Landlord Insure - STATEMENT OF FACT

Property Owners STATEMENT OF FACT

Please read the following information carefully. It forms a record of information advised and constitutes the basis of your contract of insurance.

If you are satisfied that to the best of your knowledge and belief that this is a true statement of facts, you need take no further action. If any of the facts in this statement are incorrect or you are unsure, you must notify ourselves to enable us to provide a correct insurance quotation, as your insurance broker/intermediary. Failure to advise that the facts in this statement are incorrect, incomplete or inaccurate could result in the invalidation of the policy if it is subsequently placed on cover at a future date upon payment of the premium requested and subject to the statement of fact not being rejected by you, you are accepting the insurance offered on the terms contained in this statement of facts, the Policy Schedule and the Policy Document which will be available from your broker/intermediary.

1About The Business

2Property to be Insured

3Tenancy Agreements (when occupied) ( Building 1)

4Security

5Have you or your Directors, Partners or joint/co-insured:

6Material Facts

7GDPR

About The Business (if applicable)

By filling in your details, you are agreeing to our Terms and Conditions
Please note that 'You' or 'Your' in the context of this Statement of Facts means the person(s) named as Proposer/Policyholder and/or any other director or partner of the named Proposer company.
Business/Trading Name
What type of business do you have?
When did you first become a landlord?
When do you want cover to start? When do you want cover to start? / DD / MM YYYY
Renewal Date Renewal Date / DD / MM YYYY
About You - Proposer/Director
Title
Forenames
Surname
Date of Birth Date of Birth / DD / MM YYYY
Occupation
Part-time Occupation
Contact Number
Mobile Number
Email Address
Alternative Email Address
Correspondence Address

Landlord Insure - STATEMENT OF FACT

Landlord Insure - STATEMENT OF FACT

Property Owners STATEMENT OF FACT

About The Business (if applicable)

About You - Proposer/Director