Insurance Claim Form - Capitol BCA

Property details Download PDF
Lot Owner's Name*
First Last
Property address*
Street address City State Postcode
Building name
Lot number*
CTS number*
Details of claim
Date of Event
MM slash DD slash YYYY
What happened?*
Damages claimed*
Cause rectification*
Supporting documents
Drop files here or

Accepted file types: doc, docx, jpg, gif, png, pdf, Max. file size: 4 MB.
4MB file limit.
Applicant details
I am*
- Owner
- Agent
Agent name if applicable
Phone*
Email*
Acknowledgement
*
- * I am the owner of the abovementioned lot in the community titles scheme, or I am the owner’s agent acting with the express consent of the owner of the lot.