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Graham Lyle Insurance

Property Claim Insurance Application

Your details

Insured Name

Policy Number(Required)

Have you paid your insurance premium for this claim?

Yes

No

Contact phone number(Required)

Email Address(Required)

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

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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Accepted file types: jpg, pdf, png, ttf, docs, Max. file size: 64 MB.

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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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Major Uninsured Risks

Contact

PO Box 84, Seaford VIC 3198
0492888740
[email protected]
Everyday 7am-7pm

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