€
                            
                                
                            
                            
                         
                        
                        
                         
                        
                        
                        
                        
                        
                        
                        
                            
                                
                            
                            
                                
                                
                            
                         
                        
                            
  Kilometers per year
  
  
  
                         
                        
                            
  In what year did you obtain your driving licence?
  
  
  
                         
                         
                        
                            
  For how many years have you been insured?
  
  
  
  
                         
                        
                            
                                
                            
                         
                        
                            
  Number of self-inflicted accidents in the last 5 years
  
  
  
                         
                        
                            
  The year in which the accident was your fault
  
  
  
                         
                        
                            
  Number of accidents in which you were involved in the last 5 years that were not your fault