Green Card!

You will automatically receive the insurance policy via email after payment is made.

1
Insured person
2
Confirmation

/var/www/moldasig-prod-v1/storage/framework/views/01870fe88faefb436d5ea4b8ddc2a1f4.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] => Array
        (
            [class] => calculator-input-dependent-result
            [required] => 1
            [forcedLabel] => Insured IDNP or IDNO
            [pattern] => \d{13}
            [maxlength] => 13
            [placeholder] => *************
            [data-valid-example] => 1234567890123
        )

)

Insured IDNP or IDNO *

/var/www/moldasig-prod-v1/storage/framework/views/01870fe88faefb436d5ea4b8ddc2a1f4.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] => Array
        (
            [required] => 1
            [forcedLabel] => Vehicle/trailer registration certificate
            [pattern] => [BN]?\d{9}
            [maxlength] => 10
            [placeholder] => *********
            [data-valid-example] => 123456789
        )

)

Vehicle/trailer registration certificate *

/var/www/moldasig-prod-v1/storage/framework/views/01870fe88faefb436d5ea4b8ddc2a1f4.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] => Array
        (
            [required] => 1
        )

)

Start Date *

Validity Area *

Insurance Period *

How do you want to receive the insurance policy?

Online (email)

/var/www/moldasig-prod-v1/storage/framework/views/ce292582aaec94a0a4a737a69e7fa1f9.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] => Array
        (
            [unlabeled] => 1
        )

)

I agree with the MOLDASIG Terms and Conditions, including the Payment Terms and Conditions, and I give my consent for the processing of personal data.

Vehicle:

Insured person:

Insured period:

MDL

Please complete the reCAPTCHA to proceed.

Validity Area

Registration certificate (vehicle):

Insured period:

Insured:

Drivers

Unlimited

Ownership of the vehicle:

Personal

Insurance company:

MOLDASIG

Total price:

0 MDL

/var/www/moldasig-prod-v1/storage/framework/views/6aa69521732277c699f186ff1ccd1c02.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] => Array
        (
            [required] => 1
            [forcedLabel] => Right of possession of the car?
        )

)

/var/www/moldasig-prod-v1/storage/framework/views/ce292582aaec94a0a4a737a69e7fa1f9.php
Illuminate\View\ComponentAttributeBag Object
(
    [attributes:protected] => Array
        (
            [required] => 1
            [forcedLabel] => Right of possession of the car?
        )

)

Right of possession of the car? *

Personal

Leasing

Rent (mandate)

Attorney

First Name *

Something went wrong...

Last Name *

Something went wrong...

Phone number *

Something went wrong...

Email *