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  Product Enquiry  
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 ENQUIRY FORM

   INSURED NAME *
   ADDRESS *
   RISK LOCATION
   INSURANCE CLASS *
   CONTACT PERSON *
   PHONE CODE ( )- *
   FAX CODE ( )-
   HP
   EMAIL *
  HAVE YOU EVER
   INSURED WITH MSIG?
Yes   No
   If yes, please state Client Number  
   REMARKS

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