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TAX AUDIT INSURANCE QUOTE Form
Insured's Details
Policy Details
Insured Amount
Claims
General
Insured’s First Name
Insured’s Last Name
Business / Individual Occupation
Business Address
Number of Directors
Insured's Mobile Number
Insured's Email
Annual Turnover
$
Entity Type
-- Select an answer --
Company
Partnership
Sole Trader
Trust
Individual
Association/ Committee/ Other
Body Corporate/ Strata / Owners Corporation
Liquidator / Administrator / Receiver
Cover Type
-- Select an answer --
Business AND Directors Audit
Business Audit Only
Audit of Individuals
Self- Managed Superfund (SMSF)
Has any owner/director or officer of the business ever been declared bankrupt or been involved with a business that has gone into receivership, or liquidation in the last 5 years?
-- Select an answer --
Yes
No
Has any owner/director or officer of the business, or the business itself had any insurance policy cancelled, declined or refused in the last 5 years?
-- Select an answer --
Yes
No
Prestige
Has any owner/director or officer of the business, or the business itself been convicted of a criminal offence in the last 10 years?
-- Select an answer --
Yes
No
Insured amount
-- Select an answer --
$10,000
$15,000
$20,000
$50,000
$100,000
Stamp duty exemption
-- Select an answer --
No
Charity/ Not for Profit
Input tax credit (ITC) percentage
Has the business or any owner, director, partner or officer of the business sustained more than 3 losses, or had losses totaling more than $5,000 in the last 3 years, for those covers to be insured by this policy?
Yes
No
When answering our questions, you must be honest and tell us anything that you, and a reasonable person in the circumstances, would include in your answer. It is important that you understand you are answering the questions for yourself and anyone else to whom the questions apply. We may reduce or refuse to pay a claim, or cancel the policy, if you have not answered our questions in this way. I agree to the duty of disclosure
I agree
Email address
