One Underwriting - Online Portal Sign Up Form

Online Portal Sign Up Form

Portal Access Application

Broker Name / Contact Person:	Broker Name / Contact Person	Please enter a value.
Applicant Email Address	Applicant Email Address	Please enter a value.
Phone Number:	Phone Number	Please enter a value.
Brokerage Situation Address (incl Postcode):	Brokerage Situation Address (incl Postcode)	Please enter a value.
AFSL/CAR/AR Number:		Please enter a value.
Are you an Authorised Representative (CAR/AR) of an AFSL Holder? :	Yes No
Who is the AFSL Holder?:
Are you a member of a Broker Group (ie. Steadfast/Austbrokers)?:	Yes No
Please advise which Broker Group:
Are all requests and placements to be nett of commission? :	Yes No Note by ticking "Yes" all existing and future placements will be provided on this basis. (Yes/No)

By submitting this access request, you acknowledge and agree to the following:
• access to the portal is granted to the Broker noted on this application form only and you agree that you will not share login details with any other individual, including colleagues, managers, or third parties without One Underwriting's prior written consent.
• You will notify One Underwriting immediately should you become aware of any unauthorised access.
• you have read, understood and agree to abide by our Terms of Business Agreement - https://www.oneunderwriting.com.au/Au-OneUnderwriting/media/oneunderwriting/Common/Terms-of-Use.pdf.*

Tick this box to confirm you have read and understood the above.

One Underwriting’s Terms of Business

To make our working relationship with brokers more efficient, One Underwriting Pty Ltd ABN 50 006 767 (One Underwriting) makes it Terms of Business available online.

These Terms of Business, effective 1 July 2017, will apply to any Australian Financial Service Licenced insurance broker dealing with One Underwriting, unless we have expressly agreed to different terms in writing. One Underwriting may vary these Terms of Business from time to time.

Please click here to view One Underwriting’s current Terms of Business