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Household Proposal Form

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Proposal for Shipment
Household Goods and Personal Effects

INSURANCE IS THE SUBJECT MATTER OF SOLICITATION: The liability of AXA Insurance (Gulf) B.S.C. (c) does not commence until the Proposal has been accepted and the Premium paid or agreed to be paid. AXA Insurance (Gulf) B.S.C. (c) reserves the right to ask for special terms or decline the Proposal. Please refer to the Policy for full terms, conditions & exclusions. A specimen copy of this Policy is available from any AXA branch office in the Gulf or on our website www.axa-gulf.com. Please complete this form in BLOCKS CAPITALS, tick the appropriate boxes and send to your local AXA office or your appointed Insurance broker/forwarding agent.

Proposer:

Address at Origin:

Address at Destination:

Shipped by (Please Tick):

Packing (Please Tick):

Approx. commencement date of transit: No of packages:

Packing Company’s Name:

All items should be insured for present day market value at destination. Failure to do so will result in valuation clause being applied. All items being shipped must be declared for insurance. Describe each Item and give Individual values. Please give details of each set. Please list separately any items exceeding US$ 1,000/=

No. ARTICLES No. Items Replacement cost
ALIVING ROOM
1Sofas
2Chairs
3Lamps & Shades
4Tables
5Radios
6TVs
7Rugs & Carpets
8Curtains
9Piano & Musical Instruments
10Bookcase/Wall Unit
11Cupboards
12Hi-Fi system/Home Theatre
13Pictures & Paintings
14Video Recorder/DVD
BDINING ROOM
1Tables
2Chairs
3Cupboards
4Sideboard
5Lamps & Chandeliers
6Rugs & Carpets
7Curtains
8Mirrors
9Table Linen
10Pictures & Paintings
11Desk
No. ARTICLES No. Items Replacement cost
5Kitchen Linen
6Dishwasher
7Oven/Cooker
8Microwave
9Crockery
10Utensils/Cutlery
11Pots & Pans
12Bowls, Trays Etc
13Plastic/Tupperware
14Food Processor
15Refrigerator
16Freezer
17Vacuum Cleaner
18Washing Machine
19Dryer
ECHINAWARE/PORCELAIN
1 
2 
3 
4 
FCRYSTAL/GLASSWARE
1 
2 
3 
4 
GSILVERWARE/BRASSWARE
1 
2 
3 
4 
HANTIQUES/ WORKS OF ART
1 
2 
3 
4 
ISPORTS EQUIPMENT
1 
2 
3 
4 
No.ARTICLESNo. ItemsReplacement cost
JLINEN/CLOTHING
1Coats/Jackets
2Suits
3Dresses
4Trousers
5Sweaters
6Blouses
7Skirts
8Sleepwear
9Shirts
10Footwear
11Hosiery/Socks
12Ties/Scarves
13Underwear
14Lingerie
15Sportswear
16Sheets/Linen
KBEDROOM (MAIN)
1Beds
2Chairs
3Tables
4Wardrobes
5Dressing Table
6Chest of Drawers
7Mirrors
8Rugs
9Lamps
10Curtains
11Bookcases
12Pictures/Paintings
LBEDROOM(S) OTHERS
1Beds
2Chairs
3Tables
4Wardrobes
5Dressing Table
6Chest of Drawers
7Mirrors
8Rugs
9Lamps
10Curtains
11Bookcases
12Pictures/Paintings
MBATHROOM
1Rugs, Toilet Covers
2Toiletries
3Medical Supplies
4Towels
No.ARTICLESNo. ItemsReplacement cost
NMISCELLANEOUS
1Clocks
2Telephone/Fax
3Plant Holders
4Toys & Games
5Food (Non-perishable)
6Computer
7Computer Printer
8Computer Accessories
9Sewing Machine
10Video Cameras
11Cameras/Lens
12Pictures/Paintings
13Bicycles
14Books
15Audio Tapes
16CDs
17Video Tapes/DVD’s
18Garden Equipment
19Garden Furniture
20Suitcases/Trunks
21Tools
22
23
24
25
OANY OTHER ITEMS
1
2
3
4
5
6
7
8
TOTAL (Insured Value) Please state currency

Please Tick cover required:

Extensions For Full Conditions Only: (Please tick if cover required)

All material facts must be disclosed, failure to do so could invalidate the policy. A material fact is one which would be likely to influence an insurer in the assessment and acceptance of the proposal. If in any doubt as to whether a fact is material then it should be disclosed here.

Declaration: I declare that the details herein are correct according to the best of my knowledge and belief and agree that the particulars and statements given shall form the basis of contract between us and shall be incorporated in the Policy, if issued. It is agreed that the Insurer is liable in accordance with the terms of the Policy only and that the Insured will not lodge any other claims of whatever nature. I shall provide any additional information that maybe required by AXA Insurance (Gulf) B.S.C (c).

Date:

Proposer Signature:

UAE: 800 48 45, Bahrain: 800 010 60, Oman: 800 70 292, Qatar: 800 29 21

Enter text✕

What the Household Proposal Form Is and when it’s used

The Household Proposal Form is a structured document used to propose terms for household-level services, shared living arrangements, or joint expense agreements. It collects party information, proposed financial arrangements, responsibilities, timelines, and required signatures so all household members review and accept terms. Common uses include roommate agreements, shared utilities allocation, housekeeping service proposals, and informal occupancy arrangements. The form is typically completed by the initiating party and circulated to other household members for review, negotiation, and signature, either on paper or via compliant eSignature platforms.

