Property Insurance Application


Applicant name


Type of Property


Address of the Property Insured
City
Street
Building
Floor
Plot Number
Caza
Mobile number
e-mail Address
Phone


In which currency would you like your insurance cover?


Schedule of Benefits
 Sum Insured
Construction
Content
Neighbor's Recourse
Earthquake
Burglary by forcible entry


Requested Effective Date (dd/mm/yyyy)