Motor Trade Insurance Quote


Please Fill in the following:


Full Name

Address




Telephone No

E-mail Address

Date of Birth

Licence Type

Occupation

Accidents, Claims or Convictions

Full Business Description

Are you VAT registered?
YESNO
 

Please state your involvement in the following activities:

 
Buying/Selling Cars & Vans
Repairs/Service Cars & Vans
Crash Repairs & Sprayin
Windscreen/Exhaust Fitting
Tyre Sales & Fitting
Assessor/Motor Engineer
Repossession/Liquidations
Petrol Sales
Valet/Customer Parking
Vehicle Recovery
Car Valeting/Cleaning
Vehicle Accessories

Occupation details:

Number of years in current occupation
Are you involved in the Motor Trade
Full Time Part Time

If Part Time

What is your full time occupation?
Do you require Additional Business Use to drive a vehicle in connection with this other business?

Drivers Details

Driver 1:

Drivers Name
Relationship to you
D.O.B
Type of Licence
Exact Occupation
Accidents, Claims or Convictions
Business Use?
YES NO

Social, Domestic & Pleasure Use?
YES NO

Driver 2:

Drivers Name
Relationship to you
D.O.B
Type of Licence
Exact Occupation
Accidents, Claims or Convictions
Business Use?
YES NO

Social, Domestic & Pleasure Use?
YES NO

Driver 3:

Drivers Name
Relationship to you
D.O.B
Type of Licence
Exact Occupation
Accidents, Claims or Convictions
Business Use?
YES NO

Social, Domestic & Pleasure Use?
YES NO

Driver 4:

Drivers Name
Relationship to you
D.O.B
Type of Licence
Exact Occupation
Accidents, Claims or Convictions
Business Use?
YES NO

Social, Domestic & Pleasure Use?
YES NO

Type of Cover Required

Comprehensive

Third Party Fire and Theft

Third Party

Past History Information

N.of Years No Claims Bonus earned in your name:
Is your bonus from Motor Trade/ Private Motor/ Commercial Vehicle?
Previous Insurer?
If no No Claims Bonus, N. of Years Named Driving Experience (must be current):
Do you require Motorcycle Cover?

Have you or any named driver ever had any Accidents, Claims, Convictions, Penalty Points or Disabilities in the past or ever been convicted of a CRIMINAL non-motoring offence?

Drivers Name
Date of Offence or Claim Conviction Date Offence or Claim Details Sentence, Fine, Disqualification Period or Penalty Points or cost of claim

Vehicles currently owned by and registered to you

Year
Make
Model
Engine Size
Value €
Main Driver

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