Insolvency Appointment Notification Portal
Appointment Details
Date of Appointment:
*
Type of Appointment:
Liquidation
Administration
Controller
Receiver & Manager
Bankruptcy
Mortgagee in Possession
Other
*
Name of Company
:
*
A.C.N or A.B.N:
*
Business Activity or Occupation:
*
Main Business Address
:
Address Line 1:
*
Address Line 2:
*
City:
*
State:
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
*
Postcode:
*
Practitioner Details
Insolvency Firm:
*
Appointee(s):
*
Primary Contact:
*
Primary Contact office location:
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
*
Email:
*
Phone Number:
*
Please complete the below Name and Email Address field if you require a copy of the notification receipt to be sent to the appointee or a colleague:
Additional Recipient:
Additional Recipient Email:
Trading:
*
Yes
No
Unknown
Employing:
*
Yes
No
Unknown
General and Underwriting Information
Estimated Annual Turnover:
*
Up to $1M
$1 - 5M
$5 - 20M
$20M+
Unknown
N/A – not trading
Estimated Asset Values:
*
Up to $500K
$500K - $3M
$3M - $10M
$10M+
Unknown
Number of Employees:
*
1 - 10
10 - 30
30 - 50
50+
Unknown
N/A – not employing
Trading Locations:
*
VIC
NSW
QLD
TAS
SA
ACT
NT
WA
OVERSEAS
WH&S inspection required:
*
Yes
No
Environmental inspection required:
*
Yes
No
Pre Appointment Insurance Details
General Insurance Program
Insurer and/or Broker:
*
General Insurance Program
Workers Compensation:
*
Letter of Appointment
Please ensure the Letter of Appointment and Deed of Appointment files are not in use or open prior to attaching otherwise the appointment will not be able to be submitted.
Attachments must be in PDF format.
Upload Letter of Appointment:
Max File Size upto 4 MB
Upload Deed of Appointment (optional):
Max File Size upto 4 MB
Captcha:
BUGLDGLN
*