26 April, 2011

Dear

STATEMENT OF ADVICE (“SOA”) Our Reference:

Thank you for giving me the opportunity to provide you with advice on your insurance requirements. Your adviser is .

When you deal with us as a Retail Client and we give You Personal Advice, you will either receive an SOA or we will provide income and relationship information on the relevant invoice. Personal Advice is advice that takes into account any one or more of your objectives, financial situation or needs. This SOA is designed to assist you in making an informed decision about whether or not to act on our advice.

RECOMMENDATION

I have assessed your requirements below against the products on our Approved Product Listing and recommend the product and coverage as detailed on the attached invoice/quotation that forms part of this SOA.

The reasons for our recommendation include:

One of our Approved Insurers & Products / Industry standard excess structureLow excess structure
Fast policy issue and administrationElectronic delivery of policy documentation / Speedy and simple claims serviceClaims handled locallyPaperless claims handling system
Breadth of Policy coverage & benefitsIBNA coverage enhancementsSteadfast coverage enhancements / Cover provided matches your requirementCover provided is best match available
Lowest cost option availableSpecialist insurer for this type of coverOnly insurer willing to provide cover required / Financial strength of insurerSpecialist insurer for this type of product

IS THIS ADVICE APPROPRIATE FOR YOU?

This advice is based on information I have obtained from you. Please check that the information you have given me is accurate and correct. If it is not, this advice may be based on inaccurate or incomplete information. Before acting on this advice you should consider its appropriateness, relevant to your personal circumstances.

IMPORTANT NOTES

If you are a new client you should also receive a Financial Services Guide (FSG) as part of the documentation being provided to you. If this advice recommends the purchase of a new product you should also receive a Product Disclosure Statement (PDS). Both the FSG and PDS are important documents that I recommend you read and understand, prior to acting upon any recommendation. Please advise me if you have not received both of these important documents or if you have any questions about them.

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INFORMATION PROVIDED

Detailed below is information on your needs, situation and circumstances that I have based my recommendation on.

