Chartered Accountants Ireland Enquiry Forms

Holiday Home Enquiry Form

Personal Details

Name This is a required field

Date of Birth This is a required field

Occupation This is a required field

Contact Details

Postal Address This is a required field

Home Phone Number
Work Phone Number
Mobile Phone Number Please provide at least one phone number

Email Address Please enter a valid email

Address of the Holiday Home This is a required field

Details of Property to be Insured

Type of Property Please select a type of property

Approximate Size of the Property Please note the approximate size of the property, in either Sq. Ft. or metres square

Value of Buildings Please include the value of the buildings to be insured

Value of Contents Please include the value of contents to be insured

Is the Holiday Home rented out?

Yes No

Discount-Related Questions

Does the holiday home have a minimum of two smoke detectors?

Yes No

Is the holiday home protected with a burglar alarm?

Yes No

Is the alarm subject to a maintenance contract?

Yes No

Is the alarm connected to a central monitoring station?

Yes No

Are all external doors fitted with 5-lever mortice deadlocks or their equivalent and are all accessible windows fitted with key operated window locks?

Yes No

Is the holiday home in a Garda approved Neighbourhood Watch or Community Alert Scheme?

Yes No

Declaration

I declare that my Holiday Home is

built of brick, stone or concrete and is roofed with slates, tiles, metal, concrete or asphalt
in good repair and will be so maintained
not especially exposed to damage from storm, flood, subsidence, landslip, falling trees or vandalism
not more than 100 years old.

I declare that neither I nor any member of my family normally residing with me have

had any Insurer decline a proposal, refuse to renew or cancel a policy, or impose special terms or conditions
sustained any loss, damage, or incurred any liability to third parties during the past 5 years in relation to the cover now being sought for this or any other property.

If the above declaration is not correct, you must provide details of exceptions

If the above Declarations are not correct in every detail please provide details below:

If the above declarations are not correct, you must provide details of exceptions