Eagle Protect Insurance Application Form.

Insurance designed with you in mind.

Eagle Protect

Landlords Insurance competitively priced.
$449.00 for Property insurance is an additional premium.
This price is the NSW premium and subject to meeting underwriting criteria and T&Cs.

Click here to see Product Benefits.

Landlords Insurance competitively priced.
$449.00 for Property insurance is an additional premium.
This price is the NSW premium and subject to meeting underwriting criteria and T&Cs.

Click here to see Product Benefits.

Does your property fall into any of the following categories:

Holiday Home, Historic Home, National Trust, Heritage Listed, Estate Registered, Commercial or trade building, Backpacker accommodation, Guesthouse, Bed and Breakfast, Hostel, Retirement Home or property used for illegal purposes. If No, please continue. If Yes, sorry we cannot insure you under this policy.

Yes

Is your property managed by a professional managing agent?

If Yes, please continue. If No, sorry we cannot insure you under this policy. Please contact our office 1300 109 295

Yes

Do you want to insure:

Tenant Risks only

Tenant Risks and Building

Policy Start Date *

Application Details

Insured’s Name: *

Mailing Instructions: (For delivery of correspondence)

Fax No:

Email:

Phone No: *

Other Interested Parties:

Property Details

Building Complex Name (if applicable)

Street Address of Property:

Postcode of Property:

Is the Property over 50 years old?

Yes

Is the Property currently vacant?

Yes

Do you require cover for flood?

Yes

Email:

Suburb of Property:

State: *

Date of last major renovation:

If Vacated, please state the number of days:

Building Replacement Value $

CONSTRUCTION External Walls (e.g. Brick)

Floor (e.g. Concrete)

Year Built

On Acreage

Yes

Roof (e.g. Tile)

Building level of property

Safety Switch on Switchboard?

Yes

Double keyed deadlocks on doors:

Yes

Patio/bolts on all external sliding doors:

Yes

What is the weekly amount of rent for the Property?

Has a bond equivalent to 4 weeks rent been lodged with the appropriate state body?

Yes

In the last 5 years have you or anyone else proposing for this insurance been charged or convicted with any criminal offence?

Yes

In the last 5 years, have you made any claims under a landlords’ insurance policy?

Yes

Has your tenant or Property manager advised you that the tenant has lost their job or had their hours/income reduced by more than 20% as a result of Covid-19?

Yes

Have you ever had a claim for tenant default at the property to be insured?

Yes

Security screens on all external doors:

Yes

Keyed locks on all accessible windows:

Yes

Has a residential tenancy agreement for 3 month ormore been entered into?

Yes

Is rent currently in arrears or has rent been in arrears in the last 2 months?

Yes

Has any insurer ever declined to insure you or declined to renew a policy or imposed special items or conditions?

Yes

Please detail any total cost of claim(s), date of claim(s) and how the loss occurred:

Has the tenant been behind in their rental payments for more than 14 days in the last two months?

Yes

DECLARATION (a) If I/we are a managing agent, I/we are duly authorised to complete this application form on behalf of the applicant. (b) I/we declare that: • the answers and information given by me/us in this Application are true and correct in all respects; • no information has been withheld that would affect Eagle Protect’s decision to accept this Application; • where answers in this Application are not my/our own handwriting, they have been checked by me/us. (c) I/we have read and understood the clauses detailed under the important Notices section in the attached brochure. (d) If there was insufficient space to fully answer any questions, we have attached supplementary pages providing the additional information required. (e) I/we authorise EagleProtect to give to, or obtain from other insurers or an insurance or credit reference bureau, any information relating to these insurance covers, and any other insurances held by me/us and claims under those insurances. (f) I/we have received or downloaded from the internet the Financial Services Guide, Product Disclosure Statement and Policy Wording. (g) Before completing this Application form, I/we have read and understood the Financial Services Guide, Product Disclosure Statement and Policy Wording.

This advice has been prepared without taking into account your personal circumstances. Before you act on the ad vice you should consider the appropriateness of the policy coverage for your particular circumstances and you should read the Product Disclosure Statement before you make a decision.

Full Name (In Place of Signature) *

Todays Date *

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Eagle Protect Insurance Application Form.

Eagle Protect

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