EIB 07-01A, Sectio Electronic Claim Filing System, Short-Term Insurance

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Claim Control No.:CAP0001091 (Draft)

Short-term Multi-buyer Policy Claim
Section G - DCL Prior Trade Experience
Worksheet

( * An asterisk denotes that a field is a required entry)
If DCL is not applicable, click here:

and do not fill in this worksheet, otherwise:

1. Complete the worksheet listing all shipments made during the year prior to the first claimed shipment.
2. Be specific regarding the credit terms extended to the buyer for each shipment.

*Invoice No.

*Invoice Amount

*Terms

* Shipment
Date
00/00/0000

*Date Due
00/00/0000

Date Paid
00/00/0000

Amount Paid

*Prior Trade
Experience Limit
Based on 200%
of Highest
Amount
At Any One
Time
Owed & Paid
Promptly

30 days
30 days
30 days
30 days
30 days
30 days
30 days
30 days
30 days

https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/0/63804A759F69B35F852572A4004D4A3C?EditDocument&Login

3/20/2007

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30 days
For additional invoices click here

https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/0/63804A759F69B35F852572A4004D4A3C?EditDocument&Login

3/20/2007