AIB Tradefinance - Debtor Insurance - Enquiry Form Wed, 19 Nov 2008
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DEBTOR INSURANCE - ENQUIRY FORM

Note : Please insert all currency amounts in Euros
Your Details
Forename Surname
CompanyName
Address
Telephone No. FAX


Your Business
What do you sell/What Service do you provide?
To which trade sector do you sell?
What are your normal terms of payment?
(e.g. 60 Days from invoice)


Your Debtor Profile
Maximum amount outstanding Total no of clients in range Total amount outstanding in range
Over €250,000
€50,000-€250,000
€1,000-€50,000
Up to €1,000
Total


Your Business in the last three years
Financial Year Turnover(ex VAT) Total Credit Losses Largest Individual
Loss
Number of Losses
Year To Date


Overdue Accounts
Please give details below of Top 5 Accounts that are overdue by 60 days from agreed original payment date.
Company Name Country Amount o/s Original Due Date Action Taken



Your Markets
Please list your turnover for each country to which you sell(excluding inter-company sales)
Country Name Estimated turnover
for next 12 months
Normal terms
of payment
Ireland
EU Countries
US/Canada
Australia/New Zealand
Japan
Rest of the World
Total Estimated Turnover
Your Buyers
Please list your Top 6 Buyers
Company Name Country Name Estimated Turnover
Premium Financing
Will you require insurance premium financing YesNo

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AIB Trade Finance Services is a part of Allied Irish Banks p.l.c.
Registered in Ireland: Registered Number is 024173
Allied Irish Banks p.l.c. is regulated by the Financial Regulator
Registered Office:
Bankcentre
Ballsbridge
Dublin 4
Ireland