HOME INSURANCE FORM
Kasra A.Ş.
Insured's
Name
:
*
Surname
:
*
E-Mail
:
*
Daytime telephone
:
(
)
*
ss
Telephone
:
(
)
Mobile
:
(
)
Best Time To Call
:
09.00-11.00
11.00-13.00
13.00-15.00
15.00-17.00
Fax
:
(
)
Status
:
Owner
Renter
Information About Building
Types of Construction
:
Concrete
Semi-Concrete
Woode/Timber
Type of use
:
Flat
House
Summer House
Area of the Flat m2
:
Number of Storeys
:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Code of the City
:
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
Amount to be Insured
Actual Value of the Building
(Excluding land value)
:
Actual Value of the Contents
:
Total
:
Do you want the following risks to be included in the cover ?
Earthquake
Home assistance
Glassbreakage
Additional Comments and Questions
:
