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Renewal Declaration Form
Are you based in New South Wales?
Has your business activities changed from what previously advised and noted in your paperwork
Will the turnover be over $2,000,000 for next 12 months
Have you changed your address?
Do you use any Subcontractors ?
How many staff do you have (including yourself)
Have your business contents, stock or fitout value changed
NSW Stamp Duty Exemption – Small Business Declaration

This declaration covers policies effected or renewed during the year ended 30 June 2024.

I hereby declare that I am a Capital Gains Tax small business entity (within the meaning of section 152-10(1AA) of the Income Tax Assessment Act 1997 of the Commonwealth).

I am a small business individual / partnership/ company and/ or trust, which is carrying on a business, and the business has an aggregated turnover of less than $2 million*.

Aggregated turnover is your Australia wide annual turnover plus the annual turnovers of any business entities that are your affiliates or are connected with you.

A fraudulent declaration may invalidate your insurance contract.

The following questions relate to any director, partner or manager.
Been declared bankrupt or put into receivership or liquidation?
Been charged with or convicted of a criminal offence?
You are the listed insured, or authorised by the listed insured to organise insurance on their behalf.
If there is more than one insured, you are authorised to organise insurance on their behalf, and that if you disclosed personal information about any insured person or any other person, you have made them or will make them aware that you have provided their personal information to us and the types of third parties we may provide it to, the relevant purposes we and third parties will use it for, and how the insured person or other person can access it:
The disclosed information is true and correct:
You have not withheld or supressed any information concerning the details of this application:
You have read the above duty of disclosure and are aware that should you not fully and truthfully disclose all relevant information, an insurer may decline a claim or void a policy
You consent that any personal information you provide to Insurance HQ will be collected, stored, used and disclosed in accordance with our Privacy Policy/Financial Services Guide. We may provide your information to insurance companies and other intermediaries in order to provide insurance quotes and offer insurance terms to you or the companies that deal with your insurance claim (such as loss assessors and claims staff).