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In accordance with the European directive MiFID we are required by Belgian legislation to register all pre-contractual actions, to document personal details and keep these available for review by the appointed authority FSMA. This means we are obliged to ask you to complete the below form completely and correctly before we can offer you a quote or personal advice.

  • Current Person to be insured
  • Purpose of your stay abroad
  • Your contact details
Person to be insured:

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