Online Motor Insurance Quote Form

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ONLINE MOTOR INSURANCE QUOTE
Please fill in the following form below. Please note that fields marked with * are required.
Forces Solutions was set up to provide unique cover for members of HM Forces (and associated civilians) and aims to provide you with a low cost motor insurance policy but with all the benefits you need and yet, so rarely offered by any of our competitors.
All our insurers are ‘Forces friendly’ and we are able to provide cover throughout the UK and for personnel based in British Forces Germany and at SHAPE. We (and all of our insurers) are authorised and regulated by the Financial Conduct Authority.
To enable us to provide you with a quotation please ensure you answer all the questions on the following form honestly and as accurately as possible. If you don’t, any claim you make may be rejected.
When completing the form please remember to include your contact phone number as it may be necessary for one of our specialist insurance advisers to contact you to clarify any specific issue that may arise.
If you are unsure about any aspect of the form please contact us on +44 (0) 116 473 5 473
Proposer Details
Prefix*
First Name*
Surname*
ADDRESS
Address Line 1/Military Unit*
Address Line 2/Barracks*
Address Line 3/Location*
BFPO*
Country*
Date of Birth*
Date Format: DD dash MM dash YYYY
Email Address*
Mobile Phone*
Home Phone
Branch of Services*
Rank*
Service Number*
Where did you hear about Forces Solutions?*
Number of years full UK licence held?*
Driving Licence Number
Which country was the licence issued?*
If Full Licence Held outside UK Please Indicate Number of Years
Main Driver Trade*
Do you hold a CAT C+E (HGV)?*
Have you had any Accidents/Claims regardless of Blame (Within 5 years)?
If Yes Please provide details
Have you had any motoring Convictions or Endorsements including any pending Prosecutions (Within 5 Years)?*
If Yes Please provide details
Any Disabilities, where DVLA need to be notified?*
If Yes, Please provide details
Marital Status*

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Additional Driver Details
Would you like to add an Additional Driver?*
Name of Additional Driver:
Additional Driver's Date of Birth
Date Format: DD dash MM dash YYYY
Additional Driver Marital Status
Relationship to Proposer
Additional Driver's Occupation
Number of years Additional Driver's Full Licence Held
Driving Licence Number for Additional Driver
Which Country was the Licence Issued for Additional Driver?
If Full Licence Held outside UK Please Indicate Number of Years for Additional Driver
Have you had any Accidents/Claims regardless of Blame (within 5 Years) for Additional Driver?
If Yes Please provide details
Any motoring Convictions or Endorsements including any pending Prosecutions (Within 5 Years) for Additional Driver?
If Yes Please provide details
Any Disabilities for Additional Driver, where DVLA need to be notified?
If Yes Please provide details

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Vehicle Details
Make of Car (e.g. Ford)*
Model of Car (e.g. Focus Zetec)*
Engine Size (i.e. c.c.)*
Year of first Registration / Year of Make*
Date Format: DD dash MM dash YYYY
Registration Number (If Known)
Body type (e.g. Hatchback/Saloon)*
Fuel Type*
Number of Doors*
BHP/PS (Break Horse Power) If Known
Is the Car a Right/Left Hand Drive?*
Value (tax paid value, if tax free)*
Vehicle Transmission*
Annual Mileage*
Security (If factory Fitted put Standard)
Where is car kept at night? (if kept on base behind the wire, please use Locked Compound)*
Purchase Date*
Date Format: DD dash MM dash YYYY
Does the vehicle have a tracking device fitted?*
Has the vehicle had any modifications other than manufacturers optional extras?*
If Yes Please provide details

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Cover Details
Cover required (Comprehensive/ Third Party Fire & Theft)*
Start Date of Policy*
Date Format: DD dash MM dash YYYY
Number of Years No Claims Bonus Available to apply to this policy*
Would you like to Protect your No Claims Bonus?*
Have you had any quotes for this Vehicle?*
If you have had a quote can you please advise the Company & Premium quoted?
Any Additional Information
Due to the new General Data Protection Regulation we are required to get your consent that you are happy for us to hold your personal data on our system. This data will be shared with other organisations who we work with in providing your motor insurance policy.
Are you happy for us to hold this information?*

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Summary of Completed Form
Please check all details are correct before submiting
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Name
This field is for validation purposes and should be left unchanged.

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Step 1 of 5

ONLINE MOTOR INSURANCE QUOTE

Proposer Details

ADDRESS

Additional Driver Details

Vehicle Details

Cover Details

Summary of Completed Form

Please check all details are correct before submiting