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Proposal Form
Full name of Proposer (if not a Limited Company, show full names of all Principals/Partners and the Trading Name)
Your address
Post code
Email Address
Telephone No
Fax No
Date from which Insurance cover is required
Full address(es) of properties this insurance relates to, indicating property type (e.g. detached/semi-detached/terraced etc)
Address
Postcode
Property Type
Occupancy
1. Is the property occupied by:-
Professional Tenants
Student Tenants
Refugees/Asylum Seekers
Other DSS Tenants
Yes
No
Yes
No
Yes
No
Yes
No
Others (please specify)
2. Is the tenancy agreement between the Landlord & Tenant directly?
Yes
No
3. Do you live on the premises?
Yes
No
If No, is there an appointed manager or caretaker living there?
Yes
No
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Guidance Notes
Please answer all questions fully and carefully. There is a duty to disclose all material facts. Material facts are those that affect the judgment of a prudent Underwriter.
The proposal form and the information you provide forms the basis of the insurance policy you are purchasing and therefore is extremely important. Full disclosure should eradicate many issues at the time of a claim being made on the policy.
Full Name of Proposer
If a Limited Company please insert this name in the full name of the Proposer.
If a sole trader – please list your name in the full name of the Proposer and any Trading Name below this.
If a partnership, list all partners’ names in Full Name of Proposer and any Trading Name in the next box.
T: 020 8315 5000
F: 020 8460 2118
E:
mail@camberfordlaw.com