International Trade Credit Insurance Single Risk Questionnaire

Single Risk Questionnaire

If you prefer to contact us to discuss your Trade Credit Insurance, then please send an email to info@fp-marine.com or call your nearest FP Marine Risks' office.

Contact Information

Contact Name

Address

City

State/Province

Zip/Postal Code

Country

Phone Number

Email

Company Website

Main Business Activity

Date Established

 

Parent Company

Country

Contact Name

Position

Debtor Information

Debtor Name

Address

City

State/Province

Zip/Postal Code

Country

Website Address

Contract Details

Limit Required:

Description of Goods/Services to be supplied:

Please summarise your conditions of sale and payment terms:

On what basis are credit limits and payment terms established

(a) Audited/management accounts Yes No
(b) Status Reports Yes No
(c) Bank Report Yes No
(d) Visit to buyer's premises Yes No
(e) Other (please specify)

Please be ready to provide all financial information which you have concerning the buyer and any further background material.

Why do you wish to insure this particular transaction?

Have you traded with this buyer before

Yes No

Have payments been received promptly

Yes No

(If "NO" please provide full details of previous trading experience on a separate sheet)

Debtor balance outstanding as at (dd/mm/yy) // is

Current and not yet due 1-30 days overdue 31-60 days overdue 61-90 days overdue More than 90 days

Other Information

Please provide any further information that may be material to the insurers:

Please provide the following

Name Position
Company Date

Important Note: The questions contained in this form are designed to give insurers information regarding your business. It may not address every aspect and it is your duty to disclose all material information to insurers that may affect the premium or conditions.