Rentsure | Apply now form
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Apply now form

Online Application Form
Please fill in the form below to apply for instant cover. Cost: $353.34 per tenancy (incl GST).

    Full Name

    Email Address

    Postal Address

    Contact Phone Number

    Addtional Phone Number (optional)

    Date insurance is to start

    Properties to insure

    Properties to be Insured

    Address of Property

    Property Questions

    Are the properties in a sound condition? yesno

    Do you have current insurance for your properties? yesno

    Are the tenants' bonds registered with Tenancy Services? yesno

    If you have answered 'No' to any of these please give full details.

    General Questions

    Each question must be answered on behalf of You ( the person applying for this insurance) and also any other person
    who may be covered under the insurance which is being applied for.

    Have you claimed on any type of insurance in the past 5 years? yesno

    Has any Insurance Company ever refused to insure you? yesno

    Has any Insurance Company ever cancelled, refused to renew or imposed special conditions on insurance held by you? yesno

    Have you ever been found guilty of a criminal offence or is any prosecution pending?(excluding parking or speeding offences) yesno

    Has there been any damage by tenants (whether insured or not) in the past 5 years? yesno

    Have you had any problems with your current tenants? yesno

    Is there any other information likely to affect the acceptance of this application? yesno

    If you have answered 'Yes to any of these please give full details.

    I accept the Terms and Conditions

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