This declaration covers policies effected or renewed during the year ended 30 June 2024.
I declare that at the time the above policies are effected or renewed, I am/will be a “small business” as defined in section 259A of the Duties Act 1997 (NSW)
I have read and understand the Guidance provided above with this Declaration and do not have any questions
Insured Name:
ABN:
I declare the above as the Insured or if not the Insured, do so with the authorisation of the Insured to declare on their behalf.
Print Name:
Contact Number:
Email:
Signed,
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