Property Address*

Type of property*
—Please choose an option—Semi DetachedDetachedTerracedEnd TerraceFlatBungalowTown HouseOther

Estimated year property built*

Post Code*

Number of living rooms*

Number of bedrooms*

Number of kitchens*

Number of bathrooms*

Are there any trees taller than 10m within 5m of the property:*
—Please choose an option—YesNo

Approximate % of flat roof*
—Please choose an option—NoneLess than 20%Less than 40%Less than 50%More than 50%

Do you own this property:*
—Please choose an option—Yes (Mortgaged)Yes (Own outright)Renting (Council)Renting (Private)Housing Association

Who lives in the property:*
—Please choose an option—UnoccupiedPolicyholder and FamilyPolicyholder and LodgersPolicyholder Only

How many years have they lived at the property:

How many adults live in the property:

How many children under the age of 18 live in the property:

When is the property usually occupied:
—Please choose an option—Day and NightOnly NightOnly Day

For how many days in a row is the property left empty (e.g. holidays):
—Please choose an option—Less Than 14Less Than 30Only NightMore Than 60 Days

Does anybody in the property smoke:
YesNo

Is the property ever used for business use:
YesNo

Does the property have an alarm:
—Please choose an option—Yes Bells OnlyYes Maintained by NACOSS or NSI AnuallyNo

What lock is fitted to your main door:
—Please choose an option—5 Lever Mortice DeadlockKey Operated multi Point LockRim LockOther Lock

What other lock is fitted to any other external doors:
—Please choose an option—No Other External Doors5 Lever Mortice DeadlockKey Operated Multi Point LockRim LockOther Lock

Do all ground floor windows have key operated locks:
—Please choose an option—YesNo

How many working smoke alarms are there in the property:

Rebuild value of the property:

How many years NCB do you have buildings insurance:
—Please choose an option—Never Had Building Insurnce12345678More

Contents value of the property: (including fixtures, furniture, utensils):

Would you like accidental damage cover for buildings:
YesNo

Any specific items worth over £1000:
YesNo

Would you like cover away from home:
YesNo

Would you like accidental damage cover for contents:
YesNo

In the past 5 years, have you or anyone living at the property made any home insurance claims or suffered any losses or damage, whether insured or not:
YesNo

How much was the claim for?

What type of claim was it?
—Please choose an option—BuildingsContents

What date was the claim?

Has the claim been settled?
YesNo

When would you like the cover to start:

Is built with brick walls?

Has no significant cracks on the external wall

Is more than 400 meters away from water

Has a roof made of slate or tile

Is not for sale

Has never shown signs of heave, landslip or subsidence

Is your main residence

Has not had underpinning or structural support

Is not currently undergoing building work

Has never suffered from flooding

Do you agree with the above assumptions?
YesNo

Name of your last insurer:

Renewal quote from your insurer: