Your home quote

Where did you hear about AXA Agence International?
Other
What is the name of the relocation agency, estate agent, person who recommended us, or which exhibition
Are you in the process of moving to live in France
Title
Surname
First name
Mobile telephone number
Country Code
Email address
Marital status
Occupation
Job Title
Date of birth (Format DD/MM/YYYY)

CORRESPONDANCE ADDRESS

First line of your address
Additional address details
Additional address details
Post Code
Town/City
Country
Same as risk adress
Is the property ?
Type of property
Which floor level is the apartment located on:
Number of rooms - Any living space (including a conservatory) greater than 6m² and less than 40m² excluding kitchens, entrances, toilets, bathrooms, hallways. For rooms larger than 40m², count one room for each 40m²
Are any of the rooms over 40m² ?
Yes No
Are you the
You other

ADDRESS OF PROPERTY TO BE INSURED

Address
Additional address details
Post Code
City / Town
Is this your
When was the building built?
Is the building protected or an historical monument
Will the property be rented out?
Please select which best describes the use of the property
Will the property be unoccupied for more than 90 days in TOTAL during the year (cumulative throughout the year)
Do you have other buildings on the land? E.g. Garages, barns, pool house or shed etc. Basements, garages and attics which communicate directly with the property (by way of a door/corridor) are automatically insured. The cave in a sous-sol of an apartment (not communicating with the residential area) or a garage not connected with an internal door to a house must be declared
What is the size in m2?
Do you want to insure the outbuildings?
Value of goods to insure in our outbuildings - tools, DIY/hardware materials, lawnmower …
Do you have any specific insurance needs i.e. non domestic pets, one or two rooms used for business purposes, land over 5Ha, lake/water on the land, property under tele surveillance...
What is the value of goods to insure in your outbuildings - tools, DIY/hardware materials, lawnmower etc. ?

Does the property have any of the following:

Conservatory - additional room with glass roof/walls
Wood burning stove, insert (enclosure within a fireplace with a door)
Yes No
Garden
Yes No
Outside furniture and equipment - pergola, locks, fencing, patio, paved driveway, compost bin, water collection tank, septic tank, micro station (waste water treatment equipment), sheds, trees and shrubs, tennis court, garden furniture
Yes No
Swimming pool
What is the size in m2
Spa, Jacuzzi
Yes No
Renewable energy equipment
Yes No
Solar Thermal Panels (to heat water)
Yes No
Photovoltaic panels
Yes No
Heat pumps (Pompe à chaleur)
Yes No
Wind or Water Turbine
Yes No
What is the value of contents you want to insure in case of theft, vandalism, and escape of water - we will automatically provide a higher sum assured for fire
What is the value you want to cover your valuables, up to a maximum of 50% of the above contents insured figure? Valuables are jewellery, watches, precious and semi-precious stones, pearls, items of precious solid metal (gold, silver, gilt and platinum), clocks, sculptures, vases, paintings, drawings, tapestries, carpets, ivory objects and precious stones, ancient weapons, rare books and furs, Collections of all kinds
Do all access doors to the property have at least one lock? Locks without keys and padlocks are not considered to be locks. Accepted technology: mechanical locks (grooved, cylinder, pump) and electronic locks (connected, biometric)
Yes No
Do all access doors to the outbuildings have at least one lock? Locks without keys and padlocks are not considered to be locks. Accepted technology: mechanical locks (grooved, cylinder, pump) and electronic locks (connected, biometric)
Yes No
If you have other security measures at the property please specify
Number of adults living at the property
Number of children living at the property
Habitable surface in m2
Are you currently insured in France?
Name of current insurer
Have you made any claims in the last 36 months? If yes please give details including the date of the claim
Number of claims in the last 36 months
What was each claim for?
Is this policy
Type of payment
What is the start date for the insurance? (Format DD/MM/YYYY)

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