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Request a quotation for: Buy To Let Insurance

Your details

Name
Occupation
Preferred contact method
Telephone
Email
Preferred contact time

Home details

Home Postcode
Home Address

Renewal dates

Surgery Insurance Renewal Date
Locum Insurance Renewal Date
Home Insurance Renewal Date
Professional indemity Renewal Date

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All information submitted via this enquiry form is covered by the Data Protection Act 1998

Risk Address
Risk Postcode
Date of Birth
Type of Property	Detached Semi-Detached Terraced End terrace Bungalow Flat Other
Approx date property was built
Is your property listed?	No Grade I or equivalent Grade II or equivalent
Buildings Sum Insured £
Contents Sum Insured £
Accidental damage cover £	Yes No
Loss of rent indemnity period	12 24 36
Is the property in good state of repair?	Yes No
Is there existing/intended buildings works at the property other than renovation? Yes No
Has the property or surrounding area ever suffered from subsidence, landslip or heave? Yes No
Has the property or surrounding area ever suffered from flooding? Yes No
Building construction
Roof construction
Is there any flat roof? (if 'yes', is it more than 10 years old?)	Yes No
10 years or more?	Yes No
Does the property comply with all current Gas, Electrical and Fire and Furniture Regulations? Yes No
Who is the property let to? Professional Students DSS (non-referral) DSS (referral) Asylum seekers Unoccupied
Are the premises occupied for any business purposes?
Have you or you aware of any tenancy dispute in the last 12 months?	Yes No
Have you had any claims or accidents at the property in the last 5 years? (If 'yes' please provide details of reason, amount paid and date)	Yes No
Claims Details
Property alarm type?	None Bells Digital Communicator Redcare
Has insurance cover ever been refused, cancelled or special terms imposed?	Yes No
Have you or any of your family ever been convicted or cautioned with any criminal offence, other than driving offences?	Yes No

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Request a quotation for: Buy To Let Insurance