Quote - Brownhill Insurance

1 Policy details • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

2 Quote • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

3 Statement • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

4 Payment • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

Your details

Title

First Name

Last Name

E-mail

Telephone

Correspondence address

Address
Town
Postcode

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Contact preferences

We like to keep our members updated on the latest offers and promotions that we feel would be of interest to them. We would like to include you in these updates but only with your consent. The updates are not frequent and can offer our members genuine savings on the products and services that they are interested in.

Would you like us to contact you with the latest offers and promotions?

Yes No

What are your acceptable methods of contact?

SMS

Post

Collection address

Is the collection kept at the correspondence address?

Yes No

Please confirm where the collection is kept (risk address)

Address
Town
Postcode

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Policy details

Policy start date

Enter a promotion code

Not validated

Your collection

Your collection value

Is any single item in your collection valued at or in excess of £50,000?

Yes No

Item

Name of Piece

Current value

Notes

What you'll need to know

Your information

Your personal information and details of your collection

Your obligations

To provide fair and accurate information to us. For full details, please see the Policy Wording and Terms & Conditions below.

Payment details

Your bank account details to set up interest free Direct Debit

Documents

Your details

Collection address

Policy details

Your collection

Item

What you'll need to know

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