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Name:
*
Address:
*
Tel:
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Email:
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Risk Address (inc postcode):
*
Tenancy Details:
» Professional Let
» Student Let
» DSS (Individual, Couple or Family)
» Unoccupied - Please give details
» Asylum Seekers
» Commercial - Please specify details
» Holiday home
If unoccupied and undergoing renovation, Fire, Lightening, Aircraft and Explosion only cover will apply. (please give further details of unoccupancy and renovation works):
More details
Buildings Sum Insured:
Contents Sum Insured:
Loss of Rent:
Current Insurer:
*
Date cover is required from:
*
Will the property be single tenure:
» Yes
» No
*
Is the property of standard construction:
» Yes
» No
Please give an example of “Brick and Tile”
*
Have you had any claims in the last 3 years:
» Yes
» No
More details
Are there any other material facts or convictions (other than motor) to disclose i.e if the property is over 200 years old:
Further Information:
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