It is an offence under the Road Traffic Act to make a false statement or withhold any material or information for the purposes of obtaining a Certificate of Motor Insurance. By completing this form you hereby consent to our partner brokers using the personal information provided by you to conduct appropriate anti-fraud and DVLA checks. You also consent to this information being shared with other outside agencies in the course of investigating any claim or confirming that the information given is true and correct. Insurance underwriters reserve the right to decline any proposal submitted.