Home Issues / Requirement
Insured D.O.B.
Age of Dwelling / Years old Rewired in
Use of premises / Insured's usual residencePart time residenceTenanted premisesBed and BreakfastHoliday homeUnoccupied Not unoccupied more than 60 daysMay be unoccupied for more than 60 days
Construction of building / Brick veneerDouble BrickConcreteWeatherboardFibro CementOtherMixed
Security / No BarsBars No alarmLocal AlarmMonitored Alarm No window locksSome window locksKeyed window locks Deadlocks on all exernal doors
Coverage type / Defined events only - Basic CoverDefined events plus Personal PropertyAccidental damage - broad cover
Home Office Exposure / Not ApplicableYes -
Reason for Advice / New PurchaseCurrent insurance expiringLooking to change insurer mid termRealised items were not insuredUnhappy with current broker/insurer
Art/Valuables/Jewellery / No specific exposuresSpecific coverage required
Other Insurance’s
Other issues
Cover Requirement / Provided / Cover Requirement / Provided
Rent default / Not ApplicableNot availableNoYesRefer comments below / Flood / Not provided
Damage by tenants / Not ApplicableNot availableNoYesRefer comments below / Domestic Workers / Not ApplicableNoYes - 1 staffYes - More than 1 staffRefer comments below
Unoccupancy period / Less than 60 daysMore than 60 days / Cover whilst away / Not ApplicableNoYes - Aust WideYes - WorldwideRefer comments below
Motor Issues / Requirement
Young/inexperienced drivers / No drivers U25 or licensed less than 2 years
Nominated driver option / Cover is not to be restricted to nominated driversCover is to be restricted to nominated drivers -
Use of vehicle / Purely private use, no commercial/business use.Mainly private use with some business use50/50 private/business useMainly business use
No Claim Bonus Cover / Not an issuePreferred if availableMust be included
Vehicle modifications / No modifications at allModifcations have been made -
Vehicle security / No alarmAlarm - Lights onlyAlarm - Horn onlyAlarm - Lights and horn No immobiliserFactory fitted immobiliserAfter market immobiliser
Garaging details / Parked on streetParked in carportParked in locked garage
Coverage type / ComprehensiveThird Party OnlyThird Party Fire & Theft
Settlement basis required / Market ValueAgreed ValueSettlement basis not an issueNot Applicable
Choice of repairer / Not an issueMust provide for choice
Specified items / No specific exposuresSpecific coverage required
Reason for Advice / New PurchaseCurrent insurance expiringLooking to change insurer mid termRealised items were not insuredUnhappy with current broker/insurer
Other Insurance’s
Other issues
Travel Issues / Requirement
Destination/Itinerary / Within AustraliaOverseas - Europe/AmericaOverseas - AsiaOverseas - Developing countries
Period of trip / days
People to be covered / IndividualCoupleFamily (Children Under 21 Years of age) (No cover over 70 years of age)
Baggage/document cover / Not an issuePreferred if availableMust be included
Cancellation cover / Not an issuePreferred if availableMust be included
Death cover / Not an issuePreferred if availableMust be included
Disability cover / Not an issuePreferred if availableMust be included
Income cover / Not an issuePreferred if availableMust be included
Liability cover / Not an issuePreferred if availableMust be included
Overseas medical/dental and additional expenses / Not an issuePreferred if availableMust be included
Resume Travel cover / Not an issuePreferred if availableMust be included
Return of Hire car and Excess Waiver / Not an issuePreferred if availableMust be included
Pre existing illnesses / NilYes -
Other Insurance’s
Other issues
Personal Accident Issues / Requirement
Your Age
Your Occupation / Managerial/ClericalSales/marketingFactory workTradesmanOther -
Current Earnings (p.a.) / $
Financial commitments
Pre existing illnesses/conditions / NilYes -
Guaranteed renewal / Not an issuePreferred if availableMust be included
Death by accident / Not an issuePreferred if availableMust be included
Loss of income – Illness / Not an issuePreferred if availableMust be included
Loss of income – accident / Not an issuePreferred if availableMust be included
Period of income protection required / Not an issuePreferred if availableMust be included
Excess/Franchise options / Not an issuePreferred if availableMust be included
Loss of limb cover / Not an issuePreferred if availableMust be included
Loss of use of limb cover / Not an issuePreferred if availableMust be included
Reason for Advice / New PurchaseCurrent insurance expiringLooking to change insurer mid termRealised items were not insuredUnhappy with current broker/insurer
Other Insurance’s / No Workers Compensation CoverWorkers Compensation No superannuation insurance coverSuperannuation Death CoverSuperannuation Death & Disability cover No Life Insurance CoverLife Insurance - Death CoverLife Insurance - Death and Disability coverLife Insurance - Critical Injury/Trauma cover No other coversOther covers - Personal Accident covers
Other issues
Pleasurecraft Issues / Requirement
Boat Type / Half Cabin CruiserCanoeKayakDinghyCruiserHouseboatRunaboutSail BoardSki BoardJetskiYacht - Single HullYacht - Multi Hull
Storage / TrailedMooredDry Storage
Boat usage / Private/Pleasure onlyPrivate and business/commercial/other
Horsepower & Speed / HP Knots
General Liability Cover / Not an issuePreferred if availableMust be included
Skiers Liability Cover / Not an issuePreferred if availableMust be included
Cover whilst racing / Not an issuePreferred if availableMust be included (sailboats only)
Trailer cover / Not an issuePreferred if availableMust be included
Boat accessories / Not an issuePreferred if availableMust be included
Boat Contents / Not an issuePreferred if availableMust be included
Specified items / No specific exposuresSpecific coverage required
Reason for Advice / New PurchaseCurrent insurance expiringLooking to change insurer mid termRealised items were not insuredUnhappy with current broker/insurer
Other Insurance’s
Other issues

REMUNERATION of Licensee (Before GST)

The insurer will pay the licensee $ 0.00 commission, calculated as % of $ (Premium before charges) should you accept this recommendation. This is not an additional payment required by you over and above the quoted premium. The licensee also charges a Broker Fee of $. .

REMUNERATION of Authorised Representative (Before GST)

I will receive a payment from the Licensee for arranging this insurance. The amount I receive is % .

APPROVED PRODUCT LIST

We only recommend products on our Approved product list. This means that we have only looked at products on that list we prepared your advice. The list is put together by our senior management and is regularly reviewed.

COOLING OFF

Even after you have paid for the products recommended you might be able to get your money back if you are not happy. Generally you can do this within 14 days of buying the product. The PDS has more information on this.

ADVICE TIME LIMIT

This advice is only valid for 30 days from the date of this SOA. You should not rely on this advice after that time if you haven’t acted on it by then.

TAX

We are not tax advisers. You may be entitled to a tax deduction for the premiums paid on this insurance. We suggest you seek separate advice on this matter.

Should you have any queries regarding the above please do not hesitate to contact us.

Regards

Name of Authorised Representative and AR No.

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