Questionnaire
* Required fileds
Tenant(s) Last name(s) and First name(s) :
Email :
Phone number :
Check-in :
Check-out :
Renouvelable automatiquement au terme
Full adress (Name of the road, number of the road, postal code, city) :
Website link on which we can see the property :
Website reference of the property :
What is the reason for your stay * :
What is your profession * :
What is your marital status * :
What is the value of the rented furniture * :
What is the overall value of your belongings, valuables non included * : (furniture, appliances, audiovisual and computer equipment, dishes, household linen, clothing, books, decorative objects, etc.)
What is the overall value of your valuables * : (valuables: jewelry, watches, precious stones, pearls, precious metals, paintings, sculptures, rare books, furs, collections…)
What are the nature and value of your most expensive good * :
In absolute terms, which level of assurance corresponds to your wish * basic, discounted insurance, no options, with a deductible? median insurance, with some options and a reduced deductible? a high-end insurance offering you the best possible protection, with more options and even no deductible?
Is the accommodation equipped with a fireplace, insert, woodburning stove * :
Is the accommodation equipped with a veranda * :
How long are you away from the house every year *(absences under 24 hours do not count)
less than 90 days more than 90 days
Is the dwelling your primary or secondary residence * primary secondary
Do you have a special need for insurance (activity, leisure items, etc.) * :
For this unit, have you reported claims in the last 36 months * yes no
For this unit, have you been terminated by an insurer in the last 36 months * yes no
Please provide us with a copy of the lease and identification.
Add the lease * :
ID * :
Write the following code :
