I understand that where the insurance requires supply of information relating to other persons who may be insured under the contract, that the information must be factual and accurate to enable correct assessment of risk by the insurer. I confirm that I have the consent of these individuals to supply their personal details to the insurer.
For the purposes of the Data Protection Act 1998 the data controller in relation to any personal data you supply is Cox Braithwaite Insurance Brokers.
I/we understand that the information I/we supply may be used by Cox Braithwaite Insurance Brokers to keep me informed by post, telephone, e-mail or other means about products and services which may be of interest to me. Please note that your information may also be used for these purposes after your policy has lapsed. If you do not wish your information to be used for marketing purposes, please tick this box
Your quotation will be based on the information you have provided above and this information will form the basis of your policy if you decide to buy, please check the information you have entered.