DIGITAL ASSET PROPOSAL FORM

Step 1 of 6

General instructions for completing this Proposal Form

Please answer all the questