INSURANCE ZA
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First Name
Surname
Email
Contact Number
ID Number
Street Address
Suburb
Postal Code
Type Of Residence —Please choose an option—HouseTownhouseFlat - On Ground FloorFlat - Above Ground Floor
Move-in Date
Insured Amount
Roof: —Please choose an option—TilesSlateZinkCementThatchOther
Wall: —Please choose an option—BrickCementSteelStoneWoodOther
Burglar bars at all openable windowsGates at all doors leading outsideAlarm - Not LinkedAlarm - Linked Armed ResponseElectric fencingComplex with access control24-hour security guards
—Please choose an option—No Previous InsuranceLess Than 1 Year1 - 2 Years2 - 3 Years3 - 4 Years4 - 5 Years5 - 6 Years6 - 7 Years7 - 8 Years8 - 9 Years9 - 10 Years10+ Years
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Accept Terms & Conditions