Devis Auto Ce site est sécurisé, vos données personnelles sont respectées et ne sont accessibles qu'aux personnes en charge du dossier, conformément à notre politique de confidentialité détaillée sur le présent site. Titre*MonsieurMadameMademoiselleNom* Prénom Nom Téléphone*Email* Entrer un email Confirmer l'email Date de naissance* JJ MM AAAA Adresse* Adresse Adresse ligne 1 Ville ZIP / Code postal Profession*Situation Familiale*Marié(e)PacseUnion LibreCélibataireDivorcé(e)Veuf(ve)Enfant(s)AvecSansLogement*PropriétaireLocataireAutreDate du permis* JJ MM AAAA Le permis a-t-il été obtenu dans le cadre de la conduite accompagnée ?OuiNonPouvez-vous fournir un relevé d’informations à votre nom justifiant d’une période d’assurance au cours des 36 derniers mois ?*OuiNonAvez vous été assuré sans interruption au cours des 36 derniers mois ?*OuiNonQuel est votre bonus actuel ?*50% de bonus = coef. 0.50 de plus de 3 ans50% de bonus = coef. 0.5049% de bonus = coef. 0.5148% de bonus = coef. 0.5247% de bonus = coef. 0.5346% de bonus = coef. 0.5445% de bonus = coef. 0.5544% de bonus = coef. 0.5643% de bonus = coef. 0.5742% de bonus = coef. 0.5841% de bonus = coef. 0.5940% de bonus = coef. 0.6039% de bonus = coef. 0.6138% de bonus = coef. 0.6237% de bonus = coef. 0.6336% de bonus = coef. 0.6435% de bonus = coef. 0.6534% de bonus = coef. 0.6633% de bonus = coef. 0.6732% de bonus = coef. 0.6831% de bonus = coef. 0.6930% de bonus = coef. 0.7029% de bonus = coef. 0.7128% de bonus = coef. 0.7227% de bonus = coef. 0.7326% de bonus = coef. 0.7425% de bonus = coef. 0.7524% de bonus = coef. 0.7623% de bonus = coef. 0.7722% de bonus = coef. 0.7821% de bonus = coef. 0.7920% de bonus = coef. 0.8019% de bonus = coef. 0.8118% de bonus = coef. 0.8217% de bonus = coef. 0.8316% de bonus = coef. 0.8415% de bonus = coef. 0.8514% de bonus = coef. 0.8613% de bonus = coef. 0.8712% de bonus = coef. 0.8811% de bonus = coef. 0.8910% de bonus = coef. 0.909% de bonus = coef. 0.918% de bonus = coef. 0.927% de bonus = coef. 0.936% de bonus = coef. 0.945% de bonus = coef. 0.954% de bonus = coef. 0.963% de bonus = coef. 0.972% de bonus = coef. 0.981% de bonus = coef. 0.990% de bonus = coef. 1.001% de Malus = coef. 1.012% de Malus = coef. 1.023% de Malus = coef. 1.034% de Malus = coef. 1.045% de Malus = coef. 1.056% de Malus = coef. 1.067% de bonus = coef. 1.078% de Malus = coef. 1.089% de bonus = coef. 1.0910% de Malus = coef. 1.1011% de bonus = coef. 1.1112% de bonus = coef. 1.1213% de bonus = coef. 1.1314% de bonus = coef. 1.1415% de bonus = coef. 1.1516% de bonus = coef. 1.1617% de bonus = coef. 1.1718% de bonus = coef. 1.1819% de bonus = coef. 1.1920% de bonus = coef. 1.2021% de bonus = coef. 1.2122% de bonus = coef. 1.2223% de bonus = coef. 1.2324% de bonus = coef. 1.2425% de bonus = coef. 1.2526% de bonus = coef. 1.2627% de bonus = coef. 1.2728% de bonus = coef. 1.2829% de bonus = coef. 1.2930% de bonus = coef. 1.3031% de bonus = coef. 1.3132% de bonus = coef. 1.3233% de bonus = coef. 1.3334% de bonus = coef. 1.3435% de bonus = coef. 1.3536% de bonus = coef. 1.3637% de bonus = coef. 1.3738% de bonus = coef. 1.3839% de bonus = coef. 1.3940% de Malus = coef. 1.4041% de Malus = coef. 1.4142% de Malus = coef. 1.4243% de Malus = coef. 1.4344% de Malus = coef. 1.4445% de Malus = coef. 1.4546% de Malus = coef. 1.4647% de Malus = coef. 1.4748% de Malus = coef. 1.4849% de Malus = coef. 1.4950% de Malus = coef. 1.5051% de Malus = coef. 1.5152% de Malus = coef. 1.5253% de Malus = coef. 1.5354% de Malus = coef. 1.5455% de Malus = coef. 1.5556% de Malus = coef. 1.5657% de Malus = coef. 1.5758% de Malus = coef. 1.5859% de Malus = coef. 1.5960% de Malus = coef. 1.6061% de Malus = coef. 1.6162% de Malus = coef. 1.6263% de Malus = coef. 1.6364% de Malus = coef. 1.6465% de Malus = coef. 1.6566% de Malus = coef. 1.6667% de Malus = coef. 1.6768% de Malus = coef. 1.6869% de Malus = coef. 1.6970% de Malus = coef. 1.7071% de Malus = coef. 1.7172% de Malus = coef. 1.7273% de Malus = coef. 1.7374% de Malus = coef. 1.7475% de Malus = coef. 1.7576% de Malus = coef. 1.7677% de Malus = coef. 1.7778% de Malus = coef. 1.7879% de Malus = coef. 1.7980% de Malus = coef. 1.8081% de Malus = coef. 1.8182% de Malus = coef. 1.8283% de Malus = coef. 1.8384% de Malus = coef. 1.8485% de Malus = coef. 1.8586% de Malus = coef. 1.8687% de Malus = coef. 1.8788% de Malus = coef. 1.8889% de Malus = coef. 1.8990% de Malus = coef. 1.9091% de Malus = coef. 1.9192% de Malus = coef. 1.9293% de Malus = coef. 1.9394% de Malus = coef. 1.9495% de Malus = coef. 1.9596% de Malus = coef. 1.9697% de Malus = coef. 1.9798% de Malus = coef. 1.9899% de Malus = coef. 1.99100% de Malus = coef. 2.00101% de Malus = coef. 2.01102% de Malus = coef. 2.02103% de Malus = coef. 2.03104% de Malus = coef. 2.04105% de Malus = coef. 2.05106% de Malus = coef. 2.06107% de Malus = coef. 2.07108% de Malus = coef. 2.08109% de Malus = coef. 2.09110% de Malus = coef. 2.10111% de Malus = coef. 2.11112% de Malus = coef. 2.12113% de Malus = coef. 2.13114% de Malus = coef. 2.14115% de Malus = coef. 2.15116% de Malus = coef. 2.16117% de Malus = coef. 2.17118% de Malus = coef. 2.18119% de Malus = coef. 2.19120% de Malus = coef. 2.20121% de Malus = coef. 2.21122% de Malus = coef. 2.22123% de Malus = coef. 2.23124% de Malus = coef. 2.24125% de Malus = coef. 2.25126% de Malus = coef. 2.26127% de Malus = coef. 2.27128% de Malus = coef. 2.28129% de Malus = coef. 2.29130% de Malus = coef. 2.30131% de Malus = coef. 2.31132% de Malus = coef. 2.32133% de Malus = coef. 2.33134% de Malus = coef. 2.34135% de Malus = coef. 2.35136% de Malus = coef. 2.36137% de Malus = coef. 2.37138% de Malus = coef. 2.38139% de Malus = coef. 2.39140% de Malus = coef. 2.40141% de Malus = coef. 2.41142% de Malus = coef. 2.42143% de Malus = coef. 2.43144% de Malus = coef. 2.44145% de Malus = coef. 2.45146% de Malus = coef. 2.46147% de Malus = coef. 2.47148% de Malus = coef. 2.48149% de Malus = coef. 2.49150% de Malus = coef. 2.50151% de Malus = coef. 2.51152% de Malus = coef. 2.52153% de Malus = coef. 2.53154% de Malus = coef. 2.54155% de Malus = coef. 2.55156% de Malus = coef. 2.56157% de Malus = coef. 2.57158% de Malus = coef. 2.58159% de Malus = coef. 2.59160% de Malus = coef. 2.60161% de Malus = coef. 2.61162% de Malus = coef. 2.62163% de Malus = coef. 2.63164% de Malus = coef. 2.64165% de Malus = coef. 2.65166% de Malus = coef. 2.66167% de Malus = coef. 2.67168% de Malus = coef. 2.68169% de Malus = coef. 2.69170% de Malus = coef. 2.70171% de Malus = coef. 2.71172% de Malus = coef. 2.72173% de Malus = coef. 2.73174% de Malus = coef. 2.74175% de Malus = coef. 2.75176% de Malus = coef. 2.76177% de Malus = coef. 2.77178% de Malus = coef. 2.78179% de Malus = coef. 2.79180% de Malus = coef. 2.80181% de Malus = coef. 2.81182% de Malus = coef. 2.82183% de Malus = coef. 2.83184% de Malus = coef. 2.84185% de Malus = coef. 2.85186% de Malus = coef. 2.86187% de Malus = coef. 2.87188% de Malus = coef. 2.88189% de Malus = coef. 2.89190% de Malus = coef. 2.90191% de Malus = coef. 2.91192% de Malus = coef. 2.92193% de Malus = coef. 2.93194% de Malus = coef. 2.94195% de Malus = coef. 2.95196% de Malus = coef. 2.96197% de Malus = coef. 2.97198% de Malus = coef. 2.98199% de Malus = coef. 2.99200% de Malus = coef. 3.00201% de Malus = coef. 3.01202% de Malus = coef. 3.02203% de Malus = coef. 3.03204% de Malus = coef. 3.04205% de Malus = coef. 3.05206% de Malus = coef. 3.06207% de Malus = coef. 3.07208% de Malus = coef. 3.08209% de Malus = coef. 3.09210% de Malus = coef. 3.10211% de Malus = coef. 3.11212% de Malus = coef. 3.12213% de Malus = coef. 3.13214% de Malus = coef. 3.14215% de Malus = coef. 3.15216% de Malus = coef. 3.16217% de Malus = coef. 3.17218% de Malus = coef. 3.18219% de Malus = coef. 3.19220% de Malus = coef. 3.20221% de Malus = coef. 3.21222% de Malus = coef. 3.22223% de Malus = coef. 3.23224% de Malus = coef. 3.24225% de Malus = coef. 3.25226% de Malus = coef. 3.26227% de Malus = coef. 3.27228% de Malus = coef. 3.28229% de Malus = coef. 3.29230% de Malus = coef. 3.30231% de Malus = coef. 3.31232% de Malus = coef. 3.32233% de Malus = coef. 3.33234% de Malus = coef. 3.34235% de Malus = coef. 3.35236% de Malus = coef. 3.36237% de Malus = coef. 3.37238% de Malus = coef. 3.38239% de Malus = coef. 3.39240% de Malus = coef. 3.40241% de Malus = coef. 3.41242% de Malus = coef. 3.42243% de Malus = coef. 3.43244% de Malus = coef. 3.44245% de Malus = coef. 3.45246% de Malus = coef. 3.46247% de Malus = coef. 3.47248% de Malus = coef. 3.48249% de Malus = coef. 3.49250% de Malus = coef. 3.50Depuis combien d'année êtes-vous assuré sans interruption ?*Plus de 13 ans13 ans12 ans11 ans10 ans9 ans8 ans7 ans6 ans5 ans4 ans3 ans2 ans1 ansAu moins 9 moisMoins de 9 moisCombien de conducteurs vont conduire le véhicule ?*1234 Deuxième conducteurNom* Prénom Nom Date de naissance* JJ MM AAAA Date de permis de conduire* JJ MM AAAA Profession*Lien de parenté*ConjointDescendant (enfant)Ascendant (Parent)AutrePermis de conduire*En cours de validitéAAC (conduite accompagnée -18 ans)Conduite supervisée (+ de 18 ans)bonus actuel du deuxième conducteur*50% de bonus = coef. 0.50 de plus de 3 ans50% de bonus = coef. 0.5049% de bonus = coef. 0.5148% de bonus = coef. 0.5247% de bonus = coef. 0.5346% de bonus = coef. 0.5445% de bonus = coef. 0.5544% de bonus = coef. 0.5643% de bonus = coef. 0.5742% de bonus = coef. 0.5841% de bonus = coef. 0.5940% de bonus = coef. 0.6039% de bonus = coef. 0.6138% de bonus = coef. 0.6237% de bonus = coef. 0.6336% de bonus = coef. 0.6435% de bonus = coef. 0.6534% de bonus = coef. 0.6633% de bonus = coef. 0.6732% de bonus = coef. 0.6831% de bonus = coef. 0.6930% de bonus = coef. 0.7029% de bonus = coef. 0.7128% de bonus = coef. 0.7227% de bonus = coef. 0.7326% de bonus = coef. 0.7425% de bonus = coef. 0.7524% de bonus = coef. 0.7623% de bonus = coef. 0.7722% de bonus = coef. 0.7821% de bonus = coef. 0.7920% de bonus = coef. 0.8019% de bonus = coef. 0.8118% de bonus = coef. 0.8217% de bonus = coef. 0.8316% de bonus = coef. 0.8415% de bonus = coef. 0.8514% de bonus = coef. 0.8613% de bonus = coef. 0.8712% de bonus = coef. 0.8811% de bonus = coef. 0.8910% de bonus = coef. 0.909% de bonus = coef. 0.918% de bonus = coef. 0.927% de bonus = coef. 