Please rotate device to view the credit protection form Credit Protection Application Business name:*Trading name:Business address:*Postcode:*Country:*SelectEnglandNorthern IrelandScotlandWalesBusiness phone no:Business mobile no:Business email:* Business contact:*Position:*Years trading:*New startPhoenix startEstablished business 0 – 6 Months6 months – 12 months1 year – 2 years2 years – 4 years4 years +Do you already have Credit Protection?*YesNoTell us who you’re with now as we wouldn’t like to match you with your current provider and cause any embarrassment*Have you had insurance of any kind declined within the last three years?*YesNoPlease Provide Details*Business activity:Select an optionAdvertisingAerospace & DefenceAgricultural Production – AnimalsAgricultural Production – CropsAgricultural ServicesAir TransportationAmusement & Recreation ServicesApparel & Other Finished Products (Manufacture)Automotive Hire CompaniesAutomotive ManufacturingAutomotive Repair, Services & ParkingChemicals & Allied ProductsCoal MiningCommunicationsComputer Hardware and Related ServicesComputer Software and Related ServicesConstruction – Building CompletionConstruction – Building / MasonryConstruction – Electrical InstallationConstruction – Floor ScreedingConstruction - Groundwork’sConstruction – JoineryConstruction – Plastering / RenderingConstruction – Plumbing & HeatingConstruction – RoofingConstruction – Steel ErectingConsumer Credit InstitutionsDairy Production & Related ServicesEating & Drinking PlacesEducational ServicesElectronic Equipment, Except ComputersEngineering, Research & Management ServicesFabricated Metal ProductsFishing, Hunting, TrappingFood & Kindred ProductsForestryFuel SuppliersFurniture and FixturesGeneral Merchandise StoresGlazing and RoofingHaulageHealth ServicesHeavy Construction – CivilsHome FurnishingHotels & Other Lodging PlacesIndustrial / Commercial Machines &ComputersInstruments / Photo – Med – Optical / ClocksInsurance Agents, Brokers & ServicesInsurance CarriersLeather & Leather ProductsLegal ServicesLogistic Clearing and ForwardingLumber & Wood Products Except FurnitureManufacturingMembership OrganisationsMetal MiningMining of Non – Metals, Except FuelMiscellaneous Repair ServicesMotor Freight Transport & WarehousingMuseums, Gardens, Galleries & ZoosOil & Gas ExtractionPackagingPaper & Allied ProductsPassenger Transportation ServicesPetroleum Refining & Related IndustriesPharmaceuticalsPhotography & FilmPipelines, Except Natural GasPrimary Metal IndustriesPrinting, Publishing & Allied IndustriesRailroad TransportReal EstateRecruitment – ConstructionRecruitment – DiversifiedRecruitment – Haulage and TransportRecruitment – ManufacturingRecruitment – Temporary StaffRecycle CollectionRetail Fashion – SupplyRetail Food – SupplyRetail Miscellaneous – SupplyRetail Textiles – SupplyRubber & Miscellaneous Plastic ProductsSecurity Guards and Related ServicesSheet Metal WorkSteel ManufacturingStone, Clay, Glass & Concrete ProductsTextile Mill ProductsTobacco ProductsTransportation EquipmentUtility Services (Electricity, Gas, Sanitary)Wholesale - Durable GoodsWholesale - Electrical GoodsWholesale – FoodWholesale – Hardware / Garden SupplyWholesale – MiscellaneousWholesale – Office SuppliesWholesale – TextileOther - Not Specified ElsewhereFull business description:*Commercial turnover Please provide the following information based on commercial turnover only. This is to exclude any sales to the general public. (Please quote figures excluding VAT)Projected Turnover in the next 12 Months:*Current year’s Turnover: (From the first day after your last financial year end to the present day)*Now please provide the last previous three year’s trading figures (if applicable):Previous YearMonth/Year End Date Turnover2nd Prior YearMonth/Year End Date Turnover3rd Prior YearMonth/Year End Date TurnoverMajor Customers Please provide us with information about your top ten customers by the highest value of credit outstanding.1Customer name*Customer address*Company registration number*Credit limit required*2Customer nameCustomer addressCompany registration numberCredit limit required3Customer nameCustomer addressCompany registration numberCredit limit required4Customer nameCustomer addressCompany registration numberCredit limit required5Customer nameCustomer addressCompany registration numberCredit limit required6Customer nameCustomer addressCompany registration numberCredit limit required7Customer nameCustomer addressCompany registration numberCredit limit required8Customer nameCustomer addressCompany registration numberCredit limit required9Customer nameCustomer addressCompany registration numberCredit limit required10Customer nameCustomer addressCompany registration numberCredit limit requiredPlease provide the approximate number of live clients requiring credit limits above £5,000*Select an option123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899100101102103104105106107108109110111112113114115116117118119120121122123124125126127128129130131132133134135136137138139140141142143144145146147148149150151152153154155156157158159160161162163164165166167168169170171172173174175176177178179180181182183184185186187188189190191192193194195196197198199200201202203204205206207208209210211212213214215216217218219220221222223224225226227228229230231232233234235236237238239240241242243244245246247248249250250+Normal credit terms offered*Select days1 day2 days3 days4 days5 days6 days7 days8 days9 days10 days11 days12 days13 days14 days15 days16 days17 days18 days19 days20 days21 days22 days23 days24 days25 days26 days27 days28 days29 days30 days31 days32 days33 days34 days35 days36 days37 days38 days39 days40 days41 days42 days43 days44 days45 days46 days47 days48 days49 days50 days51 days52 days53 days54 days55 days56 days57 days58 days59 days60 days61 days62 days63 days64 days65 days66 days67 days68 days69 days70 days71 days72 days73 days74 days75 days76 days77 days78 days79 days80 days81 days82 days83 days84 days85 days86 days87 days88 days89 days90 daysInvoice periodFrom the end of monthFrom date of invoiceBad Debt/Losses Please provide the current & previous three years bad debt information (if applicable):Date fromCurrent trading period(From the first day after your previous financial year to current date) Last Financial Year(Month / Year) 2nd Prior Year(Month / Year) 3nd Prior Year(Month / Year) Date toCurrent trading period Last Financial 2nd Prior 3nd Prior Total Value of Bad debtsCurrent trading periodLast Financial2nd Prior3nd PriorNumber of bad debtsCurrent trading periodLast Financial2nd Prior3nd PriorLargest Individual Debt In ValueCurrent trading periodLast Financial2nd Prior3nd PriorDebtor Name & Company Registered Number of the largest lossCustomer addressCustomer addressCustomer addressCustomer addressAdditional Information Is your business involved in any of the following?Consignment stocksYes/NoYesNoPlease give details and advise estimated annual turnoverPaid-when-paid contractsPaid-when-paid contracts Yes/NoYesNoPlease give detailsContra TradingContra Trading Yes/NoYesNoDo you have a formal agreementSale or returnSale or return Yes/NoYesNoPlease give detailsDo you have invoice Discounting/factoring Arrangements?Do you have invoice discounting/factory arrangements Yes/NoYesNoPlease give detailsFuture Contact From time to time we would like to contact you with details of other relevant products, offers and services. If you consent to us contacting you for this purpose please tick to say how you would like us to contact you.Future Contact* Post Email Phone Text If you prefer not to be contacted please tick this box By clicking submit, you are agreeing that you have read, understood and accept our Terms and Privacy Policy and that you are happy for us and one of our panel approved credit insurers to contact you in order to progress your application.