• Letter of Appointment

  • To Whom It May Concern,   

    This letter confirms the appointment of {brokerage}, Authorised Representative of SMS Insurance Pty Ltd t/as repX (AFSL 425573), to act as my/our insurance broker and to provide insurance broking and related services on my/our behalf, including managing my/our insurance requirements in respect of the insurance policies detailed below, effective from {date}.

    I/We authorise any current and previous insurer(s) to provide {brokerage} with all information relating to my/our insurance policies, including policy details, premiums and claims history.

     

  • Details*

  • I/We confirm that I am/we are duly authorised to provide this appointment.

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

  • Date*
     - -
    2 digit day, 2 digit month, 4 digit year
  • Should be Empty: