1. General Information
DECLARATION TO CLAIM THE NSW DUTIES ACT 1997 SMALL BUSINESS STAMP DUTY EXEMPTION:
This declaration covers policies effected or renewed during the year ended 30 June 2019. You are a small business for the current year if you carried on a business in the previous year and your aggregated turnover for that previous year was less than $2million and/or your aggregated turnover for the current year is likely to be less than $2million. For more information, visit www.revenue.nsw.gov.au/taxes/insurance/exemptions
To claim NSW Stamp Duty Exemption agree to declaration below.
2. Claims History
3. Building Details
FIRE SAFETY & SECURITY
4. Contractors/Labour Hire Details
5. Nominated Sums Insured
BUSINESS INTERRUPTION - (Complete Gross Profit or Income. Gross Rentals is optional
LIABILITY & CORPORATE TRAVEL OPTIONS
6. Disclosure Statement
Has any owner/director or officer of the business:
Additional Documents & Comments
Accepted file types: jpg, gif, png, pdf, Max. file size: 2 MB.
Drop files here or
Time Stamp 10/06/2023
User IP Stamp 188.8.131.52
Please don't close the browser after clicking SUBMIT.
The form may take several minutes to process.