This form must be completed by each person required to drive the Horsebox

Preparation before completing this form

DVLA Check Code

A Check Code is required (under the section Driving History & Licence Information) to check licence details with the DVLA. It is recommended this code be obtained prior to completing this form. 

Hirer Details

Journey Details

DVLA Check

The DVLA only record motoring convictions electronically, we need a Check Code from the DVLA to check your licence details. To obtain the Check Code, please phone the DVLA on 0300 083 0013, or log in to the DVLA’s Service on www.gov.uk/view-driving-licence (you’ll need your National Insurance No.)

Please note: The DVLA Code is not required if an existing code is still valid.

Declaration & Signature

I declare that :-

  • I confirm that there has been no change in my personal circumstances nor driving record since I completed my last hirer questionnaire and I can still agree the declaration in my last hirer questionnaire

  • I have read the above questions and answers that have been completed accurately and fully by me or on my behalf from the information that I have supplied

  • The statements and particulars given above are to the best of my knowledge and belief true and that no information has been withheld that may influence my acceptance as a driver

  • I am not suffering from any loss or loss of use of limb, eye, defective (not corrected) hearing or vision, any heart, diabetic, epileptic condition nor any other infirmity that should be disclosed to the DVLA/DVA or other licencing authority

  • I have not been convicted of any motoring or non-motoring offences other than those stated in my previous application

  • I have held a full driving licence for at least two years

I agree that the information supplied in this and my previous application:-

  • may be used to check my identity and my suitability to drive

  • may be shared with others to facilitate the arranging of insurance on my behalf and for the purposes and processing insurance claims

  • may be shared with fraud prevention agencies and databases

I further agree to be bound by the terms and conditions of the insurance which I have seen and read or have had the opportunity to  see and read. I understand that subject to the provisions of the Data Protection Act 1998, I am entitled, on the payment of a small fee, to receive a copy of the information held about me.

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