Taxi Enquiry

Your Name

Address Line 1

Address Line 2

Address Line 3

City

Postcode

Base Postcode

Your Phone

Your Email

Licensing Authority

Are you Public or Private Hire?
PublicPrivate

Are you A Homeowner?
YesNo

Are you married?
YesNo

Type of cover required?
ComprehensiveThird Party Fire & TheftThird Party Only

How many Taxis do you Own/Operate?

How many vehicles would you like to cover?

How many drivers would you like to cover?

When would you like cover to start?

Previous Insurer?

Make

Exact Model

Vehicle Year

Engine Size

Value

Number of seats

Registration number

Is this vehicle garaged?
YesNo

Please detail any vehicle modifications

If you are NOT the owner of this vehicle, please give details here

How many years no claims discount (Taxi)

How many years no claims discount (Private)

If greater than 5 years, do you wish to protect your no claims discount?
YesNo

Is Windscreen cover required?
YesNo

What is your estimated annual mileage?

Drivers full name

Number of claims this driver has had in the last 5 years

Number of convictions this driver has had in the last 5 years

Date of Birth?

All Occupations

Full or Part time?
Full TimePart Time

Relationship to you?

Date passed UK Driving Test

Years held a UK taxi Licence?

If this driver has not been resident in the UK for the last three years, please give details here

If this driver has ever had Insurance refused or cancelled, please provide details here

If this driver suffers from any physical or mental disability, please provide details here

If you have been referred to this site, please provide the name of the referring Site/Company

Please enter referral code

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