Business Insurance
Advice Line
1800 642 747
1
2
3
4
5
6
Advice Line
1800 642 747
1
2
3
4
5
6
Business Information
Occupation
Change
Number of Employees (including you)
Annual Income
$
Please provide an approximate % breakdown of Annual Income by State or Territory according to where it is earned:
Total must be 100%:
NSW
ACT
QLD
VIC
TAS
SA
WA
NT
Overseas
Are you a small business eligible for exemption from paying NSW stamp duty on certain types of Insurance?
Yes
No
Yes
No
Do you require Building and/or Contents Insurance?
(The policy covers business property only)
Location 1
Do you Own the Premises?
Yes
No
Are you the Only Tenant?
Yes
No
Please provide Names of Tenants and Industry they operate in
Is the Building Heritage Listed?
Yes
No
Facade Only
Whole Building
Street Number/Name:
Suburb:
Postcode:
State:
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
What year was the Building Constructed?
Please select year..
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
Before 1930
Has the Premises been re-wired and re-plumbed?
Yes
No
Building Construction:
Non-combustible
Combustible
Building Replacement Value:
$
Contents Replacement Value:
$
Are Deadlocks fitted on all External Doors?
Yes
No
Do you use swipe cards to access the premises?
Yes
No
Does your premises contain more than 15% Expanded Polystyrene (EPS)?
Yes
No
Location 2
Do you Own the Premises?
Yes
No
Are you the Only Tenant?
Yes
No
Please provide Names of Tenants and Industry they operate in
Is the Building Heritage Listed?
Yes
No
Facade Only
Whole Building
Street Number/Name:
Suburb:
Postcode:
State:
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
What year was the Building Constructed?
Please select year..
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
Before 1930
Has the Premises been re-wired and re-plumbed?
Yes
No
Building Construction:
Non-combustible
Combustible
Building Replacement Value:
$
Contents Replacement Value:
$
Are Deadlocks fitted on all External Doors?
Yes
No
Do you use swipe cards to access the premises?
Yes
No
Does your premises contain more than 15% Expanded Polystyrene (EPS)?
Yes
No
Location 3
Do you Own the Premises?
Yes
No
Are you the Only Tenant?
Yes
No
Please provide Names of Tenants and Industry they operate in
Is the Building Heritage Listed?
Yes
No
Facade Only
Whole Building
Street Number/Name:
Suburb:
Postcode:
State:
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
What year was the Building Constructed?
Please select year..
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
Before 1930
Has the Premises been re-wired and re-plumbed?
Yes
No
Building Construction:
Non-combustible
Combustible
Building Replacement Value:
$
Contents Replacement Value:
$
Are Deadlocks fitted on all External Doors?
Yes
No
Do you use swipe cards to access the premises?
Yes
No
Does your premises contain more than 15% Expanded Polystyrene (EPS)?
Yes
No
Location 4
Do you Own the Premises?
Yes
No
Are you the Only Tenant?
Yes
No
Please provide Names of Tenants and Industry they operate in
Is the Building Heritage Listed?
Yes
No
Facade Only
Whole Building
Street Number/Name:
Suburb:
Postcode:
State:
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
What year was the Building Constructed?
Please select year..
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
Before 1930
Has the Premises been re-wired and re-plumbed?
Yes
No
Building Construction:
Non-combustible
Combustible
Building Replacement Value:
$
Contents Replacement Value:
$
Are Deadlocks fitted on all External Doors?
Yes
No
Do you use swipe cards to access the premises?
Yes
No
Does your premises contain more than 15% Expanded Polystyrene (EPS)?
Yes
No
Location 5
Do you Own the Premises?
Yes
No
Are you the Only Tenant?
Yes
No
Please provide Names of Tenants and Industry they operate in
Is the Building Heritage Listed?
Yes
No
Facade Only
Whole Building
Street Number/Name:
Suburb:
Postcode:
State:
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
What year was the Building Constructed?
Please select year..
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
Before 1930
Has the Premises been re-wired and re-plumbed?
Yes
No
Building Construction:
Non-combustible
Combustible
Building Replacement Value:
$
Contents Replacement Value:
$
Are Deadlocks fitted on all External Doors?
Yes
No
Do you use swipe cards to access the premises?
Yes
No
Does your premises contain more than 15% Expanded Polystyrene (EPS)?
Yes
No
Promotional Code (if relevant)
