Reg.
Reason for Change
Change of Contact Details
Home Tel.
Office Tel.
Mobile
Email
Postal Address
Physical Address
Change of Driver Licence expiry date
Old Expiry Date
New Expiry Date
Delivery Address
email to customer membership
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Auto Assured Limited - 'a stress-free life!'- P. O. BOX 267-00100 Nairobi. Tel/Fax: 490 2000, 386 0296/7 Cell: 0714 - 674354 / 0737 - 433760
© Copyright 2007 Auto Assured Limited
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