Paragraph A Particulars of person signing statement of liability*

1. 1.

   Full Name.

2. 2.

   Date of birth.

3. 3.

   Permanent Address.

4. 4.

   Address at time of hiring (if different from 3 above and stay is likely to be more than two months from date of hiring).

5. 5.

   Details of driving licence:

   1. (a)

      country where issued (if not UK),

   2. (b)

      serial number or driver’s number,

   3. (c)

      date of expiry (which should be no later than date specified in B7 below).

* Where the statement of liability is in Part II of form H, the full name and address of the person by or on whose behalf the statement of liability was signed should be supplied together with the date on which it was signed. If the person taking possession of the vehicle is not the same as the person by or on whose behalf the statement was signed, the full name of that person should also be supplied (if known).