Richiesta-Apertura-Sinistro-Cliente - Agenzia Reale Mutua Gasperi Giovanni

Reale Mutua Agenzia di Rovereto Agenti Gasperi Giovanni Via Maioliche, 53 - Leno Center, (TN) Rovereto Tel: 0464 439533 Fax: 0464 439571 Email: rovereto.348@agenzie.realemutua.it

Apertura Sinistro Lite

Modulo richiesta apertura sinistro

Contraente (nome, cognome o ditta) *

Numero Telefono *

Indirizzo Email *

Luogo dell'evento *

Data Evento *

Orario dell'evento *

Descrizione dell'accaduto *

Numero Polizza

Intestatario del conto

Codice bancario IBAN

Allega file (per selezionare più di un file tenere premuto il tasto CTRL)

Maximum file size: 104.86MB

Privacy *

Dichiaro di aver letto L'informativa Privacy*

News

Vorrei rimanere informato sulle vostre novità

Controllo autenticità personale

Si precisa che la compilazione del form costituisce segnalazione di sinistro ma non ne determina l’apertura.
Il personale di Agenzia prenderà in carico la segnalazione e la contatterà per eventuali ulteriori informazioni.
Con la compilazione dei campi, il Socio presta il consenso al trattamento dei propri dati personali. Tale consenso è indispensabile per il proseguo della segnalazione.

Cookie	Durata	Descrizione
cookielawinfo-checkbox-advertisement	1 year	Set by the GDPR Cookie Consent plugin, this cookie is used to record the user consent for the cookies in the "Advertisement" category .
cookielawinfo-checkbox-analytics	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics".
cookielawinfo-checkbox-functional	11 months	The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional".
cookielawinfo-checkbox-necessary	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary".
cookielawinfo-checkbox-others	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other.
cookielawinfo-checkbox-performance	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance".
CookieLawInfoConsent	1 year	Records the default button state of the corresponding category & the status of CCPA. It works only in coordination with the primary cookie.
PHPSESSID	session	This cookie is native to PHP applications. The cookie is used to store and identify a users' unique session ID for the purpose of managing user session on the website. The cookie is a session cookies and is deleted when all the browser windows are closed.
viewed_cookie_policy	11 months	The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.

Cookie	Durata	Descrizione
_ga	2 years	The _ga cookie, installed by Google Analytics, calculates visitor, session and campaign data and also keeps track of site usage for the site's analytics report. The cookie stores information anonymously and assigns a randomly generated number to recognize unique visitors.
_gid	1 day	Installed by Google Analytics, _gid cookie stores information on how visitors use a website, while also creating an analytics report of the website's performance. Some of the data that are collected include the number of visitors, their source, and the pages they visit anonymously.