Express Insurance logo
Business Insurance
Advice Line 1300 464 989
Express Insurance logo
Business Insurance
Advice Line 1300 464 989
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 Express Insurance, please ensure you check all information and make any necessary changes.

Business Information

Occupation
Number of Employees (including you)
Annual Income   
Total must be 100%:
Yes
No
Period of Insurance