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Norfolk, NR1 ] Telephone: 01603 243600 Facsimile: 01603 243699 E-Mail: norwich. in) Independent 'ittlfSS s WHETHER VOI; CONSIDER YOU WERE AT FAULT OR NOT Did a Police Officer take any evidence or particulars l:\ri. akc a:id reaistralioa number What injuries were suffered and by whom Page 2 Mote: It is extremely important to obtain Names and Addresses of all \ 6 WITNESSES State Names and Addresses of ALL Witnesses. Postcode Occupation ot Driver if not Policyholder - Full time / Part Time How long has he/she been licensed to drive a motor vehicle State whether Fnl. Postcode VALUE ADDED TAX Are you registered tor VAT Business or Occupation (Full or Part Time) [f so, what percentage can you recover 2 PARTICULARS OF INSURED VEHICLE (a) Registration No. rive Police OlYicer'snutii bei Police Reference number (if known) Address of Police Station (b) Travelling in Insured's Vehicle (Give Full Number) p Did the Police advise they will he reporting you for Any offencefs) arising out of the accident Yes Q^] No j~ If Yes, give details of offence(s) Did a Police Officer witness accident If so, give his number 7 DAMAGE TO THE INSURED'S VEHICLE * Contact your Broker or this office for details of your nearest Approved Repairer for your area. - -iy [nsirancc Dalahase Services avente loa claim. uk PARTICULARS OF MOTOR ACCIDENT The Company does not admit liability by the issue of this form A it ik uri sed inn: i^ouian- by fia- f'in>:ciil Services Authority COMPLETE ALL SECHONS TO AVOID DELAY, DASHES AND N/A ARE NOT SUFFICIENT 1 INSURED Name PoiicyNo. iny payment 10 be require and by allinditi any meetings or conn hearings at their request and Wt authorise any solicitor 1IKC with thelenns and conditions otitic contrac: of insurance 1/Wc authorise the Company and it nominated h admissions of lability and of negligence as is thought fit and gin such consent as the Company considers nsurets pass information lo the Claims and Underwriiiiv. IT IS IMPORTANT TO SHOW POSITIONS AND DETAILS OP ALL ROAD SIGNS BEFORE IMPACT Tn ade under lite emulier of insurance Signature of INSURED and Driver (if n AFTER IMPACT -siijun: emulili io ;'. British Mini Club - BMC Insurance ServicesTry them today at : http://www.quotelinedirect.co.uk/car?INKK Graham Sykes Insurance Specialist -Limited mileage discounts, modified vehicles welcome,.Car Insurance Application ? MotorQuoteDirect - Car Insurance BlogMotorQuoteDirect are one of the UK's leading insurance intermediaries based in Wimbledon. If you change your vehicle; If you exceed your limited mileage.HomeApproved Limited Mileage Car InsuranceHomeApproved Limited Mileage Car Insurance. Obtain a low rate premium quote, and buy your policy online.Classic and Vintage Car Insurance - GB Classic CarsPolicy benefits include up to 65% introductory discount, limited mileage. You should notify your car insurance company as soon as you can after the damage has occured.. GB Classic Cars.co.uk 2002 - 2009. Disclaimer & Terms of Use.Limited Mileage Car Insurance (UK)No-one likes paying more for their car insurance than they absolutely have to - and by opting for limited mileage car insurance, you could manage to make.

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