Declaration
I/we hereby declare that to the best of my/our knowledge, that the statements made in this proposal are true and complete and that I/we have not suppressed or mis-stated any material facts.
I/we agree that this application and declaration, together with any information supplied by me/us, shall form the basis of the contract between myself/ourselves and the Insurer.
I/we understand that completion of this application form does not bind myself/ourselves or the Insurers to any form of insurance contract.