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- What would you like us to do? (our Scope of Service)*
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- Are you:
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- Are you the registered owner of the vehicle?*
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- Is the policy to be issued in the name of the registered owner?
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- What date do you want cover effective from?*
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- Will there be any business use of the vehicle?*
- What kind of business use?*
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- What will this vehicle be used for?
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- Does the above figure include or exclude GST?*
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- Is there an alarm?*
- Is there an immobiliser?*
- Was this fitted by the manufacturer before the vehicle was sold in New Zealand?*
- What is the Alarm NZSA Star Rating?
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- Where is the vehicle kept at night?*
- Under finance or lease?*
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- Does the vehicle have accessories with a total value over $1,000 or has it been modified?*
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- Does the vehicle have any accessories?*
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- Do you need some cover for a hire car if your vehicle was written off, stolen or damaged?
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- Is the vehicle to be used regularly for journeys exceeding 100kms or operated for more than 10 hours per day?*
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- Will the vehicle carry any hazardous goods?*
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- Is the vehicle used, or intended to be used, air-side at any airport?*
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- Will anyone under 25 ever drive the vehicle?*
- Do you want to exclude cover for drivers under the age of 25? (this will reduce premiums, but will mean any drivers under the age of 25 will have no cover)*
- Do you want to restrict drivers of the vehicle(s) to two persons over the age of 25? (this will reduce premiums, but will mean drivers other than the main named drivers will have a higher excess)*
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- Will the addition of this vehicle trigger change in the main or regular drivers of your other vehicles insured through us?*
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- Have you read, and understood the above declaration & privacy statements?*
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- Have you read, and understood the above authorisation statements?*
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- Is there anything else you would like assistance with? (we will contact you)
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- Should be Empty: