Declaration
1. I am informed that all notifications, related to the claim settlement under CMTPL, will be sent to the email address, specified in the CMTPL contract.2. I give my consent to the Insurance Company and the Bureau to circulate (receive and provide) any document, information, video, photo or other material (including insurance or other confidential material) about me in any way and on USB with each other or with third parties, to the extent they are necessary, according to the Insurance company/Bureau, to carry out the insurance compensation process properly, as well as certain inspections related to it and to effectively exercise the right to claim back due to the payment of compensation. In particular, I hereby kindly ask the bodies conducting criminal prosecution in case of adopting a decision to reject the initiation of a criminal case within the framework of this incident, or to dismiss the criminal case and stop the criminal prosecution or to suspend the proceedings in the criminal case, to provide the relevant decision and (if available) the documents underlying it (scheme of the scene, explanations, expert opinion) to the Insurance Company that accepted this claim or the Bureau, in a manner agreed with the latter.3. I confirm that the information presented in this claim form is true, I understand that if false information or documents are submitted, I can be held liable in accordance with the law, my claim may be denied.4. I confirm that all the documents for the claim settlement in the above case has submitted to this application and I have no other documents to submit.5․ I consent that the Insurer processes the data provided for services.
