Phone Company Details PSC Trade Credit Risk will treat all information as strictly confidential and will not make the information available to other parties except for the purpose of obtaining credit insurance quotes from the insurers. Company Name * ACN / ABN * Contact Person Name * Telephone / Mobile * Email Address * Goods/services sold Sales to which trade or industry sector? Standard terms of payment Special terms of payment What is your estimated insurable turnover for the next 12 months? Domestic Export Total Turnover Exclude turnover with associated/subsidiary companies, cash sales, sales made to public authorities/government departments, sales tax and GST. Bad Debt Experience Please list or attach information about the two largest bad debts written off for the past three years. (Insolvency / Bankruptcy / Protracted Default only. No disputes or reconciliations). Year Name of Debtor/s Bad Debt Amount Name of Debtor Bad Debt Amount No Bad Debts No bad debts Year Name of Debtor/s Bad Debt Amount Name of Debtor Bad Debt Amount No Bad Debts No bad debts Year Name of Debtor/s Bad Debt Amount Name of Debtor Bad Debt Amount No Bad Debts No bad debts OR Upload spreadsheet listing bad debt experience for the past three years Please provide one of the following file formats: .xls, .xlsx, .doc, .docx, .pdf, .txt Please list or attach below your top 10 customers (by sales) Company Name ACN / ABN Credit Limit Required Company Name ACN / ABN Credit Limit Required Company Name ACN / ABN Credit Limit Required Company Name ACN / ABN Credit Limit Required Company Name ACN / ABN Credit Limit Required Company Name ACN / ABN Credit Limit Required Company Name ACN / ABN Credit Limit Required Company Name ACN / ABN Credit Limit Required Company Name ACN / ABN Credit Limit Required Company Name ACN / ABN Credit Limit Required OR Attach spreadsheet listing ten largest customers including full legal entity, ACN/ABN, suitable credit limit, terms of payment Please provide one of the following file formats: .xls, .xlsx, .doc, .docx, .pdf, .txt Please attach the following document Aged Debtors Listing/Trial Balance Showing breakdown by 30, 60, 90 and 90+ days. Please highlight any accounts which may become bad debts. Aged Debtors upload Please provide one of the following file formats: .xls, .xlsx, .doc, .docx, .pdf, .txt Additional information Any additional information you would like to add
