Online Quotation Request
Insurance Type *
Car Owned By *
Industry of Owner *
Occupation of Named Driver(s) *
Industry of Named Driver(s)
Age (accept aged 25 to 70) *
Traffic Offence Points in the past 2 year (accept 8 points or below) *
No Claim Discount *
Claim History in the past 3 years *
Driving Experience (accept 2 years or above) *
Vehicle Make *
Vehicle Model *
Location of overnight parking *	With 24 hours Security Parking Others
Year of Make *
Vehicle License Plate Number
Cylinder Capacity *
Estimated Vehicle Value
Alarm System	Factory Built-in Others
No. of Named Driver(s)
Contact Person
Email Address
Phone Number *
Promotion Reference Number

Personal Information Collection Statement

AUTOTOLL INSURANCE AGENT LIMITED
PERSONAL INFORMATION COLLECTION STATEMENT

This statement applies to all personal data as defined in the Personal Data (Privacy) Ordinance (“the Ordinance”) which we may collect from you.

Collection of Personal Data
Your personal data will be collected from you through the quotation request form at the Auto Insurance webpage under www.autotoll.com.hk, the insurance proposal form submitted by you and any written or oral communications between us relating to the insurance services.  The provision of personal data requested by us is voluntary but if you fail to do so, we may not be able to process your application or provide you with the information requested due to lack of information.

Telephone calls between you and our insurance hotline or staff may be recorded. 

Use of Data
Your personal data may be used for the following purposes:-
•	providing you with insurance service including providing insurance quotation from various insurance companies, handling your application for insurance coverage, carrying out data updating, cancellation or renewal of your insurance policy, administration of your insurance policy, and invoicing of our services;
•	handling and following up your enquiries, suggestions and complaints;
•	compiling statistics and conducting service surveys to better understand your characteristics to improve and enhance our services to you and to design and develop new services;
•	credit control and debt collection;
•	prevention or detection of crime;
•	communicating with you.

Furthermore, recording of telephone conversation between you and our customer service hotline or staff may be used for quality control, staff appraisal and training.

Transfer of Data
Your personal data collected by us will be kept confidential and other than as set out below will not be disclosed by us to any other third party.  We may transfer your personal data to the following parties :-
•	our appointing insurer(s)/agent(s) and any other companies carrying out insurance services for the provision of the insurance service(s) to you including providing insurance quotation, handling of application for insurance coverage, carrying out data updating, cancellation or renewal of your insurance policy, and administration of your insurance policy;
•	any actual or proposed assignee of our insurance agency business;
•	any person to whom we are compelled to make disclosure under the requirements of any applicable law;
•	any person with your express consent;
•	any data processor (e.g. printer, production house or vendor provide services to us) engaged by us to process or handle personal data on our behalf; 
•	debt collection agencies to collect any amount due from you.

Rights of Access and Correction to Data Collected
Under the Ordinance, you have a right to request access to, and to request correction of your personal data held by us.  If you wish to exercise those rights, please contact our Privacy Compliance Officer by email at insurance@autotoll.com.hk, by phone at 2627 8811 or by post to the follow address:
Autotoll Insurance Agent Limited, 11/F, Tower A, Billion Centre, 1 Wang Kwong Road, Kowloon Bay, Kowloon, Hong Kong

Data Security
All your personal data we have are stored on our system in Hong Kong and are accessible only to our authorized employees and contractors.  We have also introduced procedures to ensure that data about you cannot be accessed by unauthorized persons.

Contact Person
If you have any question on this statement or our policy on collection and use of your personal data or of our customers generally, please contact our Privacy Compliance Officer referred to above. 

We may from time to time amend this statement and the latest statement will be posted at the Auto Insurance webpage under www.autotoll.com.hk.

In the event of any inconsistency between the Chinese version and the English version of this Statement, the English version shall prevail.

This Personal Information Collection Statement is up-to-date as at 18, March 2013 and is subject to further update or modification.

I/we acknowledge and confirm my understanding and acceptance of the above Personal Information Collection Statement (PICS) and I/we acknowledge that Autotoll Limited may refuse to accept this application without giving any reason therefor.

* Compulsory field