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Online Taxi Insurance - Quote Form
Location of Taxi
London
Rest of UK
Name:
Phone No:
Email Address :
Current Insurance Company:
Cover Required:
Fully Comp
TPFT
TPO
When would you require cover to commence?
dd/mm/yy
Insured Only
Insured and Spouse
Insured and Named Driver
Age of Proposer
Age of Spouse - if applicable
Age of Named Driver - if applicable
Date Passed DVLA Driving Test
dd/mm/yy
How long have you had a Cab Drivers' License
How Many Years NCB - please state number of years bonus not 'full' or 'maximum'
Do you want Protected No Claims Bonus
Yes:
No:
Ever been refused insurance cover
Yes:
No:
Age of Taxi
Does it have an immobiliser
Yes:
No:
What is your Badge No
Green
or Yellow Badge
Have you had any accidents or losses in the last 3 years?
Yes:
No:
If yes, please give dates
1)
Fault:
Non Fault:
2)
Fault:
Non Fault:
3)
Fault:
Non Fault:
4)
Fault:
Non Fault:
5)
Fault:
Non Fault:
Have you had any motoring convictions in the last 3 years
Yes:
No:
Date
Conviction Code
No of Points
Amount of Fine
Date
Conviction Code
No of Points
Amount of Fine
Date
Conviction Code
No of Points
Amount of Fine
Has your Named Driver had any accidents or losses in the last 3 years
Yes:
No:
If yes, please give dates
1)
Fault:
Non Fault:
2)
Fault:
Non Fault:
3)
Fault:
Non Fault:
4)
Fault:
Non Fault:
5)
Fault:
Non Fault:
Has your Named Driver had any motoring convictions in the last 3 years
Yes:
No:
Date
Conviction Code
No of Points
Amount of Fine
Date
Conviction Code
No of Points
Amount of Fine
Date
Conviction Code
No of Points
Amount of Fine
