HOME EXCHANGE INTERNATIONAL

NOTICE OF EXCHANGE AGREEMENT

Please fill out following form for the insurance and send it immediately back to our office at least 14 days before departure.

Attention: every time you homeswap you need to fill out a new form for the insurance. You can copy this form or ask a new one at Taxistop (tel. 070/222.292)

Our address: Taxistop – Home Exchange

Maria Hendrikaplein 65B

9000 Gent

fax: 09/242.32.19

Name: ..........................................................

Address: ..........................................................

..........................................................

..........................................................

Tel: ..........................................................

ID number: ..........................................................

Home exchange period: ..........................................................

With: ..........................................................

Address: ..........................................................

..........................................................

..........................................................

Tel: ..........................................................

PRESS?

Sometimes the press asks us some addresses for an interview on Home Exchange or some further information. Can we use your address in this case?

0 yes

0 no

Date : ............................ Signature : ............................