Completing this online Proposal Form

Please answer all questions giving full and complete answers.
It is the duty of the proposer to provide all information that is requested in this Proposal Form as well as to disclose relevant facts. A relevant fact is a known fact or circumstances that may influence the evaluation of risk by the insurer. If you are uncertain about what a relevant fact is, please contact us.
If renewing an existing policy with Fenton Green, please ensure you check all information and make any necessary changes.

Business Details

Income Details

Total Annual Income

Employee Numbers

Number of staff (including you)

Yes No

Describe the Other activities you perform:

Are you a small business eligible for exemption from paying NSW stamp duty on certain types of Insurance?

Yes No

Are you a member of the Australian Institute of Interpreters & Translators (AUSIT)?

Yes No

Member Name

Member Number

Period of Insurance

Policy Start Date