Harbourline Mutual
Household claims · PO Box 4410, Leeds LS1 9HM · 0330 100 4410Property damage claim
Form HM-PD-3 · Fields marked * are required1. Your policy
2. About you
3. The loss
Rooms affected
Can you still live in the property?
Emergency repairs
4. Amount claimed
5. Declaration
I confirm the information on this form is true and complete. I understand that a false or exaggerated claim may be refused.
Signature