at 4 p.m.
Please list all employed members of an employer's family residing in the employer's dwelling. List all directors of the employer and remuneration.
Note: Any such persons not included in this Schedule are not insured.*
I/we acknowledge that the information given is accurate and complete and that I/we have complied with the obligation imposed by law concerning disclosure of information.
I/we agree that this proposal shall, subject to the terms and conditions of the Policy, be the basis of the contract.
Click her to complete the information required for Fully Insured to provide a fast quote
PO BOX 393
Glenelg SA 5045
Phone: 1300 76 84 11 / Fax: 08 7123 6143
ABN 58 624 758 345
Authorised Representative No 1262528 of PSC Connect Pty Ltd ABN 23 141 574 914 AFS License No 344648
© COPYRIGHT 2021 Fully Insured Pty Ltd.