We are a solution to everyone in the motor vehicle value-chain. Servicing motorists, fleet management and logistics companies.

Gallery

Contact

082 767 5416

1 Indwe Road, Fort Jackson Industrial Area, Mdantsane, East London 5219

info@intsika.myblisstech.com

Motorist Plan

Motorist Plan






Motorist Plan Application Form

  • To be completed by all subscribers seeking registration as an AutoHost subscriber;
  • The questionnaire must be completed in full and be signed;
  • All fields on application form MUST be completed by the applicant;
  • Applicants will be contacted via email or fax and must therefore submit an email address and fax number;
    failure to comply will result in declining the application;
  • It should be noted that AutoHost reserves the right to accept or reject any application in this respect;
  • Applicants must comply with all the registration-criteria for registration to be finalized – failure to do so may result in the application being declined.

 

Name
Name

First


Last




Address
Address



City

Province

Zip/Postal

Vehicle Information








Is Vehicle Financed?
Is Vehicle Insured?

Consent

By submitting this form, you give consent to AutoHost to share your details with our partners for quotation purposes on:

  1. Insurance (vehicle and/or premises)
  2. Vehicle tracking system
  3. Vehicle Finance