Landlord Response Sign Up Form

Sign up

In order to get you set up, we need you to complete our short signup form, it only takes a couple of minutes.

Client Name and Contact Details Your name * Your email * Your phone* Your mobile Your address*

Property Address Property address* Property Type* If HMO or Guest House does each room have individual facilities? If Flat what floor? Number of bedrooms Is there gas at the property? Boiler make and model (if known) Boiler age (if known) Central heating Date of last wire test (if known) Date of last gas safety certificate (if known) Number of portable appliances belong to you? Letting Agents* Tenants Name* Tenants Phone Number* Tenants Mobile Tenants Email

Package required BronzeSilverGoldPlatinum

Where did you hear about us?

To be completed by agents Company Name* Branch Location* Introducers Name* Brochure Number

The Small Print

I agree to Landlord Response deducting the sum of the relevant monthly package each month, I understand the first months payment is taken immediately and is held until the policy commencement date. This is a non refundable deposit and in the event you do not proceed this is used towards administration costs I also agree that by completing this order form Landlord Response will contact me/my agent/my tenant to arrange an Initial Inspection. I understand that the total cost of the remedial works (if any) will be confirmed in writing (usually by email) within 5 working days of the Initial Inspection being carried out. I understand I will need to sign an acceptance of estimate within 14 days, if I do not contact you within this time I will be charged for the tests and certification carried out on the Initial Inspection. This would be taken automatically less the initial payment already deposited. This would also apply if I decided NOT to proceed with the package. Once this fee has been taken I would expect to receive all the certificates and relevant documentation within 10 working days. I understand if I do go ahead there is NO charge for the Initial Inspection tests and certification and this is included in my monthly package fee quoted at signup.

I agree

In all other cases

Once any remedial works are instructed you will be automatically go onto cover that same day. We normally allow you to have an account facility so that you are able to spread the cost of any remedial works over 12 months subject to our normal account terms.. We will then schedule the remedial works and contact you / your tenants to carry out these works.

Please tick if you would like an account facility set up:

Yes Please

Terms and Conditions

I have read the terms and conditions and agree to the contents within.

Yes, I agree

Payment Name on Card* Card Type* Card Issuer Card Number* Start Date Expiry Date* Issue Number Security Code*

Submit the form

Landlord Response

Report a fault / Request a repair

Thank you, we have received your sign up form.

Sign up