0.936% de bonus = coef. 0.945% de bonus = coef. 0.954% de bonus = coef. 0.963% de bonus = coef. 0.972% de bonus = coef. 0.981% de bonus = coef. 0.990% de bonus = coef. 1.001% de Malus = coef. 1.012% de Malus = coef. 1.023% de Malus = coef. 1.034% de Malus = coef. 1.045% de Malus = coef. 1.056% de Malus = coef. 1.067% de bonus = coef. 1.078% de Malus = coef. 1.089% de bonus = coef. 1.0910% de Malus = coef. 1.1011% de bonus = coef. 1.1112% de bonus = coef. 1.1213% de bonus = coef. 1.1314% de bonus = coef. 1.1415% de bonus = coef. 1.1516% de bonus = coef. 1.1617% de bonus = coef. 1.1718% de bonus = coef. 1.1819% de bonus = coef. 1.1920% de bonus = coef. 1.2021% de bonus = coef. 1.2122% de bonus = coef. 1.2223% de bonus = coef. 1.2324% de bonus = coef. 1.2425% de bonus = coef. 1.2526% de bonus = coef. 1.2627% de bonus = coef. 1.2728% de bonus = coef. 1.2829% de bonus = coef. 1.2930% de bonus = coef. 1.3031% de bonus = coef. 1.3132% de bonus = coef. 1.3233% de bonus = coef. 1.3334% de bonus = coef. 1.3435% de bonus = coef. 1.3536% de bonus = coef. 1.3637% de bonus = coef. 1.3738% de bonus = coef. 1.3839% de bonus = coef. 1.3940% de Malus = coef. 1.4041% de Malus = coef. 1.4142% de Malus = coef. 1.4243% de Malus = coef. 1.4344% de Malus = coef. 1.4445% de Malus = coef. 1.4546% de Malus = coef. 1.4647% de Malus = coef. 1.4748% de Malus = coef. 1.4849% de Malus = coef. 1.4950% de Malus = coef. 1.5051% de Malus = coef. 1.5152% de Malus = coef. 1.5253% de Malus = coef. 1.5354% de Malus = coef. 1.5455% de Malus = coef. 1.5556% de Malus = coef. 1.5657% de Malus = coef. 1.5758% de Malus = coef. 1.5859% de Malus = coef. 1.5960% de Malus = coef. 1.6061% de Malus = coef. 1.6162% de Malus = coef. 1.6263% de Malus = coef. 1.6364% de Malus = coef. 1.6465% de Malus = coef. 1.6566% de Malus = coef. 1.6667% de Malus = coef. 1.6768% de Malus = coef. 1.6869% de Malus = coef. 1.6970% de Malus = coef. 1.7071% de Malus = coef. 1.7172% de Malus = coef. 1.7273% de Malus = coef. 1.7374% de Malus = coef. 1.7475% de Malus = coef. 1.7576% de Malus = coef. 1.7677% de Malus = coef. 1.7778% de Malus = coef. 1.7879% de Malus = coef. 1.7980% de Malus = coef. 1.8081% de Malus = coef. 1.8182% de Malus = coef. 1.8283% de Malus = coef. 1.8384% de Malus = coef. 1.8485% de Malus = coef. 1.8586% de Malus = coef. 1.8687% de Malus = coef. 1.8788% de Malus = coef. 1.8889% de Malus = coef. 1.8990% de Malus = coef. 1.9091% de Malus = coef. 1.9192% de Malus = coef. 1.9293% de Malus = coef. 1.9394% de Malus = coef. 1.9495% de Malus = coef. 1.9596% de Malus = coef. 1.9697% de Malus = coef. 1.9798% de Malus = coef. 1.9899% de Malus = coef. 1.99100% de Malus = coef. 2.00101% de Malus = coef. 2.01102% de Malus = coef. 2.02103% de Malus = coef. 2.03104% de Malus = coef. 2.04105% de Malus = coef. 2.05106% de Malus = coef. 2.06107% de Malus = coef. 2.07108% de Malus = coef. 2.08109% de Malus = coef. 2.09110% de Malus = coef. 2.10111% de Malus = coef. 2.11112% de Malus = coef. 2.12113% de Malus = coef. 2.13114% de Malus = coef. 2.14115% de Malus = coef. 2.15116% de Malus = coef. 2.16117% de Malus = coef. 2.17118% de Malus = coef. 2.18119% de Malus = coef. 2.19120% de Malus = coef. 2.20121% de Malus = coef. 2.21122% de Malus = coef. 2.22123% de Malus = coef. 2.23124% de Malus = coef. 2.24125% de Malus = coef. 2.25126% de Malus = coef. 2.26127% de Malus = coef. 2.27128% de Malus = coef. 2.28129% de Malus = coef. 2.29130% de Malus = coef. 2.30131% de Malus = coef. 2.31132% de Malus = coef. 2.32133% de Malus = coef. 2.33134% de Malus = coef. 2.34135% de Malus = coef. 2.35136% de Malus = coef. 2.36137% de Malus = coef. 2.37138% de Malus = coef. 2.38139% de Malus = coef. 2.39140% de Malus = coef. 2.40141% de Malus = coef. 2.41142% de Malus = coef. 2.42143% de Malus = coef. 2.43144% de Malus = coef. 2.44145% de Malus = coef. 2.45146% de Malus = coef. 2.46147% de Malus = coef. 2.47148% de Malus = coef. 2.48149% de Malus = coef. 2.49150% de Malus = coef. 2.50151% de Malus = coef. 2.51152% de Malus = coef. 2.52153% de Malus = coef. 2.53154% de Malus = coef. 2.54155% de Malus = coef. 2.55156% de Malus = coef. 2.56157% de Malus = coef. 2.57158% de Malus = coef. 2.58159% de Malus = coef. 2.59160% de Malus = coef. 2.60161% de Malus = coef. 2.61162% de Malus = coef. 2.62163% de Malus = coef. 2.63164% de Malus = coef. 2.64165% de Malus = coef. 2.65166% de Malus = coef. 2.66167% de Malus = coef. 2.67168% de Malus = coef. 2.68169% de Malus = coef. 2.69170% de Malus = coef. 2.70171% de Malus = coef. 2.71172% de Malus = coef. 2.72173% de Malus = coef. 2.73174% de Malus = coef. 2.74175% de Malus = coef. 2.75176% de Malus = coef. 2.76177% de Malus = coef. 2.77178% de Malus = coef. 2.78179% de Malus = coef. 2.79180% de Malus = coef. 2.80181% de Malus = coef. 2.81182% de Malus = coef. 2.82183% de Malus = coef. 2.83184% de Malus = coef. 2.84185% de Malus = coef. 2.85186% de Malus = coef. 2.86187% de Malus = coef. 2.87188% de Malus = coef. 2.88189% de Malus = coef. 2.89190% de Malus = coef. 2.90191% de Malus = coef. 2.91192% de Malus = coef. 2.92193% de Malus = coef. 2.93194% de Malus = coef. 2.94195% de Malus = coef. 