Complaints and Significant Dealings

Contact Details

First name *

Last name *

Email Address *

Phone number *

Job Title

Company Details

Company name *

Street address *

Suburb *

Postcode *

Event Details

When did this significant dealing occur? *

Please enter a valid event date

Is there an existing reported dealing for this significant dealing? *

Yes

Reported dealing number *

If this significant dealing has ended, when did it end? (Optional)

Which TMD(s) does this significant dealing relates to? *

0/500

Entity Details

Entity name *

What is your unique identifier (e.g. AFSL, FAR, ABN) of distributor*? *

Report on multiple entities? *

Yes

Name of entities *

0/500

Significant dealings information

Please describe the circumstances of the significant dealing. *

0/500

Please describe how the nature and extent the dealing is inconsistent with the TMD? *

0/500

Size of dealing

The value of this specific event. Should be a sum insured for life, TPD, and crisis and/or a monthly benefit for IP. For S&I the initial amount invested. For change in future strategy (e.g. set up for future contributions) the value could be $0.

$ Value *

Number of customers *

Number of policies *

Complaints and Significant Dealings

Contact Details

Company Details

Event Details

Entity Details

Significant dealings information

Size of dealing

#,#