Your Préname/Name
Address
Postal Code/City
[Name of your insurer]
Address
Postal Code/City
Done à [your city], on [précate the date].
Object : Déclaration of loss covered by the damage insurance contract n° [indicate the number of your insurance policy;insurance]
Madam, Sir,
I am the owner of a dwelling located [indicate your address]. As of today, I note that [describe the damage and the consequences suffered]. The work has been completed for less than 10 years.
Therefore, I wish to invoke the damage insurance that I took out on[indicate the date the contract was taken out].
Waiting for your return, please accept, Madam, Sir, my best regards.
[Your signature]