Faith Insurance

How did you find us?

Please provide details:

First Name

Last Name

Contact Phone Number

Re-enter Email address

Are you currently insured

Expiry Date

Name of current insurer

Name of Broker (if applicable)

Are you a religious / worship group based in Australia?

Please describe percentage split of your activities you wish to be noted on the policy as the business description (e.g. Religious organisation including fundraising, social welfare camps, childcare, school etc)

Total must be 100%: 0%

Please provide explanation of each activity/risk to be quoted (e.g. What are the events? Where are activities held? How often? Who organises the activities?):

The policy will not cover the activities of third parties – we can help source a separate insurance policy for third party events such as weddings. If required, please contact us.

Type of Organisation

Please provide details

If your income is earned in only 1 state, please enter 100 in the corresponding box below. If your income is earned in multiple states, please provide an approximate % breakdown of Annual Income for each state in the boxes below.

NSW

ACT

QLD

VIC

TAS

Overseas

Yes

Can you provide a letter from your State Revenue Office confirming you are exempt from all Stamp Duty charges?

Please send us your stamp duty letter upon completion of this questionnaire.
This question does not relate to Tax Exemption.

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

Yes No

Registered Organisation Name(s):

ABN

Most insurers require an ABN so we recommend to make an application with the Australian Business Register if you do not currently have an ABN.

Date of commencement of first operations

Please refer to ACNC Search and provide the relevant link if available:

Primary address details

Street Number/ Name:

(select this check box if address is not listed)

Suburb:

State:

Postcode:

Policy Start Date: The policy starts from either the date of payment or future date advised following payment

Organisation Information

Insured Details