Landlords Insurance Application Form I am answering the following questions and signing this Declaration for myself and on behalf of any other person (as the property owners) to be covered by the Rental Protection Plus PDS and Policy. I have not been charged with, or convicted of, any criminal offences within the last 10 years (please note you do not have to disclose any spent convictions legislation exempts you from disclosing). I have not had any insurer refuse, cancel cover or require special terms to insure me. I have not suffered more than 3 losses (including claims made against me) under a policy. I have not had a burglary or theft loss exceeding $2000 (whether claimed or not under a policy) in the last 5 years. I am not aware of any rent being in arrears for the property in the last 4 week period. I do not use the property for business purposes other than as a residential rental property. I am not aware of there being any current threat of fire, hail or a named cyclone to the property or the property having suffered earthquake damage in the last 3 days. I understand that there is no cover where the property is unoccupied for longer than 60 days. I have read, understood and accepted the terms of the Important Notices in this application. I understand that no insurance contract is entered into until the insurer sends written confirmation to me or my nominated agent confirming they have accepted this application. The policy when entered into will be subject to the terms of the Rental Protection Plus PDS and Policy and other documents issued by the insurer that make up the policy. I authorise the real estate agent noted above (who is acting on my behalf) to transfer the information in this form to Aon and the Insurer for the purposes of applying for this policy. I declare the information provided is true and correct and I have not withheld any relevant information. I have read and acknowledge receipt of the Aon Financial Service Guide and Rental Protection Plus PDS and Policy (through my real estate agent noted above) and agree to the insurance subject to the terms, conditions, exclusions and limitations of the PDS and Policy. : OWNER DETAILSOwner Name: Owner Street address: Owner Suburb: Owner State: Owner Postcode: REAL ESTATE AGENCY DETAILSAgent’s Name: Managing Agent's Name: Agent Street address: Agent Suburb: Agent State: Agent Postcode: Agent member number (for Real Estate Agents only): Phone number (please include area code eg. 02 8888 8888): Mobile number: Email address: CORRESPONDENCECorrespondence and enquiries should be directed to: OwnerAgent PROPERTY DETAILSThis policy does not provide cover for properties located in WA above the 26th parallel.: Street address: Suburb: State: -- Please select -- ACT NSW NT QLD SA TAS VIC WA Postcode: Type of building: -- Please select -- Free standing house Townhouse / Villa / Duplex Unit / Flat Semi Detached House Retirement Village Unit Terrace What are the external walls constructed from?: -- Please select -- Aluminium Siding / Cladding Brick Concrete / Masonry block Fibro Iron Steel Stone Weatherboard Wood / Timber How old is the property?: -- Please select -- New 1-20 years 21-30 years 31-40 years 41-50 years Over 50 years PREMIUMThe premium payable for this insurance is: View Advantage Premiums: Commencement date (dd/mm/yyyy). Please note: The date cannot be more than 90 days in advance.: DECLARATIONBy ticking the box you acknowledge confirmation of all of the matters in the Declaration on behalf of yourself or the owner of the property.: I acknowledge confirmation of all of the matters in the Declaration on behalf of myself or the owner of the property. PRIVACYAon is committed to protecting your personal information in accordance with the Australian Privacy Principles under the Privacy Act 1988 (Cth). We collect, use and disclose personal information to offer, promote, provide, manage and administer the many financial services and products we and our group of companies are involved in as set out in the Aon Privacy Notice.If you are disclosing personal or sensitive information about any other person to Aon, you confirm that you have obtained the consent of that person to disclose to Aon their personal or sensitive information and you have made them aware that Aon will or may disclose their information to third parties that are reasonably necessary to assist in the provision of the relevant services or products. If you have not obtained consent from this other person to disclose their personal or sensitive information to Aon, you will inform us before providing the relevant information to us.By submitting this form, you acknowledge that you have read the Aon Privacy Notice and agree that we can handle any personal information you have provided to us in the manner set out above.: : I agree that Aon or any of its group of companies may be in touch by any means (including SMS or email) to let me know about their goods, services or promotions, that may be of interest to you.