Letting Agent Application
Full Company Name:
Names of Principals,
Partners or Directors:
(Separate by new line)
Contact Title:  
Contact First Name:
Contact Last Name:
Registration No. (if Lid. Company):

Trading Address:
Line 1:
Line 2:
Line 3:
Town/City:
County:
Post Code:
Country:

Work Number:
Fax Number:
Email Address:
Confirmation Email Address:    

Professional Indemnity Insurer:
Limit of Indemnity
Renewal Date:
FSA Number
Current Referencing Provider:
Current Volumes Per Annum:
Insurance Providers You Promote:

Current Policies Per Annum:

Tenant's Content:

Landlord's Buildings & Contents:


Approximate number of
managed properties:


Of these what percentage are occupied by:
Working: %
Students: %
DSS / LHA: %
Asylum Seekers: %
Other: %
Please tick for all product ranges you would be interested in receiving more information on: