Form – Munro

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Your Details

First Name *

Last Name *

Email Address *

Phone Number *

Relation to the Property

Owner
Property Manager
Other

Property Details

Community / Strata Corporation Number

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Claim Details

Date of Incident *

Insurable Event (Break-in, Storm Damage, Impact Damage etc.) *

Details of the Loss *

Was there any Witnesses to Loss, Theft or Damage *

If YES, please provide details

Have the Police been notified? *

If YES, please provide details

If known, please provide details of the responsible party for the damage

Repair Details

Has a repair been made? *

If YES, please provide details

Is the repair an emergency?

Should an emergency repair be required after hours then you need to call our office phone number 8132 2000

Important Notice And Declaration

I hereby declare the above statements and particulars to be true and correct and I make this declaration on the basis that I have delegation of power to sign for and on the behalf of the Insured.The completion of this application is a form of electronic signature and it has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding. *

I Accept
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Insurance Claim

Your Details

Property Details

Claim Details

Repair Details