Your First name/Last name

Address

Postal code/ CITY

[Name of your insurer]

Address

Postal code/ City

Done in [your city], on [specify the date].

Subject: Claim declaration covered by damage insurance (dommages-ouvrage) policy No. [indicate your policy number]

Madam, Sir,

I am the owner of a house located at [indicate your address]. As of today, I have noticed that [describe the damages and their consequences]. Yet, the construction work was completed less than 10 years ago.

Consequently, I would like to activate the damage insurance (dommages-ouvrage) policy I subscribed to on [indicate the subscription date].

While awaiting your reply, please accept, Madam, Sir, the expression of my best regards.

[Your signature]