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Tel 0845 226 3471 Fax 0845 226 3472 

e-mail credref@houselet.co.uk

Landlord Information Sheet
Name:
Postal Address:
Post Code
Telephone No: Fax Number:
e-mail Mobile:
Occupation: Work: Tel
Date of Birth:
Have you ever been refused cover?              Yes       No
Or had special terms imposed?                     Yes         No
Or had insurance terminated?                         Yes         No
Who are you currently insured with?

 
`Policy Number

Have you or any directors or partners ever been convicted or charged (but not yet tried) with a criminal offence (other than motoring) or been declared bankrupt, insolvent or gone into liquidation?                                         Yes     No  *
Have you or any directors or partners been involved in any other business in the last 5 years?                                 Yes            No  *

* If Yes, please give full details,

 

 

DECLARATION.

I/We do declare that to the best of my/our knowledge and belief the statements herein including those contained within the "Properly Details Questionnaire(s)’ and any attaching documents are true and complete and will form part of the contract between me/us and the Company.

If the premium & terms of cover are reliant on being a member of a recognised Landlords Association or similar affinity group, I/we accept that insurance cover will lapse if I/we do not continue to be a member of such a group.

I/We agree to accept a policy in the Company’s usual form for this class of business.

 

Signature.________________________ Date____________________

Broker Reference: LANDO3LAO2

 

Residential Property Details
Property Address:

                                   Post Code

Amount to be insured?

£

Contents if required

£

Cover to start from

                 /                  /     

TYPE OF PROPERTY  

Year  Built

   

Single Dwelling                              Yes   [   ]   No  [   ]
Shared House                               Yes   [   ]   No  [   ] 
House in Multiple Occupation         Yes:  [   ]   No  [   ] No of Units  [     ]
Self Contained Unit                        Yes   [   ]   No  [   ]
Own Dwelling (Resident Landlord)   Yes   [   ]    No [   ] 

CONSTRUCTION. Please tick

Garage    

Brick and Tile

Timber Framed

Thatched

Other (specify)
  Yes   No
Is the property in good condition    
Will it be maintained as such with regular inspections to detect any defects?    
Do you employ letting agents to manage the property?                                         
Is the property currently unoccupied?     
If Yes, why, and for how long, and what security and other measures will be undertaken?

 

 

 
Is it currently undergoing major repairs or refurbishment?     
If Yes, please give details

 

Have you sustained any accidents, losses or claims in the last 5  years,  whether insured or not.   (If Yes, details overleaf or on a separate sheet))

    
Does the property show any signs of subsidence, landslip or heave?         
Is the property in an area subject to Flooding?     
If Yes to any of the above 3 questions, please give details on the reverse or on a separate sheet:    

IN RESPECT OF POTENTIAL TENANTS DO YOU OR YOUR LETTING AGENT:-

Interview applicants personally?    
Take up employment and financial references?    

Do you accept the following types of Tenants in this property?         
Students?     
Unemployed or Housing Benefit?    
Asylum Seekers?       
Social Services Referred Tenants?    
Short term Holiday Lettings?