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Classic Car Insurance

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Classic Car Insurance

By admin / June 25, 2020

Please fill in the form below and one of our team will be in touch with a quote.

Name *

First

Middle

Last

Date of Birth *

Address *

Phone / Mobile *

Email *

Occupation *

Licence Type *

Full Irish Driving Licence
Irish Learning Permit (Provisional Licence)
UK / International Licence

Any convictions on this licence either previous or currently serving?

No
Yes

Please contact us on 057-8688888

Make of Car *

Model of Car *

Value of Car (€) *

Engine Size (cc) *

Year of Manufacture *

Registration *

Has this been modified outside the manufacturer requirements? *

No
Yes

Please contact us on 057-8688888

Are you a New or Previous/Current Customer to Classic Car Insurance? *

New Customers of Classic Car Insurance

Do you hold a current insurance policy on a conventional car earning a No Claims Bonus? *

No
Yes

Conventional Car

Make *

Model *

Engine Size (cc) *

Registration *

Number of years earning a No Claims Bonus *

Underwriting Insuring Company (Not Broker): *

Policy Number *

Expiry Date of this Policy *

Have you had any accidents or claims in the last 5 years? *

No
Yes

Please contact us on 057-8688888

If no but you have a company car, please state the number of years you have had the company car? *

Previous Customers of Classic Car Insurance

Who is your current underwriting insurer (not broker)? *

When is the expiry date of this policy? *

Add Named Drivers to your policy? *

For additional named drivers please supply the following details for each driver.

Name (Driver 1) *

First

Middle

Last

Date of Birth (Driver 1) *

Occupation (Driver 1) *

Licence Type (Driver 1) *

Full Irish Driving Licence
Irish Learning Permit (Provisional Licence)
UK / International Licence

Any convictions on this licence either previous or currently serving? (Driver 1)

No
Yes

Name (Driver 2) *

First

Middle

Last

Date of Birth (Driver 2) *

Occupation (Driver 2) *

Any convictions on this licence either previous or currently serving? (Driver 2)

No
Yes

Name (Driver 3) *

First

Middle

Last

Date of Birth (Driver 3) *

Occupation (Driver 3) *

Any convictions on this licence either previous or currently serving? (Driver 3)

No
Yes

Please contact us on 057-8688888

Any previous accidents?

If yes, please give details.

Would you like an open driving quote? *

No
Yes

What mileage per annum will you be doing on this car? *

How did you hear about us? *

Name

To find out how we can help with your specific insurance needs, contact us on 057-8688888 or email us at info@sparrowins.ie and well get back to you.

eMail: info@sparrowins.ie

Portlaoise Office

Sparrow Insurances Limited,
5 Wesley Terrace,
Portlaoise,
Co. Laois
R32 XK51

Telephone: 057 8688888
Fax: 057 8672936

Thurles Office

Sparrow Insurances,
Friar Street,
Thurles,
Co. Tipperary
E41 P6F7

Telephone: 0504 20000
Fax: 0504 58516

Nenagh Office

Sparrow Insurances Limited,
Glebe House,
Kenyon Street,
Nenagh,
Co. Tipperary
E45 D578

Telephone: 067 31276
Fax: 067 33930

Dublin Office

Sparrow Insurances Limited,
3 Main Street,
Blanchardstown,
Dublin 15
D15 YX29

Telephone: 01 8213071

Contact Us

Name *

Phone

Email *

Renewal Date

Comment or Message *

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