Please answer the questions carefully and to the best of your knowledge, as our quotation will be based on the details you provide. Incorrect information could lead to an increased premium, claim being declined or invalidate an insurance. Renewal or cover start date?(Required) DD slash MM slash YYYY Quotes valid for up to 30 daysIs the property owned by an individual or limited company?(Required)IndividualCompany nameName?(Required) Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Title First name Surname Section BreakFull company name?(Required)Address of your home to be insured?(Required)Enter postcode, then select address from drop-down Postcode 1st line 2nd line Town / city Postcode Number of bedrooms?(Required) 1 bedroom 2 bedrooms 3 bedrooms 4 bedrooms 5 bedrooms 6 bedrooms This field is hidden when viewing the formSCHEDULE OF INSURANCE (new page etc etc)This field is hidden when viewing the formDeclarationRegistered in England and Wales. Registered Office: Dallas House, Low Moor, Bradford, BD12 0HF. This e-mail message and any attachment may contain confidential information intended for the addressee(s) only. If you are not a named recipient or have received this in error, please notify us immediately by return e-mail. Any views expressed within this e-mail that do not constitute insurance advice do not necessarily reflect the views of the Company. All e-mails have been scanned for viruses however we do not accept responsibility for any loss or damage caused if this e-mail or any attachment is not virus free. T L Dallas & Co Ltd is authorised and regulated by the Financial Conduct Authority. Renewal or cover start date?(Required) DD slash MM slash YYYY Quotes valid for up to 30 daysIs the property owned by an individual or limited company?(Required)IndividualCompany nameName?(Required) Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Title First name Surname Section BreakFull company name?(Required)Address of your home to be insured?(Required)Enter postcode, then select address from drop-down Postcode 1st line 2nd line Town / city Postcode Number of bedrooms?(Required) 1 bedroom 2 bedrooms 3 bedrooms 4 bedrooms 5 bedrooms 6 bedrooms This field is hidden when viewing the formSCHEDULE OF INSURANCE (new page etc etc)This field is hidden when viewing the formDeclarationRegistered in England and Wales. Registered Office: Dallas House, Low Moor, Bradford, BD12 0HF. This e-mail message and any attachment may contain confidential information intended for the addressee(s) only. If you are not a named recipient or have received this in error, please notify us immediately by return e-mail. Any views expressed within this e-mail that do not constitute insurance advice do not necessarily reflect the views of the Company. All e-mails have been scanned for viruses however we do not accept responsibility for any loss or damage caused if this e-mail or any attachment is not virus free. T L Dallas & Co Ltd is authorised and regulated by the Financial Conduct Authority.