Insurance Tcm Form

UNDERWRITING INFORMATION FOR HOME INSURANCE 料資保投險保屋房料資保投險保屋房料資保投險保屋房料資保投險保屋房 - OWNERS NAME(s) ：名姓人保投：期日生出 Date of Birth FULL ADDRESS ：址地：號編區政郵 Postal Code HOW MANY FAMILIES ARE LIVING IN THIS HOUSE: ：址上在住口戶庭家個少多有明列請 Non-Smokers? Yes □ No □ 否是：者煙吸有否是中客住 □ □ USE OF HOUSE e.g. primary residence, rental, etc. ：人他與租出是或住自是業物此 ANY RENTAL ROOM? ：戶租名少多有 EXISTING POLICY INSURER: ：稱名司公險保之前目供提請 POLICY NUMBER AND EXPIRY DATE: ：期日效有之單保該及碼號單保 Existing Policy Building Limit (if NOT condo): e.g. $400,000, can be found in your existing policy 如，值價保投之業物該上單保出列請 $400,000 Building Information: Age of bldg (year built) ：齡樓之業物該出列請 How many storeys ：層少多高樓 Type of bldg: e.g. detached; townhouse; condo, etc.: 屋排屋鎮屋立獨：類種業物 □ 廈大文柏管共或 □ □ □ Garage e.g. detached double garage 房車單他其或房車雙 □ □ □ Exterior Wall e.g. brick, Frame, masonry; aluminium sidings - 石片鋁木磚：料物牆外屋房 % % % % Interior Wall e.g. plaster, drywall - ）板膏石，泥灰：如例（：料物牆內 % Roof e.g. shingles and % ：料物頂屋 % Ceiling - e.g. 8 ft, 10 ft 呎十呎八如例度高底樓 % - / : Living room - area & floor (e.g. carpet, hardwood, tiles) ：料材及積面廳客 Dining room - area & floor (e.g. carpet, hardwood, tiles) ：料材及積面廳飯 Family room - area & floor (e.g. carpet, hardwood, tiles) ：料材及廳庭家 No. of bedrooms and area of each bedroom ：積面間房及目數房睡 No. of Kitchens; area & floor (e.g. ceremic tiles, etc.) ：料材面地：積面及目數房廚 Other rooms - no. and area ：積面間房及目數間房他其 Basement - finished/unfinished; area ：積面或：成完否是庫地 or % % Other areas (e.g. corridors, laundry room etc) - approx. area 他其或、房衣洗、廊走：括包積面方地他其 ( ) Total Living area (total of the above): ：積面總間空動活房住 No. of bathrooms: ：目數間手洗 2-piece (toilet & basin) - how many ：目數）盆手洗及廁坐：括包（頭件兩 3-piece (toilet, basin & shower or bathtub) - how many ：目數）缸浴或灑花、盆手洗、廁坐：括包（頭件三 Ensuite; 4-piece (toilet, basin, shower and bathtub) - how many ：目數）缸浴及灑花、盆手洗、廁坐：括包（頭件四 Airconditioning system - yes/no ：目數式掛懸統系央中：類種：否有：備設節調氣空 □ □ Heating system - type e.g. forced air furnace; wood stove etc ：料資統系氣暖 Fireplace - no. and type of Fireplace: ：類種否有：爐火 □ □ Plumbing - pipes are copper, plastic or others? ：）他其或料塑、銅（類種管水 Electrical - 100 amp? ：料資應供力電 Burglary alarm - yes/no; monitored - yes/no ：台察監到駁接否有否是：裝安統系盜防 □ □ No. of Smoke detectors 否是：台察監到駁接否是，目數之器測探霧煙 ; monitored - Yes/no □ □ Is fire hydrant in the vicinity of your house? Yes/no 否是喉街火救之府政有裝安否是近附業物 : □ □ Is firehall within 8km of your house? Yes/no 否是？局防消有設否是內里公八之業物在 □ □ Outbuildings e.g. enclosed porch; gazebo; garden shed … / , , 施設之建加式各他其或房陽太格間風防如物築建他其有設否是外屋業物 Swimming pool - Yes/no 否是？池泳游家私有設否是業物 □ □ Other additions e.g. extra kitchen, skylights, hot tub; jacuzzi/jetted tub; wet bar ，等池摩按，吧水，窗天如，施設他其 If building over 20 years old, need when update been made for - Roof; electricical; plumbing; heating/aircon systems etc.: 板婊電及線電板婊電及線電板婊電及線電板婊電及線電頂屋新更時何於施設下以出列請，年廿過超齡樓如頂屋新更時何於施設下以出列請，年廿過超齡樓如頂屋新更時何於施設下以出列請，年廿過超齡樓如頂屋新更時何於施設下以出列請，年廿過超齡樓如 : 氣暖冷管水氣暖冷管水氣暖冷管水氣暖冷管水 NOTE: we cannot provide home insurance in which the house has any commercial activity e.g. clinic or it is a multi-tenant occupancy 所診居家或租分如，居家之動活業商何任有於用適不險保惠特此：意泩請 Claims History - any claim or loss in the past 6 years. If so, provide date, details of claim/loss 額金及固事償賠出列請？償索否有年六去過於下閣 Any Other comments and/or Information: Name/Address of Mortgagee: 址地及稱名司公謁按或行銀 How long have you been in this present premises? ？久多住居業物此於下閣 How long has you have home insurance? ？險保屋房買購始開時何於閣

Insurance Tcm Form

by CMAAC on Dec 08, 2009

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Insurance Tcm Form — Document Transcript