NSW Stamp Duty Small Business Declaration

Name
N/A

Required First Required Last
Date Signed
N/A

dd/MM/yyyy
Name of Insured (if different from above) *
N/A
Policy Number *
N/A
Email address (so we can send you a copy of the Declaration) *
N/A
Phone Number *
N/A

e.g. 02 1234 5678 or 0411 222 333
At the time that the contract of insurance is effected or renewed (as applicable), I am/will be a small business as defined in section 259A of the Duties Act 1997 (NSW) (the Act) for the purposes of the small business exemption in section 259B of the Act.
N/A

I Declare the above as the Relevant Person or if not the Relevant Person, on their behalf. * I Declare the above as the Relevant Person or if not the Relevant Person, on their behalf. Required

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