Cancellation/no Longer Managed Form printable pdf download

Cancellation/No longer Managed form

Date: ...............................................................

Real Estate Agent:

.......................................................................................................................

Property Manager:

.......................................................................................................................

Landlord Name(s): ..........................................................................................................................

Insured Property Address: ............................................................................................................

..........................................................................................................................................................

Landlord postal address: ...............................................................................................................

Landlord contact number/email: ...................................................................................................

☐ Landlord Preferred ☐ Scheer Short Stay

☐ Building Insurance

Policy Type:

(please select)

Please choose one of the following options;

☐ The property is no longer managed by our office;

New managing agent is: .............................................................................................................

☐ Cancel the policy effective from (DD/MM/YY) :

Reason:

(please select)

☐

☐ Owner Occupied

☐ Self Managed

Property Sold

☐

☐ Other

…………………………………………

Insured Elsewhere

(provide details):

☐ Real Estate Agent

☐ Direct to Landlord

Refund to be sent to:

Please provide the bank account details for the refund;

BSB number: …….............................................

Account number:……………………………….

Account name: ………………………………….

Please ensure all sections have been completed and email to

.au

Version: BRM605(12/2015)

Cancellation/no Longer Managed Form

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