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Premium. Date: Signature: 31) Has any company, in respect of the risk to which this Proposal relates, ever: Declined a proposal, refused renewal or terminated insurance? Yes No Required an increased premium or imposed special conditions? Yes No If 'Yes" in either case, please give details: 32) Details of other vehicles owned by You: 1) Make Model Reg.No: Insured with Cover expiry date 2) Make Model Reg.No: Insur.

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