QBE-CTP-insurance by sandeshbhat


									Choose QBE for your
CTP Insurance and support
Autism Queensland Inc.
 Nominate QBE NOW as your Compulsory Third Party (CTP) insurer and QBE will:

 P Make a $22.50 donation* for 12 month registration renewals to Autism Queensland Inc.

 P Issue you a free $1 million DriverProtect Cover*.

 Once we receive your form, we’ll register QBE as your nominated CTP insurer. Queensland Transport will record this information and
 when your renewal is paid, we’ll send your DriverProtect Certificate and pay Autism Queensland Inc. the donation.
 The DriverProtect policy offers you up to $1million worth of cover absolutely free of charge. This covers an at-fault driver for death or a
 range of permanent serious injuries.
 QBE will donate a further $10 to Autism Queensland Inc. every time you renew your CTP for 12 months or $5 for a 6 month renewal.
 * Free DriverProtect and donation are only available for Class 1 and 6 vehicles for customers aged 30 or over. $22.50 donation for a 12 month renewal or $10 donation for a
   6 month renewal. Not available with any other offer.

                                                                                                                     Compulsory Third Party
                                                                                                                Insurance Nomination Notice
 Simply complete this form to switch now or nominate QBE as your CTP insurer for your next rego renewal.
 For your convenience, you may return it to QBE using any of the following methods:
 1. Reply Paid (no postage required):                                   2. Facsimile: (07) 3031 8484
    QBE Insurance (Australia) Limited                                   3. Scan and email to: qldctp@qbe.com
    Reply Paid 1072,
    Brisbane QLD 4001
                                                                                                                                Autism Queensland Inc.
 Please check one option:
 For 12 months registration                                             For 6 months registration
     $22.50 Donation & DriverProtect Cover*                                  $10 Donation & DriverProtect Cover*

    Registered Operator’s Details
    Individual/s (if registered in joint names, only details of one operator required)

    Family Name/Business Name                                                            Given Name/s

    Driver Licence Number/Customer Reference Number                                      Date of Birth                  Phone Number
                                                                                                   /        /

    Vehicle Details
    Registration Number/s              Expiry Date         Make and Model (eg. Ford, Falcon)           Body Shape (eg. Sedan)                    Input Tax Credit - ITCE^
                                             /    /                                                                                                        Yes/No
                                             /    /                                                                                                        Yes/No

    I wish to nominate QBE Insurance as my CTP insurer to take effect from the start of the next registration renewal period.

    Registered Operator’s Signature                                                      Date                           Office Use Only
                                                                                                   /        /                              CTP0365

    NB If you’ve already received your vehicle registration renewal, call QBE on 1800 112 472 and we will explain how to transfer your CTP to us.
    A copy of QBE’s Privacy Policy is available from www.qbe.com.au or by calling us on 1800 112 472.

 * Terms and Conditions apply: DriverProtect Cover will only cover drivers 25 years and over and for vehicles classified as Class 1 (cars, 4WD’s and station wagons) and Class
 6 (utes, vans and trucks up to 4.5 tonne GVM) under Queensland Motor Accident Insurance Regulation 2004. For further information call us on 1800 112 472. A certificate of
 insurance for DriverProtect with terms and conditions will be sent to you if you qualify for cover. Insurance provided by QBE Insurance (Australia) Limited ABN 78003191035.
 ^ Note: Only GST registered businesses may be able to claim an ITCE – if unsure please contact your tax adviser.


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