GST Input Tax Credit (ITC) Entitlement
Is anyone entitled to claim an Input Tax Credit (ITC) on this greenslip?
(Only GST registered businesses may claim an ITC)
No
Yes
Commencement Date
1. What date will the CTP Policy (greenslip) commence?
This is the Due Date shown on your vehicle registration renewal, or Date of Registration for a new vehicle being registered for the first time
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2
3
4
5
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8
9
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31
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
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2009
Vehicle details
2. What type of vehicle is the greenslip for?
(Where your vehicle make or model is not listed please select "Other")
.
Please select
Motor car
Private Goods Vehicle less than 4.5 tonnes GVM
Motorcycle 100-300cc
Motorcycle over 300cc
Make
Other
Model
Other
Engine Capacity (cc)
3. What is the Year of Manufacture of the vehicle?
(eg. 1998)
4. Where is the vehicle normally garaged?
(Postcode)
5. Is the vehicle privately owned, or is it owned by a company or organisation?
Please select
Privately Owned
Company or Organisation
6. Is the vehicle registered for Private or Business use?
Please Select
Private
Business
Current Insurance Details
7. Does the vehicle have a current CTP policy (greenslip)?
Please select
Yes
No - registration has lapsed
No - new vehicle - never registered
8. Which company is this policy with?
Please select
AAMI
Allianz
CIC-Allianz
GIO
NRMA
QBE
Zurich
Other
No greenslip
9. Do you have other insurance for the vehicle?
Please select
Comprehensive
Third Party Property Damage
No current insurance policy
10. Which company is this insurance with?
Please select
AAMI
Allianz
APIA
CIC-Allianz
GIO
Just Car
NRMA
QBE
Shannons
Vero
Western QBE
Zurich
Other
N/A
11. How long have you continuously held this type of insurance?
(include current vehicle and previous vehicles it replaces)
Please select
Less than 2 years
2 to 3 years
4 or more years
N/A
12. Do you have a "no claim discount" for this insurance policy?
Please select
Yes - maximum rate
Yes - not maximum rate
No
N/A
Rate (%):
Please select
60% or more (Rating 1)
50-59% (Rating 2)
30-49% (Rating 3-4)
Less than 30% (Rating 5-6)
N/A
Registered Owner Details
13. Have you made any collision claims against your motor vehicle insurance in the last 3 years where you were held to be at fault in the collision.
No
Yes
14. If this is a privately owned vehicle, what is the owner's age?
(if more than one owner, please provide the youngest age)
Age (full years):
15. In the last 3 years, have you committed more than 2 moving traffic offences?
No
Yes
16. How many "demerit" points have you lost on your licence?
If unsure, click
here
to check your details with the RTA.
0
1
2
3
4
5
6
7
8
9
10
11
12
Driver Details
17. What is the age and gender of the youngest driver of the vehicle?
Age (full years):
Gender:
Please select
Male
Female
18. In what year did the youngest driver obtain their driver's licence?
----
Learner's Permit only
2009
2008
2007
2006
2005
2004
2003
2002
2001 or earlier
19. In the past 3 years, the youngest driver's number of 'At Fault' claims/accidents.
0
1
2
3
4
5
5+
20. Has anyone who will drive the vehicle had an accident in the past 2 years in which they were at fault?
No
Yes
NRMA Membership
21. Do you have Roadside Assistance Membership with NRMA Motoring & Services on this vehicle that has been current for the last 5 years?
No
Yes
Optional questions. Your feedback would be appreciated
22. How did you hear about the Calculator?
Television Advertisement
Radio Advertisement
Newspaper Advertisement
Internet Advertisement
From a Relative/Friend
Other Please Specify :
23. Do you intend to use the Calculator again next year?
Yes
No
