Motorcycle Insurance

Title

Name

Email Address

Telephone number

Date of Birth

How long have you been resident in UK

Gender

Marital Status

1st line of address

Postcode

Are you a homeowner?

Type of Dwelling

Are you currently in employment?

Occupation

Type of business

Any additional job (if so please give details)

Have you had any insurance declined/refused or additional terms imposed?

When do you wish cover to commence?

Expiry date of current policy (if applicable)

Has the rider been UK resident for 3 years or more?

Use required

Cover required

Type of licence

Licence date

Do you hold a current, valid CBT

How many other bikes do you ride?

Riding qualifications

Are you a member of any biking organisation

If Yes please provide details

NCD to transfer onto this policy

How many other bikes do you own?

Do you have any NCD on other bikes?

Do you have any medical conditions?

Have you made any claims in the last 5 years?

If Yes please provide details

Have you had any driving convictions in the last 5 years?

If Yes please provide details

Do you have any criminal convictions?

Have you been disqualified?

Make of bike

Model

Year

Engine size

Value

Registration

Are you the owner and registered keeper of the bike?

When did you purchase the bike?--

Does the bike have any modifications?

If Yes please detail

Where is the bike stored when not in use

Current Mileage

Expected annual mileage

Other vehcles owned?

Other vehicles driven?

NCD on other vehicles?