Commonwealth Numbered Regulations

1990 No. 446 INSURANCE REGULATIONS (AMENDMENT) - REG 6

6.1 Form 15: Omit the form, substitute:

"FORM 15
COMMONWEALTH OF AUSTRALIA
Insurance Act 1973
STATEMENT OF CLAIMS INCURRED IN THE MONTH
  Name of Body Corporate                            Month and year

  Each claim exceeding        Amount recovered

  $250,000 incurred           or recoverable

  in the month                in respect of the

  in respect of               claim through  Particulars of claim

  liabilities in Australia    reinsurance

         (1)                       (2)                     (3)

          $                         $

Signature of
Director, Secretary
                                              or Agent         /  /19".