Calculate Your contribution – House Insurance

Property address

Postal code:

Post(enter place name)

Place:

Street:

Gate number/Apartament number

/

Property

Law Title:

ownershipLease agreementOther

Usable area (m2)

Built at year:

Construction:

WoodenBrickOther

The value of the property (PLN):

Body type:

TwinFreestandingIn RowIn GroupOther

Roof type:

FlatSloping

Anti-theft alarms:

Security doorsAlarm systemMonitoring/monitoring camerassupervision protectionTwo multivalvular locks on the door or a lock with multipoint lockingBars/blinds/burglary windowsOne electronic lock or certificated lock

Is property used for economic activity?

YesNo

Number of people living in property:

012345+

The insurance company of last housing policy:

The number of detriments in the past 3 years:

New policy

The beginning of the insurance period:

Contact

Name and Surname:

PESEL:

E-mail:

Contact telephone: