Credit Risk Enquiry Form

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Credit Risk Enquiry Form

Thank you for your interest in Reynolds Insurance Services. In order that we can best respond to your enquiry, please complete as much of this form as possible, then click the ‘send’ button at the bottom.

A consultant will respond to your enquiry within one business day.

Note:
All figures quoted on this form are to exclude VAT.
Alternatively, please state if the figures include VAT.

Company:
Your name:
Position:
Telephone:
Fax:
Email:
Address:


Postcode:
Business Description:
Estimated Turnover on Credit Terms (next 12 months)
Domestic: £ 
Export: £ 
(please attach a list of export markets and respective turnover)
Debtor balance at last:
March: £ 
June: £ 
Sept: £ 
Dec: £ 

Past Analysis:
  Current Year Last Year Previous Year Previous Year
Turnover
Total Bad Debts
Largest
How Many
Name of Largest


Please list any special features to your trade
e.g. long term contracts, work in progress , consignment stock etc.


Debtor Analysis as at:   - - (dd-mm-yyyy)

Exposure Amount Outstanding Number of Debtors
Under £1,000
£1,001 - £2,500
£2,501 - £5,000
£5,001 - £10,000
£10,001 -£25,000
£25,001 -£50,000
£50,001 - £100,000
£100,001 - £250,000
£250,001 - £500,000
£500,001 - £1,000,000
Over £1,000,000

Normal payment terms given to debtors:
Maximum payment terms given to debtors:

Which of the following do you utilise in setting credit limits:
Bank Reports Yes  No Level £
Trade Reference Yes  No Level £
Reports and Accounts Yes  No Level £
Status Reports Yes  No Level £

Which Status Agencies do you use?
How often is the information updated?

Who is responsible for approving and increasing credit limits?
Position:  
Name:
Level: £
Position:  
Name:
Level: £

Who is responsible for cancelling and reducing credit limits?
Position:  
Name:
Level: £
Position:  
Name:
Level: £

Overdue accounts procedure: How many days past due date would you:
Make a telephone call?
Take recovery / collection action?
Send a letter?
Take legal action?
Stop further supplies?

Current credit insurance arrangements:
Renewal date:
Insurance company:
Broker:
Type of policy:

Please provide details of your largest debtors (UK and/or Export):
Full Trading name and registration number/address Credit limit Current balance
£ £
£ £
£ £
£ £
£ £
£ £
£ £

Please detail any seriously overdue accounts which are giving you cause for concern:
Name of debtor Amount
outstanding		 Action taken
£
£
£
£


Please outline any additional information which you feel may support your application for credit insurance: