Form No. 205.

Branch Manager,

Export Credit Guarantee Corporation of India Limited.

Mumbai.

Dear Sir,

We hereby declare that the following amounts in respect

For the month of
Name & Address of the Policy Holder. / Poilcy No.
Phone.
Fax.

of shipments declared against payment in full has not

been received till the end of the month of ______200

2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10 / 11 / 12
Sr.No. / Name & Address of the Buyer & Destination Country / Date of Shipment & Serial No. of Declaration / G.R.I. No. & Commodity / Shipment
Value in Rs. / Terms of Payment / Due Date of Payment / Amount paid by Buyer, if any. / Balance of Amount Paid / Reason for Non-Payment. / Whether goods delivered to & accepted by the buyer? yes/ no. / Action taken to recover the dues.
Total

1. Insolvency 2. Default 3. Repudiation 4. Political Risk.

P.T.O

POSITION OF OVERDUE /S AREADY DECLARED & NOT YET SETTLED

1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10 / 11 / 12
Sr.No. / Name & Address of the Buyer & Destination Country / Date of Shipment & Serial No. of Declaration / G.R.I. No. / Shipment
Value in Rs. / Terms of Payment / Due Date of Payment / Amount paid by Buyer, if any.
Rs. Ps. / Balance of Amount Paid
Rs. Ps. / Reason for Non-Payment. / Whether goods delivered to & accepted by the buyer? yes/ no. / Action taken to recover the dues.
Total

Note: 1. The overdue Bill(s) should continue to be 1. Insolvency 2. Default 3. Repudiation 4. Political Risk

declaredevery month till payment is realized

or claim is preferred with ECGC.

2. This is not a Claim Form.

Yours faithfully,

Signature & Office Seal

Place:

Date: