Date of Birth
Risk Address (Farm address)
Type of Farm
Size of Farm
Claims experience (date of claim(s), type of claim(s), is the claim settled? How much?):
Stock cover if required
Outbuildings (if any) rebuild cost:
Farm machinery (year, make, model & value)?
Employees? If so, How many, Full or part-time, Wages per annum & turnover)
If a farmhouse exists, please answer the following;
Building sums insured?
Contents sums insured?
How many bedrooms?
Year of construction?
Primary heating source?
Alarm on property (is this monitored) ?