Demands & Needs Statement (FSA)



Please complete all fields and click Submit



First name
Surname
Vehicle
Registration
Address
Phone Number (Including area code)
email address
   
How long do you intend to keep the vehicle?
Is the type / use / eligibility of the vehicle specifically excluded from cover
Would you like to protect yourself against the cost and inconvenience of mechanical breakdown beyond the stated term or mileage of any inclusive Guarantee / Warranty
Would you like the cost of replacing / repairing your tyres if they sustained accidental or malicious damage?
   
How will your vehicle be insured
If your vehicle became an insurance total loss, would you like the difference between the insurance settlement and outstanding balance / original invoice price paid to you?
   
Date of Birth (DD.MM.YYYY)
Employment Status:
If you were unable to work due to disability, accident, sickness or critical illness would you like your repayments made for you?
If you became unemployed, would you like your repayments made for you?
If you were to die during the term of your loan, would you like the outstanding balance paid for you?
I agree that this information is accurate and that by submitting it. I give Fowlers of Bristol Limited the right to hold the information as evidence that they have identified and met my demands and needs as prescribed by the FSA. I Agree
Tick this box if you are aged 18 years or over. Yes, I am
   
Print this document (before submitting) for your records?  
 
   

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Keyfacts about our insurance services.

If you need to contact a member of our Sales Team please give them a ring

 

Tel: 0117 977 0466
Out of Hours: 0797 325 2435
Fax: 0117 972 5528

For Spares Dept click here
For Servicing Dept click here
Phone 0117 9770466. 2-12 Bath Road, Bristol. BS43DR