House Online Submission Form"*" indicates required fieldsProposer’s Personal DetailsName*Address*EircodeDate of Birth* DD slash MM slash YYYY Occupation*First Time Buyer Yes NoContact No*Email* Any Current / Previous Policies with us* Yes NoIs there a Joint Proposer on Property* Yes NoJoint Proposer’s Personal DetailsName*Date of Birth* DD slash MM slash YYYY Occupation*Risk DetailsRisk Address (if different)EircodeType of Dwelling*Please ChooseDetachedSemi-DetachedBungalowTerracedEnd of TerraceApartmentType of Occupancy*Please ChooseOwner OccupiedRentedUnoccupiedHoliday HomeNo. of OccupantsType of TenantPlease ChooseFamilyCoupleSingle ProfessionalStudent(s)Year Built*Standard Construction* Yes NoPlease specify materials used in construction of dwellingStandard Roof* Yes NoPlease specify % of roof that is not standard and materials used in construction of RoofNo. of Bedrooms*No. of Bathrooms*Type of Heating*Please ChooseOilElectricSolid FuelStorage HeatersMixtureGasAir to WaterSolarNo. of Paying GuestsListed Building / Basement Yes NoEver Held Insurance on this Property* Yes NoFurther DetailsPrevious InsurerRenewal Date DD slash MM slash YYYY No. of Claims Free Years under PolicyPlease Choose0 Years1 Years2 Years3 Years4 Years5 Years or moreMortgage on Property Yes NoMortgagor Name & AddressCover DetailsRebuild Buildings Sum Insured*Contents Sum Insured*Accidental Damage Required Yes NoCover Date DD dash MM dash YYYY Specified ItemsItem 1€Item 2€Item 3€Item 4€Valuation Available for Specified ItemsYesNoUnspecified ItemsAdditional InformationIs property unoccupied for long periods of time? (more than consecutive 30 days)* Yes NoIs property always kept in a good state of repair?* Yes NoIs property under any form of construction or renovation?* Yes NoIs there any business activity carried out in or around this property?* Yes NoIs property within 100 metres of river, stream, sea or other watercourse?* Yes NoDoes the property have any history of flooding, subsidence or landslip?* Yes NoHas property been monitored, surveyed or underpinned for subsidence/landslip?* Yes NoAre all external windows and doors fitted with mortice security locks?* Yes NoAre smoke detectors fitted?* Yes NoIs the property fitted with a working alarm system?* Yes NoIs it connected to a central monitoring station? Yes NoClaims HistoryAny Claims in last 5 years?* Yes NoPlease specify when & incident details:Additional InformationThe above information was provided by:Please upload supporting documentationMax. file size: 32 MB.* please note we accept .pdf - .jpg - .png files onlyI confirm that neither Proposer(s) nor Occupant(s) of the premises have:* By ticking this box, I confirm that neither Proposer(s) nor Occupant(s) of the premises have:*• had insurance refused, declined or special terms imposed; • been cautioned, charged or convicted of any criminal offences, or any other offences involving dishonesty of any kind, within the past 7 years (excluding driving offences under the Road Traffic Acts); • been declared bankrupt.By ticking this box, I confirm that I have answered all questions honestly and with reasonable care to ensure all responses are accurate to the best of my knowledge. If I have any reason to doubt the accuracy of the information provided, I shall contact Mannion Insurances immediately. I am aware that any negligent or fraudulent misrepresentation could invalidate or affect my policy and/or lead to a policy cancellation.* By ticking this box, I confirm that I have answered all questions honestly and with reasonable care to ensure all responses are accurate to the best of my knowledge. If I have any reason to doubt the accuracy of the information provided, I shall contact Mannion Insurances immediately. I am aware that any negligent or fraudulent misrepresentation could invalidate or affect my policy and/or lead to a policy cancellation.*Consent* By clicking Submit, I/We consent to Mannion Insurances Terms of Business & Privacy Statement which can be found here .* IMPORTANT: Cover does not commence until formally confirmed by a member of our staff.CAPTCHA