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INDICATIVE OFFER REQUEST FORM

Kindly provide us with the information requested below, to enable us to indicate on the possibility of without recourse financing for your export receivables:
Importer's   country :  
Currency &   Amount :  
*Importer :  
*Guarantor Bank :  
Credit period   requested :  
Contract signed :    Yes
 No
Repayable :   Quarterly
Semi-annually
Annually
Bullet
Goods :  
*1st Shipment   date :      
(yyyy-mm-dd)
*2nd Shipment   date :      
(yyyy-mm-dd)
*3rd Shipment date :      
(yyyy-mm-dd)
*Additional   information :  
For and on behalf of -  
Name of   company :  
Address :  
*By (name) :  
*Tel no :    
Fax no :    
*email :  
Date :      
(yyyy-mm-dd)
    
Alternatively you can print this form
and fax it to us at the following number:
+353 1 6611980
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