Declaration of Identity (A) Customer Care: 0818 787839 "*" indicates required fields Step 1 of 6 16% Which County or postal code is the property site located in?* Carlow Cavan - East Clare Cork City (within 15km radius) Cork County EXCLUDING West Cork Dublin County Dublin postal codes 1 - 8 Dublin postal codes excluding 1 - 8 Galway City Kerry - North Kildare Kilkenny Laois Limerick Longford Louth Meath Offaly Tipperary Waterford West Meath Wexford Wicklow Unlisted Unlisted county or area? We can only provide quotations for area's that were specifically named in the County or area list. However, we provide you with a tips page to help you choose an engineer in your area to provide you with this service. Please click "GET QUOTE NOW" at the end of this form to go to this page.Which unlisted County is the property located in? Cavan - West Cork - West Donegal Galway County Kerry (except North Kerry) Leitrim Mayo Monaghan Roscommon Sligo Ulster Please let us know which County the property is located in so that we can understand which other areas are interested in our services. Thank you! Who is completing this quotation form?* Client / Person that requires the service Third party on behalf of a client This information enables the correct recording of client contact details.Thank you for obtaining a quotation on behalf of your client. To ensure we have the correct details associated with the quotation please provide the contact information as specified. To avoid any confusion it is best, if possible, to provide the clients own contact details in the next section. Quotations obtained using a third party email address will also be addressed to the third party and not to the client, however the clients details will be recorded in our admin copy.Whose email address will we be sending the quotation to?* Clients email address Third party email address Third parties would include Estate Agents, Solicitors, Financial Advisors etc. Please input the clients name in the "Your name" fieldsThird party please input your name in the "Your name" fields and the clients name in the "Clients name" field.Your name* First Last Clients name* First Last Third party please input your contact number in the "Your phone contact" field and provide the clients contact number in the "Client phone contact" field. Please input the clients contact number in the "Your phone contact" fieldsYour phone contact*This is required in the event that we need to clarify information.Clients phone contact*This is required in the event that we need to clarify information with the client, and also to follow up on the quote and discuss any booking.Please input the clients email address in the "Your email address" field.Third party please input your email address in the "Your email address" field.Your email address* Your email address Confirm email address The estimate will be sent to this email address. Address of Property that the Declaration of Identity is required for*EircodePlease provide the Eircode to the property if you have it to hand.Estate agent's web-link to property (if available)For example: www.myhome.ie/residential/brochure/99-finglas-road-dublin-8/1234567 What is the size of the site the Declaration is required for?* Up to ½ an acre Up to 1 acre Up to 2 acres Up to 3 acres Up to 4 acres Up to 5 acres 5 acres or more Site size 5 acres or more? We can only provide automated quotations for sites that are up to 5 acres. As your site is larger than this please click "GET QUOTE NOW" at the end of this form and Customer Care will either contact you directly with a quotation using the information submitted, or will call you to discuss the property details further.Declaration of Identity - Total excluding VAT @23% is Price: €0.00 VAT @ 23% Price: €0.00 Declaration of Identity - Total including VAT Price: €0.00 Name Live €1.00 quote test Quantity Price: €1.00 Quantity So we can thank you for the referral please let us know in the "How did you find us field" below both your occupation and your name. Thank you for completing this quotation on behalf of your client. How did you find us?* Repeat client Friend / family Solicitor referral Estate Agent referral Mortgage Broker / Financial Advisor / Bank Google Facebook Instagram YouTube LinkedIn PHC vans, engineers, business cards, leaflets etc Other Where possible we also use this information to say thank you to the people who kindly refer Property Health Check.Referrals name or companyFor example: If an Estate Agent has referred you pop in their name so we can thank them.OtherIt would be great if you could tell us a bit more about how you found us.Marketing materials PHC Van PHC Business Card PHC Information leaflet Own house surveyed by PHC engineer My Den Ad in a magazine Other CLICK HERE TO READ OUR TERMS AND CONDITIONSAcceptance of Terms and Conditions* I acceptI have read and accept the Terms and ConditionsCLICK HERE TO READ OUR PRIVACY POLICYI give consent to use this information to send additional emails and communication as described in your Privacy Policy* I agree I give consent to use this information to send additional emails and communication as described in your Privacy Policy.* I agree Click "Get Quote Now" and Customer Services will either email a quotation to you using the information submitted, or will contact you to discuss the property further.PhoneThis field is for validation purposes and should be left unchanged.