Why a clear Household Proposal Form matters

A well-prepared Household Proposal Form documents expectations, reduces disputes, and creates a clear record of financial and operational commitments among occupants. It supports enforceability when obligations are explicit, signed, and retained.

Why a clear Household Proposal Form matters

Who typically prepares and signs this form

The Household Proposal Form suits any party proposing shared household terms, where multiple adults will rely on the same written agreement.

  • Primary occupant or leaseholder proposing household rules and cost splits
  • Incoming roommate reviewing and accepting financial and conduct terms
  • Property manager or landlord offering household-level convenience services

Use clear party identifiers and signature blocks so each signer is attributable and obligations are easy to enforce.

Core sections to include in a professional proposal

A complete Household Proposal Form groups the agreement into clear sections so readers can find key terms quickly and sign with confidence.

Parties

List full legal names and contact details for every person covered by the proposal, including role (tenant, roommate, guest).

Scope

Describe specific services, shared areas, and responsibilities — for example cleaning schedule, utility sharing, and guest policy with measurable duties.

Financials

State exact amounts, due dates, payment methods, and how prorations or reimbursements are calculated to avoid ambiguity.

Term

Set the effective date and duration, renewal conditions, and termination notice periods including any move-out cost responsibilities.

Signatures

Provide signature blocks with printed name, role, date, and witness or notary areas if required by jurisdiction or landlord rules.

Attachments

Include exhibits such as room inventory, payment schedules, vendor contracts, or proof of insurance when applicable.

Essential data fields to capture

Full names: Legal names only
Contact info: Phone and email
Address: Street, city, state, ZIP
Payment terms: Amount and due date
Effective date: MM/DD/YYYY format
Signature block: Name, date, role

Step-by-step: preparing and circulating the proposal

Follow these steps to produce a clear, signed Household Proposal Form and preserve the record for later reference.

  • 01
    Draft: Complete all sections and attach exhibits.
  • 02
    Review: Share draft with all parties for comment.
  • 03
    Finalize: Incorporate edits and lock the final version.
  • 04
    Sign: Collect signatures (electronic or ink) and distribute copies.

Typical routing and execution flow

A predictable workflow helps ensure each signer receives the form, understands its terms, and signs in the correct order.

  • Upload document: Sender places fields and signs where needed.
  • Add signers: List emails and assign roles.
  • Authentication: Choose email, SMS, or ID check.
  • Completion: Signed copy and audit trail are generated.

Configuring an electronic signing workflow

Configure role order and authentication to match the agreement’s approval logic and any legal requirements.

Field Configuration
Signer Order Sequential or parallel signing
Authentication Email link, SMS code, or ID verification
Expiry Settings Set link expiration in days
Notifications Enable email reminders for signers

Technical considerations for eSubmission and storage

Confirm the signing platform supports required authentication, audit trails, and the file formats you use.

  • File formats: PDF and DOCX supported
  • Integrations: CRM and cloud storage
  • Security: TLS and AES-256 encryption

Choose a platform that preserves a complete certificate of completion and stores the signed PDF with metadata for future verification.

Timing and deadlines to keep in mind

Establish dates for payments, renewals, and notice periods so obligations and remedies are measurable and enforceable.

Payment due dates:

Specify day of month and grace period

Notice periods:

State how many days for termination notice

Renewal window:

Define auto-renewal or opt-in timing

Signature deadlines:

Set a deadline for all parties to sign

Document retention:

Record retention schedule should be set

Key milestones from proposal to completed file

Track milestone stages so responsible parties know when to act and when signed records become effective.

01

Draft Complete

Proposal finalized and exhibits attached.

02

Circulate for Review

All parties receive draft and provide comments.

03

Signatures Collected

Signers execute and audit trail is captured.

04

Distribution and Storage

Final signed copies delivered and archived.

Common preparation mistakes to avoid

  • Using informal or vague payment terms such as 'fair share' without a formula or amount increases the chance of disputes.
  • Omitting full legal names or contact details can create identity ambiguity and hinder enforcement or collection actions.
  • Failing to record the effective date or renewal mechanics can produce conflicting expectations about when obligations start or expire.
  • Relying on handwritten initials without clear intent or signature placement may not meet enforceability standards under ESIGN/UETA.

Risks of errors or incomplete execution

Dispute costs: Increased legal or mediation expenses
Enforcement gaps: Difficulty proving obligations
Tax exposure: Misstated payments may trigger reporting issues
Invalid signatures: Noncompliant e-signing may reduce evidentiary weight
Notary omissions: May delay record acceptance in some jurisdictions
Data leaks: Inadequate storage risks privacy breach

Representative eSignature pricing and feature comparison

Select an eSignature provider based on required compliance, transaction volume, and feature needs; signNow appears first in the comparison per platform ordering rules.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies Varies Varies Varies
Bulk Send Yes (Business Premium) Varies Varies Varies Varies
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes (BAA required) Varies Varies Varies Varies
Envelope Cap No cap 100 envelopes/user/year limit Varies Varies Varies

Frequently asked questions about the Household Proposal Form

Answers to common procedural and legal questions to help you finalize the form correctly and avoid typical pitfalls.


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