Quote4Insurance
Thatch, Listed and Period Homes
Section 1 - Personal Details
Title
Mr.
Mrs.
Miss
Dr.
Rev.
First Names
Surname
Date of Birth
Address
Town
City
County
Postcode
Telephone
Email
Renewal Date of Current Policy
Is the property your main residence?
Yes
No
-- Select --
How old is building?
Walls Construction
Roof Construction
What is your current renewal/ existing premium
Who are you currently insured with
Section 2 - If the roof is thatched, please answer the following questions
Is the roof in good condition
Yes
No
-- Select --
Do you burn solid fuel
Yes
No
-- Select --
If yes, is it in
Is the top of the chimney at least 1 meter clear of any surrounding thatch
Yes
No
-- Select --
Is the chimney lined
Yes
No
-- Select --
Section 3 - Sum Insured Required
Sum Insured for Building £
Sum Insured for Contents £
Sum Insured for Jewellery/personal effects £
Have you any claims in the last three years ?
Yes
No
-- Select --
f yes, give brief Details
How did you hear of
Quote4insurance
?
e.g. Name of magazine/newspaper you saw our advert in, T.V., radio, Teletext,diverted from other site = please name site / search engine, internet advert etc.