1. Are you (check as many as apply) a:
Manufacturer
Wholesaler
Exporter
Trading Company
Commercial Bank
Investment Bank
Financial Institution/Lender
Financial Advisor
Trustee for Securitized Transaction
Insurance Broker
Insurance Company

2. Trade Credit Insurance Policy use:
Do you currently have a trade credit insurance policy?
Does your customer have a trade credit inurance policy?
Are you applying for a trade credit insurance policy?
Are you considering applying for a trade credit insurance policy?

3. Which products or services would like like to have more information (check as many as apply):
On-Line Trade Banker Service
Installed Trade Banker Software
Trade Credit Policy Manager Software

4. Is there anything else you would like to tell us or provide comments:

5. Please provide the following contact information:

Name
Title
Organization
Work Phone
E-mail

6. Would you prefer to be contacted by telephone and/or by e-mail:
Telephone
e-mail