Abbeygate Motor Cyprus

Privacy Policy

Details of Proposer & Owner







Over 25
Over 30



Yes  No



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Vehicle Details

 Yes    No
 Yes    No
 Yes    No
 Yes    No
 Yes    No
 Yes    No
 

Payment Terms

Payment Terms
 Immediate
 3 Monthly Instalments
 Credit   
 Other   
Have you any other motor insurance with American Home? If yes, please state the policy numbers
Have you a homeowners or business insurance with American Home ? If yes, please state the policy numbers
Are you now, or have you ever been insured in respect of a motor vehicle, If yes, please state the policy number and insurance company
 

Cover Required

Basic Cover
 Third Party
 Protect No Claims
 TPFT
 Comprehensive
 Comprehensive (Wide)
Insurance Period
Start Time
 
 

Details of Vehicle

Are you the registered owner of the vehicle ?
If no, please state the name of the owner.
 Yes    No
Has the vehicle been bought under a hire purchase agreement ? If yes, please state the name of the financial institution
 Yes    No
Are you the main user of the vehicle ?
If no, please state the name of the main user
 Yes    No
Is the vehicle kept at the above address when not in use ?
If no, please state the address at which its kept
 Yes    No
Is the vehicle in a good operating condition ?
If no, please explain.
 Yes    No
Has the vehicle been altered in any way from the makers standard specification ? If yes, please give details
 Yes    No
Has the vehicle been imported second hand ?
If yes, please state country of origin
 Yes    No
If the vehicle has been imported second-hand, do you intend to register it in Cyprus?
N/A
 Yes    No
 

Particulars of Other Drivers

 

Declarations

To the best of your knowledge, have you or any person who will drive the vehicle...
ever been convicted of any criminal offence in connection with any motor vehicle or violation of traffic regulations or is any prosecution pending ?
 Yes    No
I confirm all drivers are aged over 30 and under 70, have held a full UK/EU driving licence for at least 2 years, have no current convictions, and are free from claims or losses in the past 5 years
During the last 3 years been penalised with penalty points inconnection with any violation of traffic regulations?
 Yes    No
Had any damage or loss claim, wether to blame or not ?
 Yes    No
Ever suffered during the last 3 years from diabetes, epilepsy, heart problems, reduced vision or hearing, or from any other disease or incapacity of the body or mind?
 Yes    No
During the last three years been driving regularly and held the appropriate licence for the specific vehicle to be insured?
 Yes    No
To the best of your knowledge, has any insurance company or any insurer at any time in connection with motor insurance for you or any person that will drive the vehicle...
Rejected any proposal for insurance ?
 Yes    No
Refused to renew or cancelled any motor policy ?
 Yes    No
Demanded increased premium or imposed special terms ?
 Yes    No
 

Category and use of the vehicle

Private Vehicle: Is it going to be used for commercial and/or business purposes?
 Yes    No
Commercial Vehicle : Is it going to transport own goods?
 Yes    No
Commercial Vehicle : Is it going to draw a trailer?
 Yes    No
Commercial Vehicle : If its a van with a passenger type body or a double cabin, is it to be used exclusively for social domestic and pleasure purposes, not for trade or business?
 Yes    No
Commercial Vehicle : Is it going to transport general cartage?
 Yes    No
Bus : Is it for private use?
 Yes    No
Bus : Is it going to transport employees of the proposer?
 Yes    No
Special Vehicle : Is it going to used for agricultural or forestery purposes?
 Yes    No
Motorcycle : Is it for private use?
 Yes    No
Motorcycle : Is it for commercial use?
 Yes    No
Motor trade vehicle : Is it going to be used for private purposes by the named drivers?
 Yes    No
Motor trade vehicle : Are they going to be driven for trial purposes by the intending purchaser accompanied by the proposer or his employee?
 Yes    No
Motor trade vehicle : Are they going to be driven for trial purposes by the intending purchaser not accompanied by the proposer or his employee?
 Yes    No