Brentacre Online Quote

About You

Title:
First Name:
Surname:
Where did you hear about us?:
Date of Birth:

(Minimum age 19)

Years Resident in the UK:
Marital Status:
Date Full Licence Obtained:

Please note only a full UK and ECC driving licence are acceptable for quotations

House Name or Number:
Postcode:

Address:
Contact Telephone Number:
Email Address:
Car Club Membership:
Main Occupation:
Business Type:
Employed/Self Employed:
Secondary Occupation
Business Type
Employed/Self Employed
Any medical conditions the DVLA are or should be made aware of?
(please include any restrictions)
Any Claims or Losses in the last 5 years?
(please include dates, amounts and whether settled fault/non-fault)
Any Driving Licence Endorsements in the last 5 years
(Include expired points, dates, codes, points and fine amount. If ANY drinking charge, include alcohol reading and test type)
Special Terms
(Ever had insurance cancelled or declined, or any non-motoring criminal convictions)
Continue to Vehicle Details >>

Your Vehicle

Vehicle Registration:
Vehicle Make:
Vehicle Model:
Subtype (GTI, CL, T30 etc):
Body Type (hatchback, van etc):
Year of Registration:
Engine Capacity and Unit:
Seats:
Doors:
Purchase Date:
Approximate Value:
Current Mileage:
Where do you keep it overnight?
Modifications:
Current BHP if known:
Security Device(s):
Who owns the vehicle?
Continue to Cover >>

Cover Required

Is this your main vehicle?
Cover Required:
Required Use:
Personal Annual Mileage:
Business Annual Mileage:
Years No Claims Discount:
Protected? (>4 yrs only):

If you have fewer than 5 years no claims, do you have any discount applied to another or main vehicle?
NCB Elsewhere:
Vehicle make and model:

With performance vehicles and rear wheel drive cars, we do ask for relevant ownership and experience when calculating your quote. If this car is RWD or performance, please list any experience and ownership below you feel is relevant. If adding named drivers, please include their experience also.
Relevant Experience:
Continue to Other Drivers >>

Drivers

Please list any other drivers you would like on the policy. All drivers must have a full valid UK licence and held it for at least 12 months. We can insure a maximum of 5 drivers on a single policy.

Main Driver: You - You

Additional Driver 1:
Title:
First Name:
Surname:
Date of Birth:

(Minimum age 19)

Years Resident in the UK:

Date Full Licence Obtained:

Please note only a full UK and ECC driving licence are acceptable for quotations

Marital Status:
Relationship to Proposer:
Main Occupation:
Business Type:
Employed/Self Employed:
Any medical conditions the DVLA are or should be made aware of?
(please include any restrictions)
Any Claims or Losses for the last 5 years?
(please include dates, amounts and whether settled fault/non-fault)
Driving Licence Endorsements:
(Please include dates, codes, points and fine amount.)

Additional Driver 2:
Title:
First Name:
Surname:
Date of Birth:

(Minimum age 19)

Years Resident in the UK:

Date Full Licence Obtained:

Please note only a full UK and ECC driving licence are acceptable for quotations

Additional Driver 3:
Title:
First Name:
Surname:
Date of Birth:

(Minimum age 19)

Years Resident in the UK:

Date Full Licence Obtained:

Please note only a full UK and ECC driving licence are acceptable for quotations

Additional Driver 4:
Title:
First Name:
Surname:
Date of Birth:

(Minimum age 19)

Years Resident in the UK:

Date Full Licence Obtained:

Please note only a full UK and ECC driving licence are acceptable for quotations

Add Another Driver

Continue to Declaration >>

Declaration

All information provided is accurate and true to my knowledge.

The quote we return will be based on the information you have given us and may change if the information provided is inaccurate, untrue or altered after the quote is given.

You confirm that your vehicle is currently not impounded or in Police custody.

We do not exchange your information with third parties except when necessary with relevant insurance companies, brokers and CUE in regards only to fraud prevention.

To help us find the most competitive quote for you, please let us know the best quote or your renewal price.
What is your best quote so far?
With which insurer?

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Minimum Criteria

Age 19-75 (under 21′s must have 2 years NCB+)

License held for minimum of 12 months

UK Residency 3 years minimum

Brentacre Insurance

Cambrian House
Cambrian Place
Swansea
SA1 1RH

Tel: 01792 650 933

Please note, all calls are recorded for training and monitoring purposes and for the prevention of fraud

Opening Times
Monday	9am – 5:30pm
Tuesday	9am – 5:30pm
Wednesday	9am – 5:30pm
Thursday	9am – 5:30pm
Friday	9am – 5:30pm
Saturday	9am – 12pm
Sunday	Closed

Brentacre Online Quote

About You

Your Vehicle

Cover Required

Drivers

Declaration

Minimum Criteria

Brentacre Insurance

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