Your details Policy number Policyholder first name Policyholder last name Mobile phone number Landline phone number Email address New residential address Address line 1 Address line 2 Town/Suburb State/Territory - Select -Australian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia Is your postal address the same as your residential address? Yes No Property details Property type - Select -HomeUnitStorage UnitOtherSingle unit Duplex Occupancy type - Select -Owner OccupiedTenant occupancyDHA TenantShared accommodationHoliday homeVacant good in storageFarm occupied *** If your goods are in storage we will require more information Land Exceeds 2 Hectares - Select -Yes - Please call us on 1300 552 662 No Connect to town water - None -YesNo Home Heritage listed - Select -YesNo Condition of Home - Select -GoodAverageNeeds repairs Approximate year of build External wall materials for new property Home security feature(s) installed Back to base Alarm Local Alarm Window Bars Deadlocks to doors High Security Window locks Fixed Safe Security Intercom Elevated Do you need to change your sum insured? Yes No Unsure Goods in storage If your goods are in storage, you must answer the following question for the underwriter to consider insuring you. Please provide us with as much information as possible so our friendly team can contact you to discuss your needs. We require the following information. Where are goods being stored Commercial Storage Facility Shipping Container Shed Room at Insureds tenanted property or at Friends/Relative place? Pod Please give us information on the address of the facility, how it’s been stored, security at the storage - we will need to contact you to get more information before referring the information to the underwriter. Additional information Privacy Privacy disclaimer The DSH Insurance privacy charter explains how we collect, handle and safeguard your personal information. To find out more about our privacy policy, you can visit the Insurance privacy policy Disclaimer Providing information in this form does not guarantee a change in your contract of insurance. We will be in contact with you to confirm your change of address as well as any other changes. Once we agree to the changes we will issue a new Policy Schedule and ask you for any additional premium, inform you of any change in terms and any additional applicable excess(es). If an additional premium is required, the change will only be effective when the additional premium has been paid.
