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Published Wednesday 8 February 2023
9AM - 4PM MONDAY - FRIDAY ***
Politically Exposed Person: Someone with a prominent position in life which gives them the power to make or influence major decisions. For example a Politician (i.e. MHK) or a chief executive of a large organisation (i.e. chief executive of a large bank).
You must be 21 or over
Required as you answered yes to "Have you ever had insurance refused?"
Required as you answered yes to "Any criminal convictions?"
Required as you answered yes to "Any medical conditions?"
If you provide a contact email address we will email you confirmation when you submit this form
Required as you answered yes to "Any Vehicle modifications?"
If yes, please fill in the details below.
If yes, please fill give the cost below.
You can provide details of the circumstances.
Full details of the reading, ie. Blood, Urine.
Note: NCB can only be used on one vehicle at a time and must be less than 24 months old.
You must confirm that you have understood and agree to the information supplied on this form.
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