I declare that to the best of my knowledge the details given in this claim form are true.
I undertake to render all possible assistance in connection with this claim.
I agree that Halo Guarantees Limited and the insurance company (and/or their agent) with whom I am insured may give to or obtain information relevant to this claim from appropriate individuals or organisations.
Note: Failure to provide correct and complete information could result in your claim not being accepted by Halo Guarantees Limited.
Halo Guarantees LimitedPO Box 13415 Tauranga CentralTauranga 3141
www.halo.nz[email protected]Ph 0800 141 490
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