Cyber Insurance

Any advice that may have been given is general advice only, please be aware that we have not taken into consideration your needs, objectives or financial requirements. Before deciding to purchase a financial product you should consider the appropriate Product Disclosure Statement to ensure the product is suitable for your needs.

Cyber Insurance Cover Limit Required

Postcode *

Occupation

Company *

Annual Revenue

Website

ABN

Please enter the full nature of the activities of your business *

State/s Business Conducted In

Any Cyber Insurance Claims in the last 5 years

Do you comply with your relevant PCI DSS obligations? *

Yes

No

Do you comply with The Privacy Act 1988 (Privacy Act)? *

Yes

No

Do you have firewalls protecting your own and customer/client data? *

Yes

No

Are you aware of any matters not disclosed above that is relevant to the underwriters consideration of this insurance.

Ever been declared bankrupt?
Ever been involved in a company or business which became insolvent or subject to any form of insolvency or voluntary administration (e.g. liquidation or receivership)?
Ever been convicted of any criminal offence (other than minor traffic convictions)? * *

If "Yes" please give details also supply details for underwriters consideration & Comments

Contacting you with your quotes

Your quotes will come from Ausure Protect Pty Ltd (ABN 46 630 269 957) an Authorised Representative (AR no 1285869) of Ausure Pty Ltd (ABN 94 096 971 854) AFSL 283433

First Name

Last Name *

Email *

Phone *

NSW	QLD	VIC	WA	SA
TAS	NT	ACT