Contents insurance



Please take a moment to fill out this form and one of our brokers will contact you shortly to offer you a quotation or discuss your requirements further.
Title* 
First name* 
Second/middle name
Surname* 
Date of birth* 
Place of birth* 
Sex* 
What is your occupation* 
Are you self employed* 
What is your employers business
Name or number of your home* 
Postcode* 
Do you own or rent this property* 
E-mail address* 
Daytime contact number (including code)* 
Evening contact number (including code)
Mobile contact number (including code)
How did you hear about us* 
When do you need this insurance to start* 
Type of property* 
Number of bedrooms* 
Is the building of standard construction (Standard construction means built of brick, stone, concrete block and roofed mainly with slate or tiles with no more than 20% flat/felt/ruberoid roofing)* 
When was the property built* 
Ownership of the property* 
Is the property occupied during the day* 
How long have you held household insurance* 
How many claims have you made in the last 3 years* 
Do you want contents insurance* 
If yes, enter your sum insured
Do you want Accidental Damage cover* 
Do you want to insure valuables and personal possessions away from your home* 
If yes, select the appropriate sum insured* 
Do you want to insure your excess?* 
Who are your current insurers
What is your current premium
Privacy and Data ProtectionThe Rossborough Group holds your details in accordance with relevant Data Protection Law in the UK, Isle of Man and Channel Islands. Some or all of the information you supply to us in connection with your insurance proposal will be held on computer and may be passed to insurance companies for underwriting and claims purposes. In addition, we may use some of the information to advise you of other products and services offered by the Rossborough Group. If you do not wish to receive such details please contact our Compliance Officer.
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