- Affirm that:
- all information provided and statements made are truthful and accurate and no information likely to affect the outcome of this claim has been withheld.
- the damaged property which is subject of this claim is owned by me/us.
- Neither I nor any person claiming on my behalf have made a claim for this damage to anyone else (including an insurer) nor will I make such a claim if I accept any payment from Western Power in settlement of this claim.
- Acknowledge and accept that:
- Western Power will reply upon information supplied by me/us when determining this claim.
- If, based on the information contained in this form, Western Power agrees to meet my/our claim, any payment received is in full and final settlement.