Insurance Requirement Form

   PLEASE COMPLETE THE FOLLOWING: Questions with a * are obligatory.

   Name: *       
   Address:      
   Email: *     
   Tel:(home)*  	   Fax:    
   Tel:(work)   	   Mobile: 

   INSURANCE CATEGORY:
    Home insurance (Buildings; Contents; Public Liability)
    Car insurance - UK reg. vehicles
    Car insurance - French reg. vehicles
    Caravan insurance
    Boat insurance
    Travel insurance (Europe)
    Travel insurance (Worldwide)
    Health insurance (Private health plan)
    Health insurance (top-up scheme to French social security system)
    Life assurance (Fixed Term ; Full Life)
    Domestic Pet insurance (Dogs and Cats)
    Mortgage Finance (to purchase and/or renovate property in France)
    Financial Services (retirement planning and investment)
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