Your Details

Please answer ALL questions. (Those marked with a * are mandatory)

Marital status: Are you married? Yes No

Do you own the property? Yes No

Is this your primary residence? Yes No

Is property used as holiday home or ST / LT Lets? Yes No

Is property Let for up to 90 days per year? Yes No

Is the property built of solid non combustible materials? Yes No

Is the property more than 300m from sea or river? Yes No

Is Property in good state of repair? Yes No

Are there any Signs or indications of possible Subsidence, Heave or Landslip in the property? Yes No

Is the property self contained with a seperate lockable entrance under your sole control? Yes No

Will property be left unnoccupied for more than 30 days/yr? Yes No

Does the property have a passenger lift or other equipment to take people from one floor to another? Yes No

Is the property Fitted with Alarm in working order? Yes No

Does the property have a safe installed? Yes No

Do external doors have either multi lever dead lock, security Deadlock or Five Lever Mortice Deadlock? Yes No

Exterior door type Reinforced Solid Neither

Do windows Patio doors etc have either key operated locks with Double glazing/ security Glass/ laminated Glass, Any Lever type Lock with glass as above, Security Metal Grills, Lockable concertina Grills, Roll down / Electric Shutters with internal bolts? Yes No

Are the windows protected with Mallorquina Shutters Other Shutters Neither

Do you require Accidental Damage cover for Buildings? Yes No

Do you require Accidental Damage cover for Contents? Yes No

Do you require cover for subsidence? Yes No

Any Valuables or high value entertainment equipment with a single article limit of €5000 or 7% of sum Insured? Yes No

Do you require cover for personal effects / valuables away from home? Yes No

Do you require cover for money / credit cards? Yes No

Do you require cover for bikes? Yes No

Do you require cover for Golfing Equipment Excluding Golf Buggy? Yes No

Do you require Cover for a Golf Buggy? Yes No

Is the property currently insured Yes No

Any losses or claims in the last 5 years? Yes No

Have you or anyone residing with you been refused insurance or had any special terms/restrictions imposed at this or any previous home? Yes No

Have you or any one living at property been convicted of any offence other than driving Offences? Yes No

Have you or anyone living with you been made bankrupt or have bankruptcy Pending? Yes No