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Application form for fixed valuation for the fire insurance ex. Art 7: 960BW (Dutch civil code)
Assured data
  Private     Business  
Company
  Mr.     Mrs.  
Initials *
Insertion
Surname *
Phone number *
E-mail *
Valuation address
Address *
Address *
Address
Zip code *
Residence *
Add additional addresses  
Address *
Addition
House number *
Zip code *
Residence *
 Building
Insured/estimated amount: €  
 inventory
Insured/estimated amount: €  
 Household
Insured/estimated amount: €  
 Art, valuables and belongings
Insured/estimated amount: €  
  First setup
  Reappraisal
Data Intermediary      (does not apply)
Contact
Company *
Residence *
  Mr.     Mrs.  
Initials *
Insertion
Surname *
Phone number *
E-mail *
Particularities
  I agree with the Terms and Conditions of this service.
Instead mission
kakeswaal taxatie opdracht
- apply for house
  value user
- valuation assignment - apply for quotation - expertise assignment