Home Insurance

Surname

First Names

Date of Birth

Correspondence address

Email

Contact telephone number

Country of fiscal residency

Address of the property to insure

Type of property: apartment, house… ?

Year of construction

Description of the property (please detail rooms, outbuildings, chimneys, land etc)

Do you own the property ?

Yes No

IF THE PERSON IS THE OWNER Please indicate the property usage:
• Main residence (ie you will live full time in the property)
• Holiday home. Please state the frequence of your visits to the property (monthly, quarterly, yearly etc)
• Holiday rental: please state the % that you will occupy the property and % holidaymakers will occupy the property
• Full time rental (ie you will sign a tenancy agreement to let the property)

Main residence: You will live full time in the property

Holiday home: Please state the frequence of your visits to the property (monthly, quarterly, yearly etc)

Holiday rental: please state the % that you will occupy the property and % holidaymakers will occupy the property

Full time rental (ie you will sign a tenancy agreement to let the property)

Date you want the insurance to begin

Number of floors (or floor number if apartment)

Please describe the different rooms in the property and their approx size in m2 (ie kitchen 12m2, bathroom 4m2 etc)

Total habitable surface (m2)

Size of garden (m2)

If applicable, size of conservatory/veranda (m2)

Type of doors (number of points of the lock / number of locks)

Does the property benefit from any specific protections (window bars, shutters, video alarm, volumetrical alarm?…) PLEASE STATE:

outbuildings (m2) : please specify the type of outbuildings and sizes

Garage (m2) / Car port (m2)

Cellar (m2)

Swimming pool ?

Yes No

Amounts to insure (€):

General furniture and household items (furniture, electrical items, white goods, clothing, laundry, tableware…):

Valuable objects (valuable objects = please list items and value):

Precious objects for which you have a valuation or invoice (jewels, watches…) please list items and value:

Do you have solar panels? if so please estimate the approx size.

Have you made more than 3 claims in the past 36 months?

Has your insurance policy ever been cancelled by the insurer?

Would you like to receive more information from us regarding insurance in France?

Home Insurance Quote Form

Surname

First Names

Date of Birth

Correspondence address

Email

Contact telephone number

Country of fiscal residency

Address of the property to insure

Type of property: apartment, house… ?

Year of construction

Description of the property (please detail rooms, outbuildings, chimneys, land etc)

Do you own the property ?

Main residence: You will live full time in the property

Holiday home: Please state the frequence of your visits to the property (monthly, quarterly, yearly etc)

Holiday rental: please state the % that you will occupy the property and % holidaymakers will occupy the property

Full time rental (ie you will sign a tenancy agreement to let the property)

Date you want the insurance to begin

Number of floors (or floor number if apartment)

Please describe the different rooms in the property and their approx size in m2 (ie kitchen 12m2, bathroom 4m2 etc)

Total habitable surface (m2)

Size of garden (m2)

If applicable, size of conservatory/veranda (m2)

Type of doors (number of points of the lock / number of locks)

Does the property benefit from any specific protections (window bars, shutters, video alarm, volumetrical alarm?…) PLEASE STATE:

outbuildings (m2) : please specify the type of outbuildings and sizes

Garage (m2) / Car port (m2)

Cellar (m2)

Swimming pool ?

General furniture and household items (furniture, electrical items, white goods, clothing, laundry, tableware…):

Valuable objects (valuable objects = please list items and value):

Precious objects for which you have a valuation or invoice (jewels, watches…) please list items and value:

Do you have solar panels? if so please estimate the approx size.

Have you made more than 3 claims in the past 36 months?

Has your insurance policy ever been cancelled by the insurer?

Would you like to receive more information from us regarding insurance in France?