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Ford Kinter

Head Office:

1 - 3 Smolic Crt, Tullamarine,
Victoria 3043, Australia

PH. (03) 9339 3333
Fax. (03) 9339 3355

Toll Free 1800 810 392

info@fordkinter.com.au

House and or Contents Insurance Quotation Form

HOUSE AND OR CONTENTS INSURANCE QUOTATION FORM

Please fill in the details below for a quotation or click here for us to contact you


Fields marked with an * are required fields.

Location Details
Area: *
Suburb / town: *
Postcode: *
Fire Brigade:
Is the property in an area which has reticulated water and Fire Brigage Services?:
Is the property on acreage?:
Is there neighbourhood or Rural Watch?:
Property occupation:
House Age or Year built: *
Building made primarily of:
Enter Home Insurance Sum Insured: *
Sum Insured on contents: *
Do you want to insure any personal valuables for special risk?
Yes  
No  

If yes please specify:

Unspecified Valuables: *
Specified Jewellery: *
Safe Deposit Valuables: *
Videos, Cameras & Access: *
Bicycles: *
Portable Computers:*
Mobile Phone:
Other Specified Valuables:*
Personal Details
Date of Birth of the Insured:*
Is the insured retired?
Yes  
No  

Is the Insured a Pensioner?
Yes  
No  

Is There any type of security installed at the house?
Yes  
No  

If yes please specify:

Someone always at home  
Windows – standard locks  
Windows – keyed locks  
Windows – Security  
Louvre windows – Bars (Or No Louvre windows)  
Doors – standard locks  
Doors – single keyed dead locks  
Doors – double keyed dead locks  
Sliding doors – Patio bolts (or No sliding doors)  
Audible Alarm  
Monitored alarm  
Safe Installed  
Enter the number of years you have been claim free:*
Are you Currently Insured?
Yes  
No  

If Yes with whom?:*
Cover
Defined Events  
Accidental Damage  
Contact Details
Name:*
Company:*
Position:*
Postal Address:*
Suburb / Town:*
State:*
Postcode:*
Phone:*
Fax:*
Email:*
Comments:





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