Property Insurance Enquiry Form Title Mr Mrs Miss Ms Dr Full Name Date of Birth Phone Email Preferred time to be contacted Risk address and Postcode (property to be insured) Type of property Basement Flat Conversion Basement Purpose Built Flat Chalet Detached Bungalow Detached House Detached Maisonette End of Terrace Maisonette End Terraced Bungalow End Terraced House Flats (Conversion to Existing Dwelling) Ground Floor Flat Conversion Ground Floor Purpose Built Flat Maisonette Mansion Mid Terrace Maisonette Mid Terraced Bungalow Mid Terraced House Mobile Home Other Floor Flat Conversion Other Floor Purpose Built Flat Purpose Built Flat Rooms Semi Detached Bungalow Semi Detached House Semi Detached Maisonette Service Flat within Employers Prem Top Floor Flat Conversion Top Floor Purpose Built Flat Unknown Unspecified Private Dwelling ZZ – Not Covered by any other item on the list Year the property was built Select the type of wall construction for this property Asbestos Brick Brick / Timber Frame Bungaroosh Cob Construction Concrete Corrugated Iron Essex Construction Fibreglass Construction Flint Glass Metal Plastic Prefabricated Building - Combustible Prefabricated Building - Non Combustible Stone Stramit Construction Timber Timber / Plaster Timber Frame Wattle and Daub Construction Woodwall Woodwork Construction ZZ – Not Covered By Any Other Item On The List Select the type of roof construction for this property Asbestos Concrete Corrugated Iron Felt on Timber Fibreglass Glass Metal Plastic Shingle Slate Stramit Thatch - Fibre Thatch - Reed Tile Timber Turnerised Woodwork Construction ZZ – Construction as advised and as specified Number of bedrooms How many months has the property been unoccupied? How many further months will the property be unoccupied for? Reason for unoccupancy Buildings sum insured Contents sum insured
