Buildings & Contents Insurance Enquiry

Buildings & Contents Enquiry Form

Please complete as much of the form as you can. David will review your answers and contact you to discuss your options and provide a quote.

First Name *

Last Name *

Date of Birth *

Email Address *

Phone Number *

Do you have a partner to include on the policy?

YesNo

Risk Address (property to be insured) *

Is your correspondence address different to the risk address?

YesNo

Total number of occupants (including applicants) *

Number of occupants under 18 *

How many years no claims on insurance do you have? *

Have you ever been refused insurance?

YesNo

Have you or your partner ever been convicted of a criminal offence?

YesNo

Will the property be empty during the day (9am–5pm) regularly?

YesNo

Will the property be empty in the evening (5pm+) regularly?

YesNo

Will anyone other than you, your partner, or your family be occupying the property?

YesNo

Do you want emergency call-out cover additionally?

YesNo

If this is a remortgage — would you be happy to switch your insurance immediately?

YesNo

Your details are sent securely to David Wilkinson at Look 4 Mortgages Ltd and will not be shared with third parties without your consent.