Survey

1. Please enter your address (required field)

2. Postcode (required field)

3. House Type

Owner Occupier

Tenant of Private Landlord

4. Householder Status

Tenant of Housing Association

5, Council Tax Band

Don’t know

A

B

C

D

E

F

G

H

6. Was your property flooded? tick as appropriate

2008

2010

2012

Insurance Details May 2014


Please enter property name/number and street. This information will not be stored in the final database and is used only to avoid duplication of replies.


7. Do you have Buildings insurance cover? (Required field)

Only select Combined option if you have a Building and Contents bundle that does not separate the premium details

8. Who is your Insurance Company?

9. Buildings Annual Premium      £

10. Buildings Excess (Flooding)   £

If you have a Combined Policy put total premium paid

If you have a Combined Policy only put Buildings excess here

11. When is your next Buildings renewal date?

12. Have you made a claim on your Buildings policy in the past six years for flooding?

Yes

No

Not Applicable

13. Do you have Contents insurance cover? (Required field)

14. Who is your Insurance Company?

15. Contents Annual Premium      £

If you have a Combined Policy leave blank

16. Contents Excess (Flooding)    £

17. When is your next Contents renewal date?

18. Have you made a claim on your Contents policy in the past six years for flooding?

Yes

No

Not Applicable

19. How did you obtain your current policy/policies? (Required field)

If Other, or you have any comments about obtaining your current policy/policies: please tell us about it here

Contact Details

If you would like us to contact you about the survey, please give us your details below

Person to contact

Evening telephone

Email Address

Contact details will not be held on the survey database and will only be used to contact you about this survey. They will be erased from all files on completion of gathering the survey data and will not be used for any other purpose or forwarded to a third party

Property Details


Morpeth Flood Action Group Insurance Survey May 2014

£50 & £25 shopping vouchers to be won

All completed and valid questionnaires returned to us will be entered into a free draw for two shopping vouchers. The draw will take place on 9th June 2014.