On what date is your current insurance due for renewal ?

Do you operate your business from a shop premises open to the public, or are you a Roundsperson ?

Do you operate any business other than the sale of newsprint, magazines, tobacco, alcohol, sweets and confectionery from these premises ?

What is your annual payroll ?

Do you require employers' liability cover ?

Do you require public and products liability cover ?

In the last three years, have you made any claims on this or similar policies, or have any incidents occurred which might give rise to a claim?

Please give details, with dates and amounts claimed :

Have you or has any other partner in the business ever had any insurance refused, withdrawn or subject to special conditions ?

If yes, please give details:

Have you, your business partners or anyone else with an interest in the business ever been declared bankrupt?

If yes, please give details:

Do you, your business partners or anyone else with an interest in the business have any criminal convictions which have not been spent under the rehabilitation of offenders act?

If yes, please give details: