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Tax ID No :
Tax Office :
Insurance Company :
TC. Identity No. find
If you are a Turkish Citizen 		:
Policy No :
Starting Date :
Agent Code :
Agent Name :
  RISK DECLARATION
Name Surname :
City :
Town :
Area :
District :
Street :
Apartment/Block :
Door NO :
Floor :
Flat NO :
Telephone :
Mobile :
E-Mail :
 RISK
The address of insured and the risk address is the same
City :
Town :
Area :
District :
Street :
Apartment/Block :
Door NO :
Floor :
Flat NO :
 BUILDING - RESIDENCE
Construction Style :
Brick Reinforced Other
Construction Year :
1975 and Before 1976-1996 1997-1999 2000 and After
Number of Floors in Building :
1 to 4 5 to 7 8 and Over
Usage Style :
Residence Trading House Office Other
Sheet :
Parcel :
Building of Usage m²
(Incuding the shared areas)		 :
Section :
Page :
Has The Building Had Any Damage Before ? :
Yes No