Letter of Appointment

Name

Date of Appointment

Address

To Whom It May Concern,

Letter of Appointment

Effective Date

I appoint All Star Brokers Pty Ltd as our insurance broker to manage all of the following insurance requirements for

Policy #1

Policy Number

Expiry Date

Insured Name

Policy #2

Policy Number

Expiry Date

Insured Name

Policy #3

Policy Number

Expiry Date

Insured Name

I authorise the current insurers of

to provide All Star Brokers Pty Ltd with all information which they request regarding the insurances. This appointment replaces any existing appointment in place between

and any other insurance broker. Whilst this letter of appointment is not on any letterhead, I attest to its authenticity and intent in my capacity as a(n)

Director Financial Controller Owner

Yours faithfully,
(Please sign below before submitting)

Print Name

For Business

For Personal

For Industry

Letter of Appointment