FORENAME/S:
SURNAME:
TRADING NAME
(if applicable):
TRADE OR BUSINESS:
BUSINESS ADDRESS
FIRST LINE:
SECOND LINE:
THIRD LINE:
POSTCODE:
TELEPHONE & CODE:
ARE YOU A FULL TIME MOTOR TRADER:
ARE YOU A PART TIME MOTOR TRADER:
PLEASE DESCRIBE YOUR TRADE OR BUSINESS FULLY BELOW:
  • VEHICLE SALES:
    		• %
  • VEHICLE SERVICING:
    		• %
  • MECHANICAL REPAIR:
    		• %
  • BREAKDOWN RECOVERY:
    		• %
  • BODY REPAIRS:
    		• %
  • VEHICLE VALETING:
    		• %
    IF YOU ARE A PART TIME MOTOR TRADER,
    DESCRIBE YOUR OTHER OCCUPATION/S:
    DO YOU HAVE ANY OTHER BUSINESS OR OCCUPATION?:
    IF YES PLEASE GIVE FULL DETAILS:
    ARE YOU INVOLVED IN VEHICLE SALVAGE, BREAKING,
    SCRAP OR RECOVERY FOR SUCH PURPOSES:
    DO IMPORT OR EXPORT VEHICLES:
    DO YOU SPECIALISE IN SELLING, REPAIRING, SERVICING OR RESTORING:
    SPORTS CARS, HIGH PERFORMANCE CARS, PRESTIGE CARS:
    VEHICLES OTHER THAN MOTOR CARS OR LIGHT COMMERCIAL VEHICLES:
    IF YES TO THE TWO ABOVE QUESTIONS, THEN GIVE DETAILS BELOW:

    (Cover is for named drivers only) PLEASE LIST ALL
    DRIVERS TO BE INCLUDING THE PROPOSER:
    PROPOSER:
    FULL NAME:
    DATE OF BIRTH:
    YEARS LIVING IN UK:
    YEARS FULL UK LICENCE HELD:

    OCCUPATION:
    FULL OR PART TIME:
    IF PART TIME, OTHER OCCUPATION:
    TICK USE REQUIRED:
  • MOTOR TRADE:
  • SD&P:
    • HAVE YOU OR ANY PERSON NAMED ABOVE:
    BEEN CONVICTED OF, OR CHARGED (but not tried)
    WITH A CRIMINAL OFFENCE:
    BEEN CONVICTED OF A MOTORING OFFENCE OR HAVE A PROSECUTION
    PENDING FOR ANY MOTORING OFFENCE IN THE LAST 5YRS
    (INCLUDING FINES UNDER THE FIXED PENALTY OFFENCE SYSTEM:
    GIVE DETAILS OF DRIVER, DATE OF CONVICTION, OFFENCE CODE
    TOTAL FINE/PENALTY POINTS AND DISQUALIFICATION PERIOD:
    IN CONNECTION WITH ANY VEHICLE OWNED USED OR
    DRIVEN HAD ANY ACCIDENT LOSS OR CLAIM IN THE LAST
    3YRS WHETHER OR NOT A CLAIM WAS MADE AS A RESULT:
    GIVE DETAILS OF DRIVER, DATE OF LOSS, COST OF DAMAGE TO YOUR
    VEHICLE AND THIRD PARTY AND DESCRIPTION OF ACCIDENT/LOSS:

    VEHICLES OWNED BUT NOT FOR SALE:
    MAKE/MODEL:
    BODY TYPE:
    YEAR OF MAKE:
    C.C./PLATE OR
    GROSS VEHICLE WEIGHT:
    DATE OF PURCHASE:
    PRICE PAID:
    ESTIMATED PRESENT TRADE VALUE(£):
    REGISTRATION No:

    VEHICLES FOR SALE:
    MAKE/MODEL:
    BODY TYPE:
    YEAR OF MAKE:
    C.C./PLATE OR
    GROSS VEHICLE WEIGHT:
    DATE OF PURCHASE:
    PRICE PAID:
    ESTIMATED PRESENT TRADE VALUE(£):
    REGISTRATION No:

     
    IS A NO CLAIMS DISCOUNT BEING CLAIMED:
    IF 'YES' STATE NUMBER OF YEARS:
    STATE WHICH TYPE OF POLICY YOUR DISCOUNT IS FROM:
  • BREAKDOWN RECOVERY:
  • BODY REPAIRS:
  • BODY REPAIRS:
    • IS AN INTRODUCTORY DISCOUNT BEING CLAIMED
    (where an existing policy is to remain in force):     		YRS %

     

    DO YOU REQUIRE:
    COMPREHENSIVE policies provide cover up to £7,500 for loss
    or damage to any one vehicle. This limit can be increased
    on payment to any one vehicle.
    PART TIME MOTOR TRADERS maximum limit £10,000:
    PLEASE CHOOSE INDEMNITY LIMIT REQUIRED:
    THIRD PARTY FIRE & THEFT policies provide cover up to £5,000
    for loss or damage, by fire, theft or attempted theft,
    to any one vehicle. This limit cannot be increased.
    DO YOU REQUIRE DEMONSTARTION COVER FOR AN ADDITIONAL PREMIUM:
    DO YOU HAVE TRADE PLATES:
    No OF TRADE PLATES:

    Additional information form

     

    Terms and Conditions