Motorcycle Fire & Theft Insurance

Name

Telephone

Age

Have you had any claims or incidents in the last 3 years

Do you have any driving convictions?

Is/are the bike(s) kept in a locked garage or similar secure building? (photos may be required)

First line of home address

Home postcode

First line of address of storage address (if different from home address)

Postcode (where stored) if different from home address

Bike 1 Make

Bike 1 Model

Bike 1 Stroke/Electric

Bike 1 Engine Size (CC)

Bike 1 Value

Bike 1 Registration / Frame Number

Bike 1 Security Device

Bike 1 Purchase Date

Bike 2 Make

Bike 2 Model

Bike 2 Stroke/Electric

Bike 2 Engine Size (CC)

Bike 2 Value

Bike 2 Registration / Frame Number

Bike 2 Security Device

Bike 2 Purchase Date

Bike 3 Make

Bike 3 Model

Bike 3 Stroke/Electric

Bike 3 Engine Size (CC)

Bike 3 Value

Bike 3 Registration / Frame Number

Bike 3 Security Device

Bike 3 Purchase Date

Bike 4 Make

Bike 4 Model

Bike 4 Stroke/Electric

Bike 4 Engine Size (CC)

Bike 4 Value

Bike 4 Registration / Frame Number

Bike 4 Security Device

Bike 4 Purchase Date

Bike 5 Make

Bike 5 Model

Bike 5 Stroke/Electric

Bike 5 Engine Size (CC)

Bike 5 Value

Bike 5 Registration / Frame Number

Bike 5 Security Device

Bike 5 Purchase Date

Bike 5 Stroke/Electric