Donewell Insurance

Enter Name^*

Email(s) ^*

Telephone Numbers(s)^*

Property Value ^*

Occupation or Business

Nationality

Additional Information

Situation of property to be Insured

Plot / House No.

Name / No. of Street^*

Name of Suburb/Locality ^*

Name of Town/City ^*

Description of walls

Roofed with ^*

Sum to be insured

The purpose of building

Where there is more than one building, please indicate separate values for each

Is the Building Detached with an

Outhouse Semi-Detached Flat Storey

If Storey, state the number of Storeys

If building is under-construction, please indicate

Yes No

If building is fenced, please indicate

Yes No

Sum to be insured ^*

INCLUDING HOUSEHOLD GOODS AND PERSONAL EFFECTS of every description, the property of the Proposer or permanently resident members of the family and of servants in the above dwelling.

Note: Any article (furniture, pianos and organs excepted) which exceeds in value 5% of the Amount must be specified below and insured separately.

Sum to be insured (Contents)

On Stock-In-Trade consisting of

On Fixtures, Fittings and Utensils in Trade

On Plant and Machinery therein

Other Property to be insured

Enter sum to be insured

Has the Proposer ever suffered loss or damage by fire or burglary? ^*

If so, give details.

Has any Insurance Company or Underwriter ever refused a Proposal from you or cancelled or refused to renew a Policy? ^*

If so, state name of Company concerned.

Is the property proposed for insurance already insured with another Company? ^*

If so, give details.

Your one-stop insurance shop

Fire Insurance

Fire Insurance Proposal Form

Situation of property to be Insured

Contents

Fire Insurance

Fire Insurance Proposal Form

Situation of property to be Insured

Contents

Donewell

Facebook

Instagram

Twitter