First Name *

Surname *

Email Address *

Mobile Phone *

Street Address

Suburb

State

Postcode

I Represent The *

Address of Property *

Suburb of Property *

Postcode of Property *

Owners Corporation Number *

Number of Units / Apartments *

Number of Levels *

Primary Usage *

Current Management

Existing Strata Insurance?

If Yes, Currently Insured With

Insurance Renewal Month

Building Replacement Value ($)

Primary Building Material

Foundation Material

Roofing Material

Public Liability Level

Does the property have a Lift?

Yes No

Does the property have an Underground Car Park?

Yes No

Does the property have Car Stackers?

Yes No

Loss of Rent / Temporary Accommodation

Yes No

Fidelity Guarantee

Yes No

Lot Owners Fixtures and Improvement

Yes No

Voluntary Workers

Yes No

Office Bearers Legal Liability

Yes No

Further Comments

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