Full Name
Email Address
Postal Address
Contact Phone Number
Addtional Phone Number (optional)
Date insurance is to start
Properties to insure
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Address of Property
Are the properties in a sound condition? yesno
Do you have current insurance for your properties? yesno
Are the tenants' bonds registered with Tenancy Services? yesno
If you have answered 'No' to any of these please give full details.
Each question must be answered on behalf of You ( the person applying for this insurance) and also any other person who may be covered under the insurance which is being applied for.
Have you claimed on any type of insurance in the past 5 years? yesno
Has any Insurance Company ever refused to insure you? yesno
Has any Insurance Company ever cancelled, refused to renew or imposed special conditions on insurance held by you? yesno
Have you ever been found guilty of a criminal offence or is any prosecution pending?(excluding parking or speeding offences) yesno
Has there been any damage by tenants (whether insured or not) in the past 5 years? yesno
Have you had any problems with your current tenants? yesno
Is there any other information likely to affect the acceptance of this application? yesno
If you have answered 'Yes to any of these please give full details.
I accept the Terms and Conditions
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