Motor Insurance Fact Find

Would you like to add an additional driver?

YesNo

Additional Driver Details

Full name:

Date of birth:

Occupation:

What industry does this driver work in?

What relation is this driver to you?

Employment status:

EmployedSelf-employed

Resident of the Isle of Man or UK since birth?*

YesNo

If no, date since:

Full Isle of Man/UK driving licence held?*

YesNo

If Yes, how long?

If No, licence type and duration:

Access to another vehicle?

YesNo

If Yes, type of vehicle:

Estimated annual mileage

Intended use of the vehicle:

Social, domestic & pleasureSocial, domestic, pleasure & commutingBusiness use

Is the driver a homeowner?

YesNo

Any claims or convictions in the last 5 years?

YesNo

If Yes, please provide the date, type of claim or conviction and the claim amount or conviction code and penalty:

Any disabilities notifiable to the Isle of Man Licensing Authority or DVLA?

YesNo

Would you like to add another driver?

YesNo

Additional Driver 2

Full name:

Date of birth:

Occupation:

What industry does this driver work in?

What relation is this driver to you?

Employment status:

EmployedSelf-employed

Resident of the Isle of Man or UK since birth?*

YesNo

If no, date since:

Full Isle of Man/UK driving licence held?*

YesNo

If Yes, how long?

If No, licence type and duration:

Access to another vehicle?

YesNo

If Yes, type of vehicle:

Estimated annual mileage

Intended use of the vehicle:

Social, domestic & pleasureSocial, domestic, pleasure & commutingBusiness use

Is the driver a homeowner?

YesNo

Any claims or convictions in the last 5 years?

YesNo

If Yes, please provide the date, type of claim or conviction and the claim amount or conviction code and penalty:

Any disabilities notifiable to the Isle of Man Licensing Authority or DVLA?

YesNo

Would you like to add another driver?

YesNo

Additional Driver 3

Full name:

Date of birth:

Occupation:

What industry does this driver work in?

What relation is this driver to you?

Employment status:

EmployedSelf-employed

Resident of the Isle of Man or UK since birth?*

YesNo

If no, date since:

Full Isle of Man/UK driving licence held?*

YesNo

If Yes, how long?

If No, licence type and duration:

Access to another vehicle?

YesNo

If Yes, type of vehicle:

Estimated annual mileage

Intended use of the vehicle:

Social, domestic & pleasureSocial, domestic, pleasure & commutingBusiness use

Is the driver a homeowner?

YesNo

Any claims or convictions in the last 5 years?

YesNo

If Yes, please provide the date, type of claim or conviction and the claim amount or conviction code and penalty:

Any disabilities notifiable to the Isle of Man Licensing Authority or DVLA?

YesNo

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