BUSINESS INFORMATION FOR PRE-ELIGIBILITY (Other Trades - Excluding builders)

Please fill out the form below. No guarantees are needed, and in most cases you will not be asked to provide financial information. Your application can be completed in just a few minutes and your eligibility confirmed usually within five working days.


1. a) Registered Business Name
    b)Business Type    
2. Trading Name (if applicable)  

* A copy of the Certificate of Business Registration for the Trading Name must be provided

3. Date Business Commenced
4. ABN Number    
5. Contractors Licence Number(s)
IMPORTANT: The name on your ABN Certificate, your company name and the name on your Licence(s) must be in the same name
6. Name of Contact
   Postal Address Post
   Phone (home)
   Phone(mobile)
   Fax
   Email
7. Are you a member of a Trade Association?
   If "Yes", please name Association
  Membership Number
8. Has any director, proprietor, principal, trustee, major shareholder or manager of your business:
a) Ever been involved with a business placed into external administration,
a scheme of arrangement, liquidation, provisional liquidation or receivership?
 
b) Ever been declared bankrupt, entered into a deed of assignment,
composition, scheme of arrangement with creditors, or been subject to
a legal judgement or currently have legal proceedings pending?
 
c) Anything you should tell us that could affect your financial position, capital structure or operations of your business of a material nature in the next 12-months?
 
d) Ever had a contractor's licence/registration refused, cancelled or
suspended in any state or territory in Australia?
 
e) Ever been refused Home Warranty Insurance?
 
f) Ever had a claim made against them or is aware of any circumstance
that may give rise to a claim against them for Home Warranty Insurance?
 
g) Ever had a penalty imposed on the by a court or Tribunal in relation
to residential home building?
 
h) Or any related parties or businesses, given any form of security to another
Home Warranty Insurer (eg. Deed of Indemnity/Assurance,
Bank Guarantee, Personal Guarantee or similar document?
 
i) Have you had a public Liability Claim in the past 5 years?
 
j) Do you currently hold a Letter of Eligibility for
Home Warranty Insurance with any other insurer?
 
9. Expiry date of your Public Liability Insurance
10. Total Number of:
   a) Working Proprietors
   b) Employees
   c) Subcontractors (average engaged at any one time)

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