Additional drivers details

Additional drivers

Driver name	Date of birth
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Additional drivers details

What is their relationship to you?

Usage

Will the named driver need commuting use?

Yes No

How often will the named driver use the vehicle?

Casual use Frequent use

Additional Driver

Title

Mr Mrs Miss More... Ms Mx Dr

First name

Surname

Date of birth

How long has he/she lived in the UK?

Since birth or Since

What is his/her relationship status

Single Married Married - Common Law More... Partnered - Civil Divorced Widowed

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Their driving licence

What type of licence does he/she have?

Full UK Car Licence Provisional (UK) Car Licence Full EU Licence Full International Licence Full European (Non-EU) Medical Restricted (Full) 3 Years Or More - Car Other

How long has he/she held this licence (years)?

How long has he/she held this licence (months)?

Has he/she had any driving related convictions, endorsements, penalties, disqualifications or bans in the past 5 years?

Yes No

Does he/she has any medical conditions notifiable to the DVLA?

Yes No

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Other Information

Has he/she had any accidents, thefts or losses within the last 5 years regardless of fault/non fault or whether this resulted in a claim?

Yes No

Has he/she ever had insurance declined?

Yes No

Has he/she ever had any special terms imposed on a previous insurance policy?

Yes No

Has he/she ever had insurance cancelled?

Yes No

Does he/she have any unspent non-motoring criminal convictions?

Yes No

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About their employment

What is his/her employment status?

Employed In Full Or Part Time Education Self Employed Household Duties Retired Unemployed Not Employed Due To Disability Voluntary Work Independent Means

What is their main occupation?

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What industry is this occupation in?

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Does he/she have a part-time/additional job?

Yes No

What is his/her part-time/Additional Job Status?

Employed In Full Or Part Time Education Self Employed Household Duties Retired Unemployed Not Employed Due To Disability Voluntary Work Independent Means

What is his/her part-time/Additional Job Role?

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What is his/her part-time/Additional Job Employer's Business?

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