GoCardless Merchant Questionnaire - Insurance

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Please enter the details of your request. A member of our support staff will respond as soon as possible.

Please enter "Not Applicable" if you have not been in contact with our Sales Team

For example, for the UK this will be the Companies House registrar entity number

For example, you expect to process £200,000 through GoCardless in the next 12 months in total please only insert: 200000

Please state this as a number, not a % i.e if 60% please only insert '60'

*Please insert this as a number only* for example if it is 40 days, please only insert: 40. If there is a further fulfilment split, i.e. 20% is 30 days and 40% is 365 days, then please insert the weighted days ( (20%*30) + (40%*365)). In this example the output would be: 152.

Please select the % of chargebacks in value terms

Please select the % of failures in value terms

e.g. 500 (£/$/€) per month in refunds

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