2.95196% de Malus = coef. 2.96197% de Malus = coef. 2.97198% de Malus = coef. 2.98199% de Malus = coef. 2.99200% de Malus = coef. 3.00201% de Malus = coef. 3.01202% de Malus = coef. 3.02203% de Malus = coef. 3.03204% de Malus = coef. 3.04205% de Malus = coef. 3.05206% de Malus = coef. 3.06207% de Malus = coef. 3.07208% de Malus = coef. 3.08209% de Malus = coef. 3.09210% de Malus = coef. 3.10211% de Malus = coef. 3.11212% de Malus = coef. 3.12213% de Malus = coef. 3.13214% de Malus = coef. 3.14215% de Malus = coef. 3.15216% de Malus = coef. 3.16217% de Malus = coef. 3.17218% de Malus = coef. 3.18219% de Malus = coef. 3.19220% de Malus = coef. 3.20221% de Malus = coef. 3.21222% de Malus = coef. 3.22223% de Malus = coef. 3.23224% de Malus = coef. 3.24225% de Malus = coef. 3.25226% de Malus = coef. 3.26227% de Malus = coef. 3.27228% de Malus = coef. 3.28229% de Malus = coef. 3.29230% de Malus = coef. 3.30231% de Malus = coef. 3.31232% de Malus = coef. 3.32233% de Malus = coef. 3.33234% de Malus = coef. 3.34235% de Malus = coef. 3.35236% de Malus = coef. 3.36237% de Malus = coef. 3.37238% de Malus = coef. 3.38239% de Malus = coef. 3.39240% de Malus = coef. 3.40241% de Malus = coef. 3.41242% de Malus = coef. 3.42243% de Malus = coef. 3.43244% de Malus = coef. 3.44245% de Malus = coef. 3.45246% de Malus = coef. 3.46247% de Malus = coef. 3.47248% de Malus = coef. 3.48249% de Malus = coef. 3.49250% de Malus = coef. 3.50Troisième conducteurNom* Prénom Nom Date de naissance* JJ MM AAAA Date de permis de conduire* JJ MM AAAA Profession*Lien de parenté*ConjointDescendant (enfant)Ascendant (Parent)AutrePermis de conduire*En cours de validitéAAC (conduite accompagnée -18 ans)Conduite supervisée (+ de 18 ans)bonus actuel du troisième conducteur*50% de bonus = coef. 0.50 de plus de 3 ans50% de bonus = coef. 0.5049% de bonus = coef. 0.5148% de bonus = coef. 0.5247% de bonus = coef. 0.5346% de bonus = coef. 0.5445% de bonus = coef. 0.5544% de bonus = coef. 0.5643% de bonus = coef. 0.5742% de bonus = coef. 0.5841% de bonus = coef. 0.5940% de bonus = coef. 0.6039% de bonus = coef. 0.6138% de bonus = coef. 0.6237% de bonus = coef. 0.6336% de bonus = coef. 0.6435% de bonus = coef. 0.6534% de bonus = coef. 0.6633% de bonus = coef. 0.6732% de bonus = coef. 0.6831% de bonus = coef. 0.6930% de bonus = coef. 0.7029% de bonus = coef. 0.7128% de bonus = coef. 0.7227% de bonus = coef. 0.7326% de bonus = coef. 0.7425% de bonus = coef. 0.7524% de bonus = coef. 0.7623% de bonus = coef. 0.7722% de bonus = coef. 0.7821% de bonus = coef. 0.7920% de bonus = coef. 0.8019% de bonus = coef. 0.8118% de bonus = coef. 0.8217% de bonus = coef. 0.8316% de bonus = coef. 0.8415% de bonus = coef. 0.8514% de bonus = coef. 0.8613% de bonus = coef. 0.8712% de bonus = coef. 0.8811% de bonus = coef. 0.8910% de bonus = coef. 0.909% de bonus = coef. 0.918% de bonus = coef. 0.927% de bonus = coef. 0.936% de bonus = coef. 0.945% de bonus = coef. 0.954% de bonus = coef. 0.963% de bonus = coef. 0.972% de bonus = coef. 0.981% de bonus = coef. 0.990% de bonus = coef. 1.001% de Malus = coef. 1.012% de Malus = coef. 1.023% de Malus = coef. 1.034% de Malus = coef. 1.045% de Malus = coef. 1.056% de Malus = coef. 1.067% de bonus = coef. 1.078% de Malus = coef. 1.089% de bonus = coef. 1.0910% de Malus = coef. 1.1011% de bonus = coef. 1.1112% de bonus = coef. 1.1213% de bonus = coef. 1.1314% de bonus = coef. 1.1415% de bonus = coef. 1.1516% de bonus = coef. 1.1617% de bonus = coef. 1.1718% de bonus = coef. 1.1819% de bonus = coef. 1.1920% de bonus = coef. 1.2021% de bonus = coef. 1.2122% de bonus = coef. 1.2223% de bonus = coef. 1.2324% de bonus = coef. 1.2425% de bonus = coef. 1.2526% de bonus = coef. 1.2627% de bonus = coef. 1.2728% de bonus = coef. 1.2829% de bonus = coef. 1.2930% de bonus = coef. 1.3031% de bonus = coef. 1.3132% de bonus = coef. 1.3233% de bonus = coef. 1.3334% de bonus = coef. 1.3435% de bonus = coef. 1.3536% de bonus = coef. 1.3637% de bonus = coef. 1.3738% de bonus = coef. 1.3839% de bonus = coef. 1.3940% de Malus = coef. 1.4041% de Malus = coef. 1.4142% de Malus = coef. 1.4243% de Malus = coef. 1.4344% de Malus = coef. 1.4445% de Malus = coef. 1.4546% de Malus = coef. 1.4647% de Malus = coef. 1.4748% de Malus = coef. 1.4849% de Malus = coef. 1.4950% de Malus = coef. 1.5051% de Malus = coef. 1.5152% de Malus = coef. 1.5253% de Malus = coef. 1.5354% de Malus = coef. 1.5455% de Malus = coef. 1.5556% de Malus = coef. 1.5657% de Malus = coef. 1.5758% de Malus = coef. 1.5859% de Malus = coef. 1.5960% de Malus = coef. 1.6061% de Malus = coef. 1.6162% de Malus = coef. 1.6263% de Malus = coef. 1.6364% de Malus = coef. 1.6465% de Malus = coef. 1.6566% de Malus = coef. 1.6667% de Malus = coef. 1.6768% de Malus = coef. 1.6869% de Malus = coef. 1.6970% de Malus = coef. 1.7071% de Malus = coef. 1.7172% de Malus = coef. 1.7273% de Malus = coef. 1.7374% de Malus = coef. 1.7475% de Malus = coef. 1.7576% de Malus = coef. 1.7677% de Malus = coef. 1.7778% de Malus = coef. 1.7879% de Malus = coef. 1.7980% de Malus = coef. 1.8081% de Malus = coef. 1.8182% de Malus = coef. 1.8283% de Malus = coef. 