Tractor Quote - Cherished Car Insurance

Are you an existing client *

Title *

First Name(s) *

Surname *

Address *

Post Code *

Telephone Number *

Email *

Date of Birth *

Occupation *

Date passed UK driving test *

Alternatively, please advise how old you were when you passed your test

Tractor Make *

Tractor Model *

Year of Make *

Current Value *

Registration

Would you like to include any additional tractors in this quote?

2nd Tractor Make *

2nd Tractor Model *

2nd Tractor Year of Make *

2nd Tractor Current Value *

2nd Tractor Registration

Would you like to include a 3rd tractor to this quote?

3rd Tractor Make *

3rd Tractor Model *

3rd Tractor Year of Make *

3rd Tractor Current Value *

3rd Tractor Registration

Would like to include any additional tractors with this quote? *

Please advise YEAR, MAKE, MODEL and VALUE for any additional tractors *

Has your tractor(s) been modified? *

Please describe any modifications *

Level of Cover *

Comprehensive Cover
Third Party Fire and Theft Cover
Third Party Only

Will the tractor(s) be taken to shows, road runs or ploughing matches? *

What will the tractor be used for? *

Will the tractor(s) be used for your own private agricultural use? *

Please describe what work the tractor might do *

This is a key question to ensure we quote your tractor under the correct policy. If the tractor is used in connection with making hay, collecting fire wood, looking after livestock or similar, we would ask if this for your own use only or if you pass or sell any of this to others or at market. It would also be useful to know how many livestock you have if applicable.

Do you earn any money or receive any payment in connection with the work the tractor does? *

If the tractor is being used for agricultural purposes, please advise if the tractor is worked on your own land? *

How many acres do you own? *

How many acres is the tractor used on? *

Do you use the tractor for agricultural purposes on anybody else's land? *

Will there be any drivers under the age of 21? *

Full Name *

For any driver under 21

Date of Birth *

Occupation *

Type of licence held *

What licence do they hold? *

Do you need to include any additional drivers under the age of 21? *

Full name *

Date of Birth *

Occupation *

Type of licence held? *

What licence to they hold? *

Do you need to include any additional drivers under the age of 21 *

Please provide full details for any additional drivers under 21 *

Who will be driving the tractor(s) *

2nd Drivers Full Name *

Please advise details for the 2nd driver. We do not need policyholder details again

Date of Birth *

Occupation *

Date passed UK driving test *

Alternatively, age they passed driving test

Would you like to include any additional drivers *

3rd Drivers Full Name *

Date of Birth *

Occupation *

Date passed UK driving test *

Alternatively, age they passed driving test

Would you like to include any additional drivers *

Please provide NAME, DATE OF BIRTH, OCCUPATION and DATE PASSED DRIVING TEST for any additional drivers *

Do all drivers have another vehicle for everyday use? *

Have all drivers been a UK resident since birth *

Have you or any driver incurred any convictions in the last 5 years? *

Drivers Name *

Conviction Date *

Offence *

Conviction Code *

Did the conviction result in a fine? *

Fine *

Did the conviction result in any points on driving licence? *

How many points were received? *

Did the conviction result in a driving ban? *

Period of ban *

If no ban, please enter 0

Are there any other convictions to declare? *

Please advise full details of any further convictions *

Have you or any driver been involved in any claims or accidents in the last 3 years? (including fire, theft and non fault claims) *

We do not need to be advised of any windscreen claims or speed awareness courses

Driver Name *

Date *

Description of claim *

Claim cost *

Were there any injuries? *

Are there any further claims or accidents to declare? *

Please give full details of any further claims or accidents *

Do you or any driver suffer with any medical conditions? *

Please advise of the drivers name, medical condition and date of onset *

Have you had to notify the DVLA of any of these medical conditions? *

Are there any restrictions on your licence *

If you have any specific questions or you are unsure of any of the answers given, please advise below