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Residential Let / Vacant Property Quotation Request Form

fields marked with * are required     *  Your Name : *  Your Email Address : * Telephone :       * Name of Proposer 1 : *  DOB for Proposer 1 : day: month: January February March April May June July August September October November December year: *  Occupation of Proposer 1 :       *  Name of Proposer 2 : *  DOB for Proposer 2 : day: month: January February March April May June July August September October November December year: *  Occupation of Proposer 2 :       *  Risk Address : *  Risk Postcode : *  Building Sum Insured : *  Contents Sum Insured :       Year Built : Listed : No Grade 1 Grade 2 *  Property Type : House Masionette Purpose-built Flat Converted Flat Other *  Number of Storeys :       Total number of flats in whole building (if flats) : Total number of flats to insure (if flats) :       If not standard construction please state type : Flat Roof Area (If Applicable) : Not applicable 1-20% 21-25% 26-50% 51-100%       *  The Property is Currently : Empty Let To be let within 90 days To be let in longer than 90 days To be sold If let / to be let then written tenancy agreement is / will be more than 6 months : Yes No If let / to be let then the landlord's agreement is / will be direct with : Tenant Letting Agent Council Housing Association If let / to be let then the tenant(s) are / will be : A Family Single Person/s If let / to be let then then what number of single unrelated persons are there / will there be : If let / to be let then the tenant(s) are / will be : Working Professional Retired DSS Student Asylum Seeker Other       Have you made a claim in the last 5 years : Yes No Current Insurers Name : Current Policy Expiration Date : Any other information :         To request further information please contact us CClick here for our instant online quotes for residential let property Click here for our instant online quotes for unoccupied / vacant property (Services available to UK residents and businesses only) (Authorised and regulated by the Financial Services Authority) +44 (0)20 8574 7796 Email Us +44 (0)20 8813 8425