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 *

I have read and understood AIA Australia’s privacy policy. I acknowledge and consent to the collection, use and disclosure of my personal information as detailed in the privacy policy.

Please agree with above statements

Complaints and Significant Dealings

Contact Details

Company Details

Event Details

Entity Details

Significant dealings information

Size of dealing

#,#