Online Application

ONLINE APPLICATION

Real Estate Agent Professional Idemnity

Company Name

Trading Name

Office Address

City

State

Postcode

First Name

Last Name

Contact Number

Email

Years in Operation

Annual Turnover Previous Year

Estimated Annual Turnover for the Forthcoming Year

BUSINESS ACTIVITIES CALCULATOR

Please confirm the business activities (must add up to 100%)

Auctioneering

Property Management (Residential)

Body Corporate Managers

Residential Sales

Business Brokers

Rural Sales

Commercial Sales

Stock and Station Agents

Property Management (Commercial)

Other

Limit of Indemnity Required

$1,000,000 $2,000,000 5,000,000 $10,000,000

Do you require a combined Professional Indemnity & Public Liability Policy?

Yes No

Have you lodged a claim or notification on your PI policy within the last 5 years?

Yes No