CAR INSURANCE

Date:
Car make and model:
Year of manufacture:
Additional accessories:
(Not in case of third party) 		No
  Yes
No-claims bonus: No
  Yes         %
DRIVER:
  Male     Female

Date of birth


Date of driving licence

2º Driver
Date of birth

Date of driving licence
   
GUARANTEES:  
Third party
Third party + windscreens + theft + fire
Fully comprehensive with escess
Third party + windscreens
Fully comprehensive
   
Observations:
Signed

 

This document is not contractual and does not link to any of two parts.

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