BIBA (British Insurance Brokers Association) Bad credit

Credit or Bad Debt Insurance

Your name
E-mail address
We may send you information from time to time about insurance generally and special offers. If you do NOT want to receive it check and we'll only send details about this enquiry/policy.
Company Name
Reg. No.
Address line 1
Address line 2
Post code
Telephone No.
Fax. No.
Contact
Your Business  
What goods or services do you provide?
Please describe your customers business
Are you always contractual principal?
Your sales

Please summarise your sales experience in the last 3 years.
Please exclude, cash sales, sales to associate or subsidiary companies, sales to government bodies, or sales on irrevocable letter of credit.

Year Turnover No. Bad Debts Largest Debt Total Bad debts
What is your projected turnover for the last 12 months : Domestic? : Export?
How Many Buyers
How long have you been trading?
What are your terms of payment
Have you any accounts more than 60 days overdue?
Customer Country Amount Original Due Date
Have you any specific demands and needs?

Please note that the premium quoted will only be an indication

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bad credit remortgage contact form | bad credit remortgage uk | bad debt credit insurance form | original financial page