I/We declare the information given in this form is correct to the best of my/our knowledge and belief. I/We undertake to advise Coverdrone EU B.V. immediately of any significant changes to the information I/We have given in this form, including any changes in the directors, partners or proprietor, or the personnel managing day to day affairs, formal termination of any agency held with any other insurer/intermediary or any relevant change in our authorisation under the regulatory body stated in section 2. I/We agree that any personal data required or held by Coverdrone EU B.V. relating to this application and any acceptance of it, including details of the director(s) and other officer(s) or the partners/proprietor and any employees, sub-agents, introducers, outsourcing providers or customers, may be disclosed to the other insurers, trade associations and regulatory bodies, for the purposes of assessing further applications for me/us, debt management and recovery and compliance with any regulatory codes/rules. I/We undertake to obtain all necessary consents for such disclosure of this data.
