Vehicles & Coverage
Product selection & policy term
Insured Type
Individual Details
Company or Trustee Details
Insured Address
Primary Address
Street address (click the field below to search for an address) *
Vehicle details & coverage selection
Vehicle 1 details
Overnight parking address (click the field below to search for an address) *
Put TBA in case there is no registration number
Vehicle details
Is this vehicle used for? Select all that apply:
Vehicle Excess
Driver
| Firstname | Lastname | DOB | Main Driver | Occasional Driver |
|---|---|---|---|---|
| John | Doe | 10-10-2025 | 54 | - |
Please add driver information by clicking here
Declaration Questions
Commission
New Business Summary
| VEHICLES | BASE PREMIUM | EMERGENCY SERVICE LEVY | GST | STAMP DUTY | TOTAL |
|---|---|---|---|---|---|
| 50 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| TOTAL | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
(Total Payable includes commission of $0.00 and GST on commission $0.00)
Quote No
QM-0000063497-01
Policy Effective Date
15/10/2025
Policy Expiration Date
15/10/2026
Quote Status
Declined
Insured Name
Vinnie M Vinnie
Primary Address
1 TESTOLIN PLACE DOREEN VIC 3754
Transaction Type
New Business
New Business Summary
| VEHICLES | BASE PREMIUM | EMERGENCY SERVICE LEVY | GST | STAMP DUTY | TOTAL |
|---|---|---|---|---|---|
| 50 | $0.00 | ||||
| TOTAL | $0.00 | $0.00 | $0.00 |
