JLT

Confirmation

I confirm that I am 18 years or over and have received and read the Policy Wording and PDS and Financial Services Guide contained herein and that, to the best of my knowledge, the information I have provided is true and hereby apply for cover under the Landlord Insurance policy based on the information I have provided in this Application.

Yes No

If you are an existing JLT Client and have a web login, please log in (via the Client Login) before applying.

Online applications must be paid by credit card (Visa or Mastercard). For cheque or money order, please download the Application Form.

Credit Card Payments

Please proceed through to the next page.

BPay, Cheque or Pay by Monthly Instalments

Please download the Application Form.