Name

Last Name

Telephone

Email

Property Use Property Use Main Home Vacation Home Business

Property Type Property TypeDetached HouseSemi Detached HouseApartmentApartment BuildingOfficesOffice Building

Bank Name(in case of mortgage)

Floor

Approximate area in m2 to be insured

Construction Year

Fire Protection? Fire Protection? Yes No

Type of insurance Type of insurance Home Basic Home Full

Type of construction Type of construction Typical Metal Wood

Area Code Of Property

Number of claims made in past

Value of prior claims(€)