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PAY AN INVOICE | 1300 768 420

Delivering Website Development, Apps & Digital Services

The go-to production company for the insurance industry. Website Development for insurance and financial services companies. Call us on 1300 768 420.

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- - - Design & Development
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      An inbound digital marketing strategy will drive website traffic, improve lead volumes and deliver conversion rates with a higher return on investment.
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      Find out more about how Bark Productions can work with your company. Fill in a Call Back Request for our undivided attention. Can’t wait? Live chat or call us on 1300 768 420.
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  - - Contact info
      Brisbane Office
      Milton, QLD 4064
      Phone: 1300 768 420
      Email: info@barkproductions.net.au

Burglary Theft Money Insurance Claim

Full Name*
First Last
Email*
Address*
Street Address
Bus Phone
Private Phone
Fax No.
Occupation/Bus/Industry/Trade
Name any other interested party
How interested
Address
Street Address
Policy Number
Due Date
Is there any other Insurance in force which would cover this in whole or part?*
- Yes
- No
Please advise
Insurer’s Name
Policy Details
What is your Australian Business Number (ABN)?
Are you registered for GST?*
- Yes
- No
To what extent are you entitled to claim an Input Tax Credit on the GST applicable to the premium? (%)
Details of Loss Damage Or Occurrence
Date of Loss / Damage / or Occurrence
Date Format: MM slash DD slash YYYY
Time
When was it reported to you (if applicable)?
Date Format: MM slash DD slash YYYY
Time
Place and/or premises where it occurred
Please state full details of how loss/damage/or accident occurred
Please describe nature of damage or injury
Where was entry gained into the premises?
How was entry gained into the premises?
Are there any signs of forced entry?*
- Yes
- No
Please give details.
Time
Police Station
Officers name
Police Report No.
Has the loss been advertised?*
- Yes
- No
Give Particulars and send a copy of the advertisement.
When was the property last seen by you?
At the time if the loss, how long had the premises been unoccupied?
For money losses – where on premises, was the money taken?
In your opinion was any other person(s) responsible for loss or damage or cause of the Occurrence?
- Yes
- No
Name
First Last
Address
Street Address
Bus Phone
Private Phone
Fax No.
Reasons
Was there a witness or witnesses to this event?*
- Yes
- No
Details
Name of Witnesses
Witnesses’ Address
Street Address
Bus Phone
Private Phone
Fax No.
Description of property loss or damage
Description 1
Description
Sum Claimed $
Date of Purchase
From whom purchased
Purchase Price $
Replacement Value $
Input Tax Credit %*
*Please show the Input Tax Credit you are entitled to claim on the purchase of each item as a percentage of the total GST payable.
Total amount claimed $
Description 2
Description
Sum Claimed $
Date of purchase
From whom purchased
Purchase Price $
Replacement Value $
Input Tax Credit %*
*Please show the Input Tax Credit you are entitled to claim on the purchase of each item as a percentage of the total GST payable.
Total amount claimed $
Description 3
Description
Sum Claimed $
Date of purchase
From whom purchased
Purchase Price $
Replacement Value $
Input Tax Credit %*
*Please show the Input Tax Credit you are entitled to claim on the purchase of each item as a percentage of the total GST payable.
Total amount claimed $
Insurance History
Have you ever previously sustained loss/damage or caused damage or injury to 3rd parties
- Yes
- No
Give details of such losses and amounts involved.
Was an Insurance Company involved?
- Yes
- No
Please state name of company and year of claim.
Have you been convicted of or had any fines or penalties imposed for any criminal offences in the last 10 years?
- Yes
- No
Please provide details.
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A little about us…

Production services with flair for the Insurance industry. Web, app, print, design, copy… anything to do with building your brand and marketing your Insurance business. We know your industry, but we know ours better.
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Our Sevices

Digital / Web
EDM – Email Marketing
Landing Pages
Website Development
Support Services
Google Ads
SEO
Google My Business
Company Linkedin Profile
Design / Print
Brokerapps
Inbound Marketing

Contact info

Our Location

Brisbane Office
Milton, QLD 4064

Phone: 1300 768 420
Email: info@barkproductions.net.au

Opening Hours

Mon to Fri: 08:30 – 5:30

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