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Renewal Declaration Professional Indemnity
Do you require your insurance renewed?
Yes, I need to renew my insurance
No, I no longer require my insurance
Are you based in NSW and your turnover is less then $2 million
Company or trading name
Estimated Fees For The Next 12 Months
Please note an increased turnover will generally increase the premium.
Estimated Payments to Sub-Contractors For The Next 12 Months
Number of employees (including yourself)
Have your or do you expect your occupational activities to change from the occupation description noted in your current insurance schedule and/or have you changed your business name or structure with ASIC?
In the last 5 years have you had any criminal convictions, been bankrupt, do you have any unreported claims or incidences that you may claim against, had any insurance declined or variations imposed or anything else that may affect your insurance that we should disclose to the underwriters?
Do you require quotes or further information on these insurance products?
Management Liability (OH&S, Fairwork, ATO, ACCC & ASIC Investigation and legal costs cover)
Home & Contents Insurance
Life or Income Protection Insurance
Cyber Liability (Cover against hacking and being held to ransom by Cyber criminals)
Other (Please describe Below)
Additional Quotes Not Required
Amount of tools cover required
We offer finance broking as one of our services. Do you require pricing on any loans or finance?
What type of finance do you require?
Truck and Commercial Vehicle Finance
Boat or Jet Ski Finance
Caravan, Camper, Motorhome or RV Finance
I Require Other Finance That Is Not Listed
GUIDELINES TO SIGNING THE NSW STAMP DUTY EXEMPTION - SMALL BUSINESS DECLARATION What is the NSW small business exemption? From 1 January 2018, NSW small businesses will be exempt from paying stamp duty on certain types of insurance. What is a small business? Revenue NSW has stated that: “You are a small business if you are an individual, partnership, company or trust that is carrying on a business, and the business has an aggregated turnover of less than $2 million. Aggregated turnover is your annual turnover plus the annual turnovers of any business entities that are your affiliates or are connected with you.” Which insurance types will the exemption apply to? This exemption can be applied for NSW small businesses with one the following insurance types: • Commercial vehicle insurance • Commercial aviation insurance • Occupational indemnity insurance • Product and public liability insurance Instructions for applying for an exemption To receive the exemption, please complete this declaration declaring that you / your client are a small business. Email the completed declaration to firstname.lastname@example.org. Please note: [a] This declaration covers all policies issued to you during the financial year ended 30 June 2021. [b] If you are uncertain whether you classify as a small business, please speak to your financial adviser. [c] Brooklyn Underwriting will place reliance on your declaration in charging the applicable insurance duty. [d] False declarations may result in penalties up to of $11,000 by Revenue NSW plus the insurance duty not paid and penal interest on that balance. [e] Revenue NSW may also be able to clarify your queries relating to the law and your obligations. [f] If you are a not for profit organisation already entitled to a NSW Stamp Duty Exemption, your premium is already exempt and the NSW Stamp Duty Exemption for Small Business is not relevant.
I earn under $2 million p.a. and qualify to have my stamp duty removed
I do not qualify for this exemption