Exemptions from Law Mutual (WA) Professional Indemnity Insurance Arrangements – National Law Practice Undertaking 2021/2022

Name of Legal Entity*

Law Practice Trading Name*

Address in Western Australia*

Street Address Address Line 2 City Postcode

Address of Main Office*

Street Address Address Line 2 City State / Province / Region Postcode

Contact name*

This notification must be submitted by an Australian legal practitioner Director/Partner or Principal of the National Law Practice whose contact details are provided below. This person is deemed to be making the declaration at the end of this form.

First Last

Contact position*

Contact phone number*

Email*

Exemption year*

Are you a new national law practice in Western Australia?

Yes

Approved National Insurance Arrangement

Please upload copy of current policy wording for review*

Please upload Certificate of Currency*

I declare that the notification is being made on the basis that the Law Practice is hereby giving an undertaking that it is a National Law Practice within the meaning of Sub-Regulation 97(4) of the Legal Profession Regulations 2009. The Law Practice acknowledges that this exemption will remain in force only whilst the Law Practice continues to be a fully integrated National Law Practice. Should the Law Practice cease to be a National Law Practice, the exemption ceases and the Law Practice undertakes to immediately notify the Law Society. I acknowledge that the exemption is subject to the Council of the Law Society of Western Australia approving our Professional Indemnity Insurance arrangements. We confirm that evidence of the Law Practice’s 2021/2022 national insurance policy arrangement will be provided once this becomes available. I note that the Law Practice will be an exempt Law Practice if each Legal Practitioner associate is an exempt practitioner (Regulation 95 of the Legal Profession Regulation 2009)*

I declare

Exemptions from Law Mutual (WA) Professional Indemnity Insurance Arrangements – National Law Practice Undertaking 2021/2022

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