0776 254 3784

01244 336003

info@mustangequinetransport.co.uk

Providing Quality Equine Logistics Throughout The UK

Self Drive Horsebox Hire Application Form

1 Step 1

This form must be completed by each person required to drive the Horsebox

Preparation before completing this form


Identification

There are requirements (under the section Identification) to upload evidence of identity. It is recommended these be prepared prior to completing this form. A summary of the evidence required is as follows..

  • Screenshot/Scan of your Driving Licence front and back
  • Screenshot/Scan of 2 x recent (Within 90 days of today's date) Proof Of Address
  • Screenshot/Scan of additional Photo ID such as your Passport

DVLA Check Code

A Check Code is required (under the section Driving History & Licence Information) to check licence details with the DVLA. It is recommended this code be obtained prior to completing this form. 

Hirer Details

How long have you lived at this address?

Journey Details

Driving History & Licence Information

The DVLA only record motoring convictions electronically, we need a Check Code from the DVLA to check your licence details. To obtain the Check Code, please phone the DVLA on 0300 083 0013, or log in to the DVLA’s Service on www.gov.uk/view-driving-licence (you’ll need your National Insurance No.)

Motoring Convictions in the last 5 years

Please tick one box

If you have more than 2 offences please tell us using the 'Tell us More' box

Motor Vehicle Accident or Motor Vehicle Fire and Theft claims in last three years

Please tick one box
Claim 1 - FaultSelect One
Claim 1 - Did your insurers recover ALL claim costs from the TP?
Claim 2 - FaultSelect One
Claim 2 - Did your insurers recover ALL claim costs from the TP?

If you have more than 2 claims please tell us using the 'Tell us More' box

Medical Conditions

Please tick a box
Declared to the DVLA?

Other Questions

Do you hold a valid licence for the weight of vehicle being hired?
Have you ever had insurance refused or declined?
Have you ever had insurance cover cancelled?
Has an insurer ever applied special terms to your motor insurance as a result of claims?
Have you any non-motoring convictions?

Identification

We Require...

  • Copy of your driving licence Front and Back​
  • 2 x Recent (Within 90 days of today's date) Proof Of Address
  • 1 x Additional Photo ID such as your Passport
Please upload using this form. We will retain copies of your documents for 12 months, failure to supply evidence of identification, will result in you not being able to complete the hire.
Driving Licence TypePlease indicate what style of driving licence you have been issued with.
Are you providing your Passport as additional Photo Identification?

Declaration & Signature

I declare that :-

  • I have read the above questions and answers that have been completed accurately and fully by me or on my behalf from the information that I have supplied
  • The statements and particulars given above are to the best of my knowledge and belief true and that no information has been withheld that may influence my acceptance as a driver
  • I am not suffering from any loss or loss of use of limb, eye, defective (not corrected) hearing or vision, any heart, diabetic, epileptic condition nor any other infirmity that should be disclosed to the DVLA/DVA or other licencing authority
  • I have not been convicted of any motoring or non-motoring offences other than those stated above
  • I have held a full driving licence for at least two years

I agree that the information supplied :-

  • may be used to check my identity and my suitability to drive
  • may be shared with others to facilitate the arranging of insurance on my behalf and for the purposes and processing insurance claims
  • may be shared with fraud prevention agencies and databases

I further agree to be bound by the terms and conditions of the insurance which I have seen and read or have had the opportunity to  see and read. I understand that subject to the provisions of the Data Protection Act 1998, I am entitled, on the payment of a small fee, to receive a copy of the information held about me.


SignatureI agree to the terms and conditions
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