Name
Address
Postcode
Telephone	Mobile Number		Email Address
Business Description			Other Occupation
No of Years In Business
Renewal Date
Claims Experience
Date	Cause		Amount
Minimum Letting Period	months
Do you require Employers Liability Insurance?	Yes No	No of Employees
Property Owners Liability	Limit of Indemnity £1Million £2Million £5Million
Details of the Let Property
Address
Postcode
Type of Property	Single Tenancy House Funished Bedsits with Own Cooking Facilties Bedsits without Own Cooking Facilities Student Halls of Residence Single Tenancy House Unfurnished Muliple Tenancy House Furnished Purpose Built Flats Furnished Purpose Built Flats Unfurnshied Flat Conversion Furnished Flat Conversion Unfurnshed Multiple Tenancy House Unfurnished
Number of Tenants( one family group is one tenant)
Tenant Description	Employed Short Term Tenancy Students DSS Short Terms Tenancy Local Authority Under Contract
- Walls - Standard Non Standard - Roof - Standard Non Standard - Floors - Timber Concrete Timber & Concrete Other - Stairs - Metal Other Concrete Timber Timber & Concrete
Are the premises self contained? Yes No Is any part unoocupied? No Yes Fire Alarm None Class A Class B Class C Unknown Sprinkler Systems None 28th Edition Class I 28th Edition Class III 28th Edition Ordinary 28th Edition Standard A 28th Edition Stamdard B 29th Edition Grade I 29th Edition Grade II 29th Edition Grade III 28th Edition Class II
Year Built
Buildings Sum Insured		Outbuildings
Fixtures and Fittings		Special Glass
Communal Contents
Subsidence Cover Required Not Required	Loss Of Rent	£	Months