Miscellaneous Professions Insurance
Advice Line
1300 464 989
1
2
3
4
5
6
Miscellaneous Professions Insurance
Advice Line
1300 464 989
1
2
3
4
5
6
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 Details
Income Details
Total Annual Income
$
Employee Numbers
Do you employ staff (excluding yourself)?
Yes
No
Please state the total number of staff including yourself:
Occupation
Change
Are all your sessions classroom based?
Yes
No
Are all your sessions classroom based?
Yes
No
Where required, is your final design signed off by a builder, engineer or an architect?
Yes
No
Do you have responsibility for project management or site management?
Yes
No
Please provide details as to what signoff process is in place for your final design with your client:
In respect of Total Annual Income, please provide a breakdown by State:
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
Period of Insurance
Policy Start Date
Promotional Code (if relevant)