Audit Fee Insurance

Thank you for considering our on-line audit fee insurance service. This policy covers professional fees incurred when you are exposed to a statutory audit or investigation  Because Greater National Group is an insurance broker, not an insurance company, we will process your application with major insurance companies in order to find the right deal for you.

Please fill in the following form as fully as possible, then click 'submit' at the end of the form.
You can use the TAB key to move to the next field. We will respond with your terms as soon as we have researched the market for the right available deals that fit your requirements.

1. Select the type organisation and level of cover from the list below:
Organisation Type What annual audit fee limit would you prefer?
A. Individual - for the nominated individual, their spouse or partner and any passive trust or superfund
$5,000 $10,000
B. Self employed - for the self employed person, their trading entity, their spouse or partner and any trust or superfund.
$10,000 $15,000
C. Business - for all operating entities under common majority ownership including any trusts or superfund.
$15,000 $25,000 $50,000
2. Available Quotations:
Audit Insurance Only
i.e., Covers professional fees incurred to respond to an audit undertaken by a State or Commonwealth Government agency on a lodged return.
Audit Insurance & Legal Defence Insurance
i.e., Section 1. of the policy covers professional fees incurred to respond to an audit undertaken by a State or Commonwealth Government agency on a lodged return and Section 2. covers legal costs incurred to defend any legal proceedings taken against you that arises from a commercial dispute (doesn't cover legal disputes of a family nature such as divorce, estates, etc.).
3. Individual or Entity Name 1:
Name 2:
Name 3:
4. Combined Annual Turnover A$:
5. Accountant firm's name:
6. Financial Year (if not 1st July-30th June indicate period):
7. Would you prefer to: pay a premium for the current year only or
pay a higher premium to include the previous year or
pay an even higher premium to include previous 2 years

Duty of Disclosure:
Are you aware of any matters not disclosed above that is relevant to the underwriter's consideration of this insurance?
Yes No
If so, please provide details:
I/We hereby declare that:
My/Our attention has been drawn to the Important Notices accompanying this form and further I/we have read these notices carefully and acknowledge my/our understanding of their content. The above statements are true, and I/we have not suppressed or mis-stated any facts and should any information given by me/us alter between the date of this form and the inception date of the insurance to which this relates I/we shall give immediate notice thereof. I/We authorise GNG and the Insurer to collect or disclose any personal information about another individual (for example, an employee, or client), I/we declare that the individual has been or will be made aware of that fact and the Privacy Policy. I/We also confirm that I/we am/are authorised to act for and on behalf of all persons who may be entitled to indemnity under any policy which may be issued pursuant to this form and I/we complete this form on their behalf.
Any other comments, requests or relevant information you need to add:
Contacting you about your quote:
In order to select the most appropriate cover for you, it may be important to discuss quote details in person. Please leave a contact phone number and best time to call to facilitate this.
Your full name:
Company/Business/Name of Applicant to be Insured:
Your phone number (please include area code):
Your mobile phone number:
Best time(s) to call:
Please send my quote by (select at least one):
email phone fax mail
Your email address:
Your website address:
Your fax number:
Your postal address: