Have you ever had any licence suspensions/disqualifications in the last 3 years?

Yes No 

Have you ever had any motorcycle or theft insurance claims?

Yes No 

Have you ever had any insurance refused or cancelled?

Yes No 

How many at fault motor vehicle insurance claims have you made in the last 3 years?

Suburb where the vehicle is stored at night?

Is the location of the vehicle metro or country?

Whichever you have held longest, how many consecutive years since you obtained your motor vehicle probationary/provisional licence, and/or, your motorcycle learners permit?