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MILLENS SELF DRIVE HIRE HORSEBOX INSURANCE PROPOSAL LONG FORM

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  Hirer and Driver Information (one form per Driver needed). 

First Name of Hirer / Driver:

Last Name of Hirer / Driver:

Email of Hirer / Driver:

Mobile Number of Hirer / Driver:

Address of Hirer / Driver:

How long have you lived here for:

Your Occupation:

Your Nationality:

  Journey Details: 

Dates of this Hire (Not to exceed 90 days):

Reason for this Journey:

Where are you traveling to?

If hiring for more than one day, please confirm the overnight parking arrange-ments:

Overnight Parking Arrangement

  Licence information - UK licences issued by DVLA

Driving Licence No. 16 digits / capital letters

DVLA Check Code: 8 digits / case sensitive

Date Check Code Obtained:

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