AJB Insurance Consultants Javea | House and Contents Insurance Form |

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The best insurance cover at the best prices

QUICK LINKS

Javea Tel: 96 579 63 57 Tel: 96 579 63 58 Tel: 96 579 44 17 Tel: 96 583 58 07 24hrs Mob: 606 213 665

House Insurance Form

HOUSE AND CONTENTS INSURANCE FORM SUBMISSION

Please fill in the form below to request an home and contents insurance quote from AJB. After we have recieved your details we will asses your needs and contact you as soon as possible.

* Indicates required field.

* Name:

* Address:

* Town:

* Postcode:

* Tel:

Please select one:

Villa:

Townhouse:

Apartment:

* Year Constructed:

* Value:

* Estimated value of domestic contents:

High value domestic items (over €3.000):

Antiques:

Jewellery:

Other:

Does the property have any protection:

Iron bars:

Alarm:

Other:

* Is there a safe in the house:

Yes:

No:

* Is the house unoccupied for more than 1 month:

Yes:

No:

If so please estimate unoccupied period in the next 12 months:

* E-mail:

Comments:

Please enter the letters you see in the box:

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