Buy To Let Form

Please fill in the form below, as fully as you can and we will contact you as soon as possible. Thank you.If you have more than 5 properties click here

Personal Details

Full Name
Date of Birth
Telephone No.
Email Address
Preferred Contact Day
Preferred Contact Time

Property 1

House Name/ Number
Post Code
Buildings Sum Insured
Contents Sum Insured
Tenant Type
Property Type
Existing Insurer

Property 2

House Name/ Number
Post Code
Buildings Sum Insured
Contents Sum Insured
Tenant Type
Property Type

Property 3

House Name/ Number
Post Code
Buildings Sum Insured
Contents Sum Insured
Tenant Type
Property Type

Property 4

House Name/ Number
Post Code
Buildings Sum Insured
Contents Sum Insured
Tenant Type
Property Type

Property 5

House Name/ Number
Post Code
Buildings Sum Insured
Contents Sum Insured
Tenant Type
Property Type

Insurer

Current Insurer
Current / Renewal Premium if known

Claims History

Have you had any claims in the last 5 years?

Yes or No
If yes please give details

QUOTATION ASSUMPTIONS

Please read carefully and confirm that you can agree to these conditions.

  • An insurance company has never cancelled one of your policies, applied special terms when renewing your policy or refused to renew your policy.
  • All buildings are of standard construction (i.e. brick or stone walls and tile or slate roof and is not a listed building).
  • All buildings are occupied regularly, throughout the year
  • All premises show no signs of damage from subsidence, landslip or groundheave, and has never suffered from any of these problems
  • All premises to be insured are not in an area that to the best of your knowledge or due enquiry, has a history of flooding,
  • And no claims have been made on the property in the last three years.

I agree to the above conditions



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