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Title:

Name:

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Date of birth:

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Email Address:

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Confirm Email:

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Telephone:

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Address:

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Locality:

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Cover start date:

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The personal information you give us may be used to communicate with you if the transaction fails or is incomplete. We may later send you information on our products. We will not share your information with any other organisation.

Summary of Cover

Motor breakdown provides 12 months cover for the vehicle detailed on the policy schedule and declared to us. If you are buying a new motor breakdown policy, there is a 24 hour exclusion period from the start date of the policy, except for Homestart which is available immediately.

Please read and ensure that you understand the policy wording and key facts documents before proceeding.

Please confirm you have read and understand the policy documents

Personal details

Policy holder

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Address

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Postcode

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Date of birth

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Email

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Vehicle details

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Cover Details

Level of cover

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Start date Edit

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Premium

£{{$.TotalPremium}}

Payment

Your credit or debit card details

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Please enter the name on your card
Please enter the card number
Please enter a valid expiry date
Please enter the 3 digit security code
Pay £{{$.TotalPremium}}

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Order summary

Here are your order details:

  • Purchased by: {{$.CustomerDetails.FirstName}} {{$.CustomerDetails.LastName}}
  • Documents emailed to: {{$.CustomerDetails.EmailAddress}}
  • Policy numbers:
    {{vehicle.RegPlate}} {{vehicle.PolicyError}} {{vehicle.PolicyNumber}}
  • Vehicles covered: {{$.Vehicles.length}}
  • Total: £{{$.Premium.toFixed(2) * $.Vehicles.length}}
What now?

You shall shortly receive a confirmation email containing your policy documents.

Need help?

If you have any questions, please do not hesitate to get in touch by calling 0333 043 1299 or click here to email us

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Vehicle details Policy number Payment status
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