Best quote system (over 100 insurance companies)
Local service
Established 28 years

 


Please fill in the form, then press the SUBMIT button. One of our experienced sales staff will contact you to discuss your requirements and to confirm your quotation.

Name

Address

 

Town/City

County

Postcode

Telephone

Email

Make of vehicle

Model

Engine size

Year of manufacture

Number of doors

Manual

Automatic

Value

Alarm /immobilizer type

Modified

 

 

Wheels Body-kit

 

Other:

Owner's name(if not proposer)

Garaged

Yes No

Cover

Comprehensive
Third party fire and theft
Third party only

 

Social domestic and pleasure incl. commuting

Yes No

Class 1

Yes No

Class 2

Yes No

Insured

Insured Only
Insured & spouse
named drivers
Any driver(over 25)

 

Renewal date

Number of cars in household

Number of years no claims discount

Protected NCD

Yes No

Proposer's date of birth

Married

Yes No

Occupation

Type of business

Number of years resident in UK

Driving licence

Full Provisional

How Long Licence Held

Any accidents or claims

Yes No

if yes please give details

 

 

Convictions

Yes No

if yes please give details

 

 

Disabilities

Yes No

if yes please give details

 

how long suffered

medications

 

 

 

 

DVLA Notified

Yes No

Restricted licence

Yes No

Smoker

Non-smoker

Use of any other vehicle

Yes No

First driver

 

Age

Occupation

Licence

Accidents

Convictions

Disabilities

Own vehicle

Yes No

Second driver

 

Age

Occupation

Licence

Accidents

Convictions

Disabilities

Own vehicle

Yes No

Third driver

 

Age

Occupation

Licence

Accidents

Convictions

Disabilities

Own vehicle

Yes No

Fourth driver

 

Age

Occupation

Licence

Accidents

Convictions

Disabilities

Own vehicle

Yes No

Fifth driver

 

Age

Occupation

Licence

Accidents

Convictions

Disabilities

Own vehicle

Yes No




J. Fenty Insurance Services, 29 Kirk Brae, Fraserburgh AB43 9BY

Tel: 01346 518081 - Fax: 01346 517939 e-mail: info@jfenty.co.uk