Letter of Appointment

Name

Date of Appointment

Address

To Whom It May Concern,

AUTHORITY TO REVIEW AND QUOTE

Effective Date

I authorise the current and former insurers of

to provide All Star Brokers Pty Ltd with all information (other than premium information) which they request regarding the following insurances and claims history in respect of those insurances over the past 5 years:

Policy #1

Policy Number

Expiry Date

Insured Name

Policy #2

Policy Number

Expiry Date

Insured Name

Policy #3

Policy Number

Expiry Date

Insured Name

This authority is provided to enable All Star Brokers Pty Ltd to review and quote for our insurances. It does not appoint them as our insurance broker.

Whilst this Letter of Authority is not on any letterhead, I attest to its authenticity and intent in my capacity as

Director Financial Controller Owner

Yours faithfully,
(Please sign below before submitting)

Print Name

For Business

For Personal

For Industry

Letter of Appointment