Part 2. Complete the form below. Write no more than two words or a number for each answer.

TAUBER INSURANCE Co

Example Answer

Insurance type: Vehicle

Policy: (6) _{…………………………………}

Make & Model: Masda Marvel

Engine size: (7) _{…………………………………}cc

Name: Lisa Marie Heathcote

Date of Birth: (8) _{…………………………………}1955

Password: (9) _{…………………………………}

Change valuation? Yes

No

Reduce value to: (10) $ _{…………………………………}

Notes to be added to policy:

Add new driver:

Name: Samel Michaels

Age: 28

Relationship to main driver: (11) _{…………………………………}

Reason: (12) _{…………………………………}

Client / new driver to provide:

* Verified (13) _{…………………………………}of driver licence

* Clean driving (14) _{…………………………………}

Start date:

* (15) _{…………………………………}

* Full cover when paperwork appoved

Most dreams disappear forever, (64) ________ you are one of those