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					Household Contents Inventory Sheet
for calculating the correct sum insured (SI)
Policyholder:
Policy number:

Basic information:           No. adults                                   House lived in by: 1 family                          House owner
                             No. children                                                    2 families                        Apartment owner
                             No. rooms                                                       3 families                        Tenant
                                                                                             Several families
In order to calculate the correct sum insured, please state the new replacement cost (the cost of obtaining a replacement at today’s
prices). Having the correct sum insured avoids indemnity being reduced in the event of a loss.

Basic household contents (children under 14 count as 50%)
Included: usual furniture and effects, domestic equipment and appliances, crockery, linen and bedding, ordinary rugs, lamps,
curtains, clothing, shoes, food, emergency provisions, guests’ personal effects and property held on loan.


  Basic household contents
Rooms                  1            11/2           2             21/2            3            31/2           4      41/2           5           51/2          6
Persons
    1              34,000        40,000        46,000         52,000         58,000        64,000        70,000    76,000      82,000       88,000       94,000
 11/2              40,000        46,000        52,000         58,000         64,000        70,000        76,000    82,000      88,000       94,000      100,000
    2              46,000        52,000        58,000         64,000         70,000        76,000        82,000    88,000      94,000      100,000      106,000
 21/2              52,000        58,000        64,000         70,000         76,000        82,000        88,000    94,000     100,000      106,000      112,000
    3              58,000        64,000        70,000         76,000         82,000        88,000        94,000   100,000     106,000      112,000      118,000
 31/2                                                         82,000         88,000        94,000       100,000   106,000     112,000      118,000      124,000
    4                                                                        94,000       100,000       106,000   112,000     118,000      124,000      130,000
 41/2                                                                                     106,000       112,000   118,000     124,000      130,000      136,000
    5                                                                                                   118,000   124,000     130,000      136,000      142,000
 51/2                                                                                                   124,000   130,000     136,000      142,000      148,000
    6                                                                                                   130,000   136,000     142,000      148,000      154,000
                                             Total basic household contents
                                             Loading for: above-average standard + 20% / luxury standard + 40%
                                             Total basic household contents after adjustment

  Additional household contents
Field                  Details                                                                       Additional   Deduction for amounts    Additional household
                       Deductions are based on an average                                            household    already included in the    to be taken taken
                                                                                                                                           contents to be into
                       household with 3 people and 3 1/2 rooms                                       contents                                account for for the
                                                                                                                  basic household contents into account the SI SI

Collections            Stamps, minerals, pewter, oriental rugs, antiques,                                             no deduction
                       silver tableware, art, etc.

Electronic             Home cinema, photographic and video equipment,
                       music systems, PCs, etc.                                                                            -3000

Travel/camping         Camping equipment, etc.                                                                             -1000

Hobbies/leisure        Books, CDs, records, tapes, model making, model railways,
                       tools and machinery, garden furniture, garden equipment and
                       machinery, etc.                                                                                     -2000

Sports equipment       Skis, snowboards, skateboards, roller skates, ice skates, sledges,
                       bicycles, tennis, squash, angling, windsurfers, hang-gliders, paragliders,
                       diving equipment, inflatable boats, hunting and sports weapons, etc.                                -2000

Sports clothing etc.   Ski suits, etc.                                                                                     -1000

Valuables              Furs, leather clothing, jewelry, musical instruments, pictures, etc.                                -2000

Miscellaneous          Stores (e.g. wine, spirits, groceries), heating oil, pets,
                       structural installations, designer furniture, etc.                                             no deduction


                                                                                     Total additional household contents
                                                                                     Subtotal (basic + additional household contents)
                                                                                     Contingency (usually + 10%)
                                                                                     Total sum insured (SI)