

	Manor House, 1 Macaulay Road, Broadstone, BH18 8AS. Tel: (01202) 642840 Fax: (01202) 658815

Long Term Let Insurance Quotation Request

For a quotation, please complete the form below and click the "Next" button. On the next page, click the "Send" button to send it to us, or click the "Print" button to print it and then post it to us at the address above. You can also call us on (01202) 642840, or fax to (01202) 658815. Our email address is info@jlmorris.co.uk

DETAILS OF YOUR LONG TERM LET PROPERTY
	POSTCODE
	CONSTRUCTION	Description (if 'Other' selected above)
	TYPE OF TENANT
VALUES TO BE INSURED
	BUILDINGS (not market value; this should be for cost of clearing site and re-building)	£
	YOUR CONTENTS (cover does not include tenants' contents)	£
CLAIMS HISTORY
	Have you experienced any claims or losses within the last five years for this property, your own home, or any other business or property insurances?
	If yes, please indicate the nature of the claim, value of claim, and date of claim.
YOUR CONTACT DETAILS (usually your own home, not the let property)
	TITLE/NAME
	CORRESPONDENCE ADDRESS
	POSTCODE
	HOME TELEPHONE
	MOBILE
	OFFICE
	E-MAIL


	Registered in England No. 1012552. Consumer Credit Licence No. 052347. Registered Office: Manor House, 1 Macaulay Road, Broadstone, BH18 8AS Authorised and Regulated by the Financial Services Authority. Firm Register Number 306499

J. L. Morris (Insurance Brokers Ltd., Manor House, 1 Macaulay Road, Broadstone, Dorset, BH18 8AS
Tel: (01202) 642840 Fax: (01202) 658815