Enter the address of the property to be insured (including Post Code):
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Is the property divided into bedsits: (i.e. cooking facilities in the bedrooms): |
Yes
No |
Please select the option which describes how your property is occupied: |
A. Holiday Home
B. Holiday Home Let
C. Second Home
D. Let Property
E. Student Let
F. DSS Let
G. Unoccupied Property |
| If the property is unoccupied, is it undergoing any refurbishment or renovation? |
Yes
No |
If yes, please provide details of works: |
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| If the property is unoccupied, state your intentions for this property
in the next 12 months: |
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| Has the property ever been used for commercial purposes (i.e. shop or office): |
Yes
No |
If yes, please provide details: |
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| Is the property let to one person or family (i.e. not multi-tenure)? |
Yes
No |
If No, please provide details: |
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| Is the tenancy agreement between yourself and the tenant only? |
Yes
No |
If No, please provide details: |
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| What is the approximate age of the property? |
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Please select which best describes the type of property:
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| Is the property listed or of historic value? |
Yes
No |
If Yes, please provide details: |
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Please state when you would like the cover to begin (start date): |
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| Please indicate the Buildings Sum to be insured: |
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| Please state any mortgage or other financial institution that requires to be
named on the policy: |
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CONTENTS sum insured: |
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| Is the property to be insured built or standard construction (i.e. brick, stone
or concrete and roofed with state, tiles, concrete or asphalt)? |
Yes
No |
If No, please give details: |
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| Is the property in good state of repair and will be maintained as such: |
Yes
No |
If No, please provide details: |
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| Is the property free from flooding and not in an area susceptible to flooding: |
Yes
No |
If no, please provide detail: |
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| Is the property free from signs of damage due to subsidence, landslip or heave
and not in an area where there has been or is evidence of these causes: |
Yes
No |
If No, please provide details: |
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| Is the property being monitored for subsidence, landslip or heave, or has it
ever been: |
Yes
No |
If Yes, please provide details: |
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| Is the property neighbouring a property which has been subject to occurrence
of subsidence, landslip or heave: |
Yes
No |
If Yes, please provide details: |
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| Has the property been extended in the last 25 years: |
Yes
No |
If Yes, please provide details: |
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| Is the property within 20 feet of any tree or shrub over 10 foot tall: |
Yes
No |
If Yes, please provide details: |
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| Does any part of the property have a flat roof: |
Yes
No |
If Yes, please provide details including approximate percentage: |
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| Does the property have boarded windows or doors? |
Yes
No |
If Yes Give Details: |
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Has any insurer declined to accept, cancelled, refused to continue or agree
to continue only on special terms, any insurance for the proposer or any other
person to whom this insurance would apply: |
Yes
No |
If Yes, please provide details: |
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| Have you or any other person whose property is to be insured hereunder sustained
any loss or damage in the last five years which would have been covered by
this type of insurance had it been in force, whether or not a claim was paid: |
Yes
No |
If Yes, please provide details: |
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| Have you or any person residing with you ever been convicted of arson or any
criminal offence: |
Yes
No |
If Yes, please provide details: |
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| Current Insurer? |
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| Expiry Date? |
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| How long have you owned the propert for? |
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