Client Acceptance Form

Client Instructions Form

Client

Premium

From when is cover required (This is subject to to us contacting Insurers)

Please confirm that you have read, understood, and agree to the following:

The information detailed in the Statement of Fact attached to my/our quotation is correct, and I/we request that this insurance be arranged from the selected date.

I/we have read and accept the Policy Terms and Clauses.

I/we agree

Please select how you wish to make payment

Payment by Bank transfer (preferred method)

Payment by cheque

Payment by Credit/Debit card

10 monthly instalments (min £1,000) - 7.2% (18.71% APR) subject to status

A member of our team will contact you to arrange payment by card. This ensures your details remain secure, as we do not retain any payment records ourselves.

Our Invoice will follow with details of who and where to send payment - payment must be received within 7 days of receipt of thsi from us.

Our Invoice will follow with reference and Bank details for payment purposes - payment must be received within 7 days of receipt of this from us.

A member of our team will contact you to arrange payment by installments over 10 monthly payments.

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