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Graham Lyle Insurance

Property Claim Insurance Application

Your details

Insured Name

Policy Number

Have you paid your insurance premium for this claim?

Yes

No

Contact phone number

Email Address

GST Details

Registered for GST?

Yes

No

Do you claim GST on your premiums paid?

Yes

No

If yes what % do your claim?

Do you claim GST on your claims?

Yes

No

If yes what % do your claim?

ABN Number:

Claim Details

Date of Loss

DD slash MM slash YYYY

Time of loss approx.

Where (address of incident)

Details of Event

Repairer Details if applicable

Invoice Amounts

EFT DETAILS

Name of Bank:

Account Name:

BSB Number:

Account Number:

Any further information or queries you have?

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Graham Lyle Insurance has 20 years of Insurance industry experience working within National and International Insurance Brokerages .

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Contact

PO Box 2066 Corinella VIC 3984
0492888740
admin@grahamlyleinsurance.com.au
Everyday 7am-7pm

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