Make of vehicle: Model: Engine size:
No. of doors:Date of first registration: Registration number:Value of vehicle: Current mileage:
Date of purchase:Do you own the vehicle?Is it kept in a garage?It is a right-hand drive?How long have you held a driving licence?
What type is it?Are you the main driver?If not, please give details of other drivers:Have you or any other mentioned drivers been involved
in an accident or suffered loss in connection with any
vehicle during the past five years?If ‘yes’, please give details:Was a claim made?Did the accident result in a conviction?If ‘yes’, please give details:Signature: Date:Fig. 14. Car insurance form.126 / PART TWO: ENGLISH IN ACTION