1.8384% de Malus = coef. 1.8485% de Malus = coef. 1.8586% de Malus = coef. 1.8687% de Malus = coef. 1.8788% de Malus = coef. 1.8889% de Malus = coef. 1.8990% de Malus = coef. 1.9091% de Malus = coef. 1.9192% de Malus = coef. 1.9293% de Malus = coef. 1.9394% de Malus = coef. 1.9495% de Malus = coef. 1.9596% de Malus = coef. 1.9697% de Malus = coef. 1.9798% de Malus = coef. 1.9899% de Malus = coef. 1.99100% de Malus = coef. 2.00101% de Malus = coef. 2.01102% de Malus = coef. 2.02103% de Malus = coef. 2.03104% de Malus = coef. 2.04105% de Malus = coef. 2.05106% de Malus = coef. 2.06107% de Malus = coef. 2.07108% de Malus = coef. 2.08109% de Malus = coef. 2.09110% de Malus = coef. 2.10111% de Malus = coef. 2.11112% de Malus = coef. 2.12113% de Malus = coef. 2.13114% de Malus = coef. 2.14115% de Malus = coef. 2.15116% de Malus = coef. 2.16117% de Malus = coef. 2.17118% de Malus = coef. 2.18119% de Malus = coef. 2.19120% de Malus = coef. 2.20121% de Malus = coef. 2.21122% de Malus = coef. 2.22123% de Malus = coef. 2.23124% de Malus = coef. 2.24125% de Malus = coef. 2.25126% de Malus = coef. 2.26127% de Malus = coef. 2.27128% de Malus = coef. 2.28129% de Malus = coef. 2.29130% de Malus = coef. 2.30131% de Malus = coef. 2.31132% de Malus = coef. 2.32133% de Malus = coef. 2.33134% de Malus = coef. 2.34135% de Malus = coef. 2.35136% de Malus = coef. 2.36137% de Malus = coef. 2.37138% de Malus = coef. 2.38139% de Malus = coef. 2.39140% de Malus = coef. 2.40141% de Malus = coef. 2.41142% de Malus = coef. 2.42143% de Malus = coef. 2.43144% de Malus = coef. 2.44145% de Malus = coef. 2.45146% de Malus = coef. 2.46147% de Malus = coef. 2.47148% de Malus = coef. 2.48149% de Malus = coef. 2.49150% de Malus = coef. 2.50151% de Malus = coef. 2.51152% de Malus = coef. 2.52153% de Malus = coef. 2.53154% de Malus = coef. 2.54155% de Malus = coef. 2.55156% de Malus = coef. 2.56157% de Malus = coef. 2.57158% de Malus = coef. 2.58159% de Malus = coef. 2.59160% de Malus = coef. 2.60161% de Malus = coef. 2.61162% de Malus = coef. 2.62163% de Malus = coef. 2.63164% de Malus = coef. 2.64165% de Malus = coef. 2.65166% de Malus = coef. 2.66167% de Malus = coef. 2.67168% de Malus = coef. 2.68169% de Malus = coef. 2.69170% de Malus = coef. 2.70171% de Malus = coef. 2.71172% de Malus = coef. 2.72173% de Malus = coef. 2.73174% de Malus = coef. 2.74175% de Malus = coef. 2.75176% de Malus = coef. 2.76177% de Malus = coef. 2.77178% de Malus = coef. 2.78179% de Malus = coef. 2.79180% de Malus = coef. 2.80181% de Malus = coef. 2.81182% de Malus = coef. 2.82183% de Malus = coef. 2.83184% de Malus = coef. 2.84185% de Malus = coef. 2.85186% de Malus = coef. 2.86187% de Malus = coef. 2.87188% de Malus = coef. 2.88189% de Malus = coef. 2.89190% de Malus = coef. 2.90191% de Malus = coef. 2.91192% de Malus = coef. 2.92193% de Malus = coef. 2.93194% de Malus = coef. 2.94195% de Malus = coef. 2.95196% de Malus = coef. 2.96197% de Malus = coef. 2.97198% de Malus = coef. 2.98199% de Malus = coef. 2.99200% de Malus = coef. 3.00201% de Malus = coef. 3.01202% de Malus = coef. 3.02203% de Malus = coef. 3.03204% de Malus = coef. 3.04205% de Malus = coef. 3.05206% de Malus = coef. 3.06207% de Malus = coef. 3.07208% de Malus = coef. 3.08209% de Malus = coef. 3.09210% de Malus = coef. 3.10211% de Malus = coef. 3.11212% de Malus = coef. 3.12213% de Malus = coef. 3.13214% de Malus = coef. 3.14215% de Malus = coef. 3.15216% de Malus = coef. 3.16217% de Malus = coef. 3.17218% de Malus = coef. 3.18219% de Malus = coef. 3.19220% de Malus = coef. 3.20221% de Malus = coef. 3.21222% de Malus = coef. 3.22223% de Malus = coef. 3.23224% de Malus = coef. 3.24225% de Malus = coef. 3.25226% de Malus = coef. 3.26227% de Malus = coef. 3.27228% de Malus = coef. 3.28229% de Malus = coef. 3.29230% de Malus = coef. 3.30231% de Malus = coef. 3.31232% de Malus = coef. 3.32233% de Malus = coef. 3.33234% de Malus = coef. 3.34235% de Malus = coef. 3.35236% de Malus = coef. 3.36237% de Malus = coef. 3.37238% de Malus = coef. 3.38239% de Malus = coef. 3.39240% de Malus = coef. 3.40241% de Malus = coef. 3.41242% de Malus = coef. 3.42243% de Malus = coef. 3.43244% de Malus = coef. 3.44245% de Malus = coef. 3.45246% de Malus = coef. 3.46247% de Malus = coef. 3.47248% de Malus = coef. 3.48249% de Malus = coef. 3.49250% de Malus = coef. 3.50Quatrième conducteurNom* Prénom Nom Date de naissance* JJ MM AAAA Date de permis de conduire* JJ MM AAAA Profession*Lien de parenté*ConjointDescendant (enfant)Ascendant (Parent)AutrePermis de conduire*En cours de validitéAAC (conduite accompagnée -18 ans)Conduite supervisée (+ de 18 ans)bonus actuel du Quatrième conducteur*50% de bonus = coef. 0.50 de plus de 3 ans50% de bonus = coef. 0.5049% de bonus = coef. 0.5148% de bonus = coef. 0.5247% de bonus = coef. 0.5346% de bonus = coef. 0.5445% de bonus = coef. 0.5544% de bonus = coef. 0.5643% de bonus = coef. 0.5742% de bonus = coef. 0.5841% de bonus = coef. 0.5940% de bonus = coef. 0.6039% de bonus = coef. 0.6138% de bonus = coef. 0.6237% de bonus = coef. 0.6336% de bonus = coef. 0.6435% de bonus = coef. 0.6534% de bonus = coef. 0.6633% de bonus = coef. 0.6732% de bonus = coef. 0.6831% de bonus = coef. 0.6930% de bonus = coef. 0.7029% de bonus = coef. 0.7128% de bonus = coef. 0.7227% de bonus = coef. 0.7326% de bonus = coef. 0.7425% de bonus = coef. 0.7524% de bonus = coef. 0.7623% de bonus = coef. 0.7722% de bonus = coef. 0.7821% de bonus = coef. 0.7920% de bonus = coef. 0.8019% de bonus = coef. 0.8118% de bonus = coef. 0.8217% de bonus = coef. 0.8316% de bonus = coef. 0.8415% de bonus = coef. 0.8514% de bonus = coef. 0.8613% de bonus = coef. 0.8712% de bonus = coef. 0.8811% de bonus = coef. 0.8910% de bonus = coef. 0.909% de bonus = coef. 0.918% de bonus = coef. 0.927% de bonus = coef. 0.936% de bonus = coef. 0.945% de bonus = coef. 0.954% de bonus = coef. 0.963% de bonus = coef. 0.972% de bonus = coef. 0.981% de bonus = coef. 0.990% de bonus = coef. 1.001% de Malus = coef. 1.012% de Malus = coef. 1.023% de Malus = coef. 1.034% de Malus = coef. 1.045% de Malus = coef. 1.056% de Malus = coef. 1.067% de bonus = coef. 1.078% de Malus = coef. 1.089% de bonus = coef. 1.0910% de Malus = coef. 1.1011% de bonus = coef. 1.1112% de bonus = coef. 1.1213% de bonus = coef. 1.1314% de bonus = coef. 1.1415% de bonus = coef. 1.1516% de bonus = coef. 1.1617% de bonus = coef. 1.1718% de bonus = coef. 1.1819% de bonus = coef. 1.1920% de bonus = coef. 1.2021% de bonus = coef. 1.2122% de bonus = coef. 1.2223% de bonus = coef. 1.2324% de bonus = coef. 1.2425% de bonus = coef. 1.2526% de bonus = coef. 1.2627% de bonus = coef. 1.2728% de bonus = coef. 1.2829% de bonus = coef. 1.2930% de bonus = coef. 1.3031% de bonus = coef. 1.3132% de bonus = coef. 1.3233% de bonus = coef. 1.3334% de bonus = coef. 1.3435% de bonus = coef. 1.3536% de bonus = coef. 1.3637% de bonus = coef. 1.3738% de bonus = coef. 1.3839% de bonus = coef. 1.3940% de Malus = coef. 1.4041% de Malus = coef. 1.4142% de Malus = coef. 1.4243% de Malus = coef. 1.4344% de Malus = coef. 1.4445% de Malus = coef. 1.4546% de Malus = coef. 1.4647% de Malus = coef. 1.4748% de Malus = coef. 1.4849% de Malus = coef. 1.4950% de Malus = coef. 1.5051% de Malus = coef. 1.5152% de Malus = coef. 1.5253% de Malus = coef. 1.5354% de Malus = coef. 1.5455% de Malus = coef. 1.5556% de Malus = coef. 1.5657% de Malus = coef. 1.5758% de Malus = coef. 1.5859% de Malus = coef. 1.5960% de Malus = coef. 1.6061% de Malus = coef. 1.6162% de Malus = coef. 1.6263% de Malus = coef. 1.6364% de Malus = coef. 1.6465% de Malus = coef. 1.6566% de Malus = coef. 1.6667% de Malus = coef. 1.6768% de Malus = coef. 1.6869% de Malus = coef. 1.6970% de Malus = coef. 1.7071% de Malus = coef. 1.7172% de Malus = coef. 1.7273% de Malus = coef. 1.7374% de Malus = coef. 1.7475% de Malus = coef. 1.7576% de Malus = coef. 1.7677% de Malus = coef. 1.7778% de Malus = coef. 1.7879% de Malus = coef. 1.7980% de Malus = coef. 1.8081% de Malus = coef. 1.8182% de Malus = coef. 1.8283% de Malus = coef. 1.8384% de Malus = coef. 1.8485% de Malus = coef. 1.8586% de Malus = coef. 1.8687% de Malus = coef. 1.8788% de Malus = coef. 1.8889% de Malus = coef. 1.8990% de Malus = coef. 1.9091% de Malus = coef. 1.9192% de Malus = coef. 1.9293% de Malus = coef. 1.9394% de Malus = coef. 1.9495% de Malus = coef. 1.9596% de Malus = coef. 1.9697% de Malus = coef. 1.9798% de Malus = coef. 1.9899% de Malus = coef. 1.99100% de Malus = coef. 2.00101% de Malus = coef. 2.01102% de Malus = coef. 2.02103% de Malus = coef. 2.03104% de Malus = coef. 2.04105% de Malus = coef. 2.05106% de Malus = coef. 2.06107% de Malus = coef. 2.07108% de Malus = coef. 2.08109% de Malus = coef. 2.09110% de Malus = coef. 2.10111% de Malus = coef. 2.11112% de Malus = coef. 2.12113% de Malus = coef. 2.13114% de Malus = coef. 2.14115% de Malus = coef. 2.15116% de Malus = coef. 2.16117% de Malus = coef. 2.17118% de Malus = coef. 2.18119% de Malus = coef. 2.19120% de Malus = coef. 2.20121% de Malus = coef. 2.21122% de Malus = coef. 2.22123% de Malus = coef. 2.23124% de Malus = coef. 2.24125% de Malus = coef. 2.25126% de Malus = coef. 2.26127% de Malus = coef. 2.27128% de Malus = coef. 2.28129% de Malus = coef. 2.29130% de Malus = coef. 2.30131% de Malus = coef. 2.31132% de Malus = coef. 2.32133% de Malus = coef. 2.33134% de Malus = coef. 2.34135% de Malus = coef. 2.35136% de Malus = coef. 2.36137% de Malus = coef. 2.37138% de Malus = coef. 2.38139% de Malus = coef. 2.39140% de Malus = coef. 2.40141% de Malus = coef. 2.41142% de Malus = coef. 2.42143% de Malus = coef. 2.43144% de Malus = coef. 2.44145% de Malus = coef. 2.45146% de Malus = coef. 2.46147% de Malus = coef. 2.47148% de Malus = coef. 2.48149% de Malus = coef. 2.49150% de Malus = coef. 2.50151% de Malus = coef. 2.51152% de Malus = coef. 2.52153% de Malus = coef. 2.53154% de Malus = coef. 2.54155% de Malus = coef. 2.55156% de Malus = coef. 2.56157% de Malus = coef. 2.57158% de Malus = coef. 2.58159% de Malus = coef. 2.59160% de Malus = coef. 2.60161% de Malus = coef. 2.61162% de Malus = coef. 2.62163% de Malus = coef. 2.63164% de Malus = coef. 2.64165% de Malus = coef. 2.65166% de Malus = coef. 2.66167% de Malus = coef. 2.67168% de Malus = coef. 2.68169% de Malus = coef. 2.69170% de Malus = coef. 2.70171% de Malus = coef. 2.71172% de Malus = coef. 2.72173% de Malus = coef. 2.73174% de Malus = coef. 2.74175% de Malus = coef. 2.75176% de Malus = coef. 2.76177% de Malus = coef. 2.77178% de Malus = coef. 2.78179% de Malus = coef. 2.79180% de Malus = coef. 2.80181% de Malus = coef. 2.81182% de Malus = coef. 2.82183% de Malus = coef. 2.83184% de Malus = coef. 2.84185% de Malus = coef. 2.85186% de Malus = coef. 2.86187% de Malus = coef. 2.87188% de Malus = coef. 2.88189% de Malus = coef. 2.89190% de Malus = coef. 2.90191% de Malus = coef. 2.91192% de Malus = coef. 2.92193% de Malus = coef. 2.93194% de Malus = coef. 2.94195% de Malus = coef. 2.95196% de Malus = coef. 2.96197% de Malus = coef. 2.97198% de Malus = coef. 2.98199% de Malus = coef. 2.99200% de Malus = coef. 3.00201% de Malus = coef. 3.01202% de Malus = coef. 3.02203% de Malus = coef. 3.03204% de Malus = coef. 3.04205% de Malus = coef. 3.05206% de Malus = coef. 3.06207% de Malus = coef. 3.07208% de Malus = coef. 3.08209% de Malus = coef. 3.09210% de Malus = coef. 3.10211% de Malus = coef. 3.11212% de Malus = coef. 3.12213% de Malus = coef. 3.13214% de Malus = coef. 3.14215% de Malus = coef. 3.15216% de Malus = coef. 3.16217% de Malus = coef. 3.17218% de Malus = coef. 3.18219% de Malus = coef. 3.19220% de Malus = coef. 3.20221% de Malus = coef. 3.21222% de Malus = coef. 3.22223% de Malus = coef. 3.23224% de Malus = coef. 3.24225% de Malus = coef. 3.25226% de Malus = coef. 3.26227% de Malus = coef. 3.27228% de Malus = coef. 3.28229% de Malus = coef. 3.29230% de Malus = coef. 3.30231% de Malus = coef. 3.31232% de Malus = coef. 3.32233% de Malus = coef. 3.33234% de Malus = coef. 3.34235% de Malus = coef. 3.35236% de Malus = coef. 3.36237% de Malus = coef. 3.37238% de Malus = coef. 3.38239% de Malus = coef. 3.39240% de Malus = coef. 3.40241% de Malus = coef. 3.41242% de Malus = coef. 3.42243% de Malus = coef. 3.43244% de Malus = coef. 3.44245% de Malus = coef. 3.45246% de Malus = coef. 3.46247% de Malus = coef. 3.47248% de Malus = coef. 3.48249% de Malus = coef. 3.49250% de Malus = coef. 3.50VéhiculeComment lire votre Carte grise (cliquez-ici)Immatriculation*Il s'agit d'un véhicule déjà acquis ou d'un projet d'achat ?*Déjà acquisProjet d'achatDate d'achat* JJ MM AAAA Date de première mise en circulation ?* JJ MM AAAA Le véhicule est-il déjà assuré ?*OuiNonDate d'échéance de votre contrat actuel :* JJ MM AAAA Marque*Alfa RoméoAston MartinAudiBMWBentleyBugattiBuickCadillacChevroletChryslerCitroënDaciaDatsunDodgeDaihatsuFiatFerrariFordHondaHyundaiJaguarJeepKiaLadaLamborghiniLanciaLand RoverLexusLincolnLotus CarsMaseratiMcLarenMazdaMercedes-BenzMGMiniMitsubishiNissanOpelPaganiPeugeotPorscheRenaultRolls-RoyceSaabSeatSmartSkodaSubaruToyotaVenturi AutomobilesVolkswagenAutreligne D.1 de votre carte griseIndiquez la marque de votre véhicule*Modèle*Précisez le modèle de votre véhicule : 207 pack sport, scennic 2 expression, Golf 4...Type mine*ligne D.2 de votre carte griseGenre*VPCTTEAutreligne J.1 de votre carte griseCarrosseries (VP)*CI (conduite intérieur)CABR (cabriolet)BREAK (break)CIALE (commerciale)HANDICAP (handicapés)NON SPEC (non spécifiée)Autreligne J.3 de votre carte griseCarrosseries (CTTE)*BEN AMO (bennes amovibles)BENNE (bennes dont le déchargement est effectué mécaniquement par le fond à l'aide d'un convoyeur à raclettes, d'une vis sans fin, etc...)BENNE (bennes basculantes de chantier et de travaux publicq)BEN CERE (bennes céréalières)BETAIL (bétaillère)CASIERS (casiers)CIT ALIM (citerne à produits alimentaires)CIT ALTD (citerne à produit alimentaire à température dirigée)CIT BETA (citerne pour aliments du bétail)CIT CHIM (citerne à produits chimiques)CIT GAZ (citerne à gaz liquéfiés)CARB LEG (citerne à hydrocarbures légers)CARB LRD (citerne à hydrocarbures lourdsCIT VID (citerne à vidange)CIT EAU (citerne à eau)CIT PULV (citerne à produits pulvérulents ou granulaires)BACHE (fourgon bâché avec parois rigides)FOURGON (fourgon avec parois et toit rigides)FG TD (fourgon à température dirigée)DERIV VP (fourgonette dérivée de VP)BETON (bétonnière)PLATEAU (plateau)PTE BAT (porte-bateau)PTE FER (porte-fers)PTE VOIT (porte-voitures)SAVOYARD (savoyardes)PLSC Carrosserie à parois latérales souples coulissantes)CHAS-CAB (châssis-cabine)NON SPEC (Divers non spécifiée)ligne J.3 de votre carte grisePuissance administrative*2 chevaux3 chevaux4 chevaux5 chevaux6 chevaux7 chevaux8 chevaux9 chevaux10 chevaux11 chevaux12 chevaux13 chevaux14 chevaux15 chevaux16 chevaux17 chevaux18 chevaux19 chevaux20 chevauxautreligne P.6 de votre carte griseEnergie*ligne P.3 de votre carte griseTitulaire de la carte grise*Conducteur principalConjoint (e)Ascendant (parent)Descendant (enfant)Le coupleSociétéSociété de leasing / conducteur principalAscendant et descendant (parent et enfant)Le(s) propriètaire(s) a-t-il (ont-ils) le permis ?*OuiNonLieu de stationnement*BoxGarage FerméRueTerrain privéeParking collectif abritéParking collectif plein airLieux multiplesUsage*PrivéPrivé + trajet travail lieu uniquePrivé + trajet travail lieu multiplesAffaires commerce artisanTous déplacement (hors transport public de marchandises / personnes)Immatriculation française*OuiNonS’agit-il d’un véhicule appartenant aux collectivités territoriales, départementales, aux hôpitaux ou aux loueurs ?*OuiNonSinistralitéUn des conducteurs a t-il eu un ou plusieurs sinistres (bris de glaces, vol, tentative de vol, perte de contrôle, vandalisme, ...) au cours des 36 derniers mois ?*NonOui 1Oui 2Oui 3Oui 4Oui 5Oui 6Oui 7Oui 8Oui 9Date du sinistre (1)* Nature*Materél 100% responsableMaterél 50% responsableMateriél non responsableCorporel 100% responsableCorporel 50% responsableCorporel non responsableBris de glaceVolTentative de volIncendieAutreConducteur*Conducteur principalConducteur 2Conducteur 3Conducteur 4AutreDate du sinistre (2)* Nature*Materél 100% responsableMaterél 50% responsableMateriél non responsableCorporel 100% responsableCorporel 50% responsableCorporel non responsableBris de glaceVolTentative de volIncendieAutreConducteur*Conducteur principalConducteur 2Conducteur 3Conducteur 4AutreDate du sinistre (3)* Nature*Materél 100% responsableMaterél 50% responsableMateriél non responsableCorporel 100% responsableCorporel 50% responsableCorporel non responsableBris de glaceVolTentative de volIncendieAutreConducteur*Conducteur principalConducteur 2Conducteur 3Conducteur 4AutreDate du sinistre (4)* Nature*Materél 100% responsableMaterél 50% responsableMateriél non responsableCorporel 100% responsableCorporel 50% responsableCorporel non responsableBris de glaceVolTentative de volIncendieAutreConducteur*Conducteur principalConducteur 2Conducteur 3Conducteur 4AutreDate du sinistre (5)* Nature*Materél 100% responsableMaterél 50% responsableMateriél non responsableCorporel 100% responsableCorporel 50% responsableCorporel non responsableBris de glaceVolTentative de volIncendieAutreConducteur*Conducteur principalConducteur 2Conducteur 3Conducteur 4AutreDate du sinistre (6)* Nature*Materél 100% responsableMaterél 50% responsableMateriél non responsableCorporel 100% responsableCorporel 50% responsableCorporel non responsableBris de glaceVolTentative de volIncendieAutreConducteur*Conducteur principalConducteur 2Conducteur 3Conducteur 4AutreDate du sinistre (7)* Nature*Materél 100% responsableMaterél 50% responsableMateriél non responsableCorporel 100% responsableCorporel 50% responsableCorporel non responsableBris de glaceVolTentative de volIncendieAutreConducteur*Conducteur principalConducteur 2Conducteur 3Conducteur 4AutreDate du sinistre (8)* Nature*Materél 100% responsableMaterél 50% responsableMateriél non responsableCorporel 100% responsableCorporel 50% responsableCorporel non responsableBris de glaceVolTentative de volIncendieAutreConducteur*Conducteur principalConducteur 2Conducteur 3Conducteur 4AutreDate du sinistre (9)* Nature*Materél 100% responsableMaterél 50% responsableMateriél non responsableCorporel 100% responsableCorporel 50% responsableCorporel non responsableBris de glaceVolTentative de volIncendieAutreConducteur*Conducteur principalConducteur 2Conducteur 3Conducteur 4AutreUn des conducteurs a-t-il été résilié par un assureur ?*NonOui pour non paiement à jour sous 3 moisOui pour non paiement non à jourOui pour sinistreOui pour alcoolemieOui pour nulitéAutreLequel ?*Conducteur principalConducteur 2Conducteur 3Conducteur 4Au cours des 36 derniers mois un des conducteurs a-t-il été sanctionné pour alcoolémie, stupéfiant, et/ou a eu un retrait ou une suspension de PC de plus de 15 jours ?*NonOui pour alccolémieOui pour stupéfiantsOui pour perte de points et autres sans motifs sans alcoolémieLequel ?*Conducteur principalConducteur 2Conducteur 3Conducteur 4A l'occasion d'un*ContrôleAccident MaterielAccident corporelCirconstances*PrivéesProfessionnellesTaux d'alcool dans le sang*De 0.50 à 0.79 g par litre de sang ou de 0.25 à 0.395 mg par litre d'air expiréDe 0.80 à 1.99 g par litre de sang ou de 0.40 à 0.995 mg par litre d'air expiré+ de 2 g par litre de sang ou plus de 1 mg par litre d'air expiréDelit de fuite*OuiNonSuspension / annulation :AucuneSuspention de moins de 2 moisSuspension de 2 à moins de 3 moisSuspension de 3 à moins de 6 moisSuspension de 6 à moins de 12 moisSuspension de 12 à moins de 18 moisSuspension de 18 mois et plusAnnulationDate de l'annulation* JJ MM AAAA Date du 1er permis de conduire* JJ MM AAAA Date de passage du nouveau permis* JJ MM AAAA Date de suspension* JJ MM AAAA Date de recupération du PC* JJ MM AAAA Y-a-til eu un 2e cas d'alcoolémie ?*OuiNonTableau des garanties automobile (cliquez-ici)Garanties Souhaitées (choix 1)*F1 = Responsabilité Civile + Défense et recours + Assurance du conducteur + AssistanceF2 = F1 + Bris de glaces + Catastrophes naturelles et technologiques + Evénements climatiques + Attentats et terrorismeF3 = F2 + Vol et incendieF4 = F2 + Dommages tous accidents (tous risques)Garanties Souhaitées (choix 2)F1 = Responsabilité Civile + Défense et recours + Assurance du conducteur + AssistanceF2 = F1 + Bris de glaces + Catastrophes naturelles et technologiques + Evénements climatiques + Attentats et terrorismeF3 = F2 + Vol et incendieF4 = F2 + Dommages tous accidents (tous risques)Informations complémentaires