Building & Contents

1 Your Personal Details

First Applicant

Second Applicant

..Surname
...Surname
..Title
...Title
..First Name
...First Name
Home Tel no.
Home Tel no.*.
..Work Tel no.
Work Tel no.*
..Address1
Address1*
Address2
Address2*
Town
Town*.
County
County*
Postcode
Postcode*
Email
Email *
    * If different from applicant 1
   

2 Details of Property

BUILDINGS SUM INSURED

   
Main Residence
£
Out Buildings £

CONSTRUCTION OF BUILDING

Brick, stone with tiled roof
   
Timber Framed
   
Thatched
   
Age of property
  years  
Is the building listed?
   
If yes, please give grading
   

CONTENTS SUM INSURED

General Contents
£
 
Books
£
 
Pictures etc.
£
 
Statues & sculptures
£
 
Porcelain, china or glass
£
 
Antique furniture
£
 
Clocks, barometers etc.
£
 
Gold, Silver & Plate etc.
£
 
Jewelry, watches & furs
£
 
Personal effects and baggage
£
 
Guns
£
 

SECURITY

Do you have an alarm?
 
Is it connected to the police or central station?
 
Do you have a safe?
 
       

Do you use your home for business purposes?

Have you had any losses during the past five years?

Do you require legal expenses cover?