EQUINE TRANSPORT UK
Self Drive or Driven
First Name of Hirer / Driver:
Koos
Last Name of Hirer / Driver:
Verhagen
Email:
Equine Transport UK
​
Upper Broadreed Farm, Stonehurst Lane, Five Ashes, TN206LL, East Sussex, UK,
MILLENS SELF DRIVE HIRE HORSEBOX INSURANCE PROPOSAL SHORT FORM
I hereby confirm that there have been no change in my personal circumstances nor driving record since I completed my last hire questionnaire and I can still agree the declaration in my long questionnaire.
Driving Licence Number:
VERHA601047JJ9VL
Mobile Number:
07584578654
Date of the Last Long Form:
20 December 2024
Date of this Hire (must be within 3 months of Last Long Form):
19 December 2024
The DVLA only record motoring convictions electronically. We need a Check Code from the DVLA to check your license details. To obtain the Check Code, please ring DVLA on 0300 083 0013, or log in to the DVLA's Service on https://www.gov.uk/view-driving-licence (you will need your Driving License Number, your National Insurance Number and your Post Code)
DVLA Access Code:
Tyuffyhg
Your Signature:
Date of Your Last DVLA Access Code:
20 December 2024
Today's Date:
20 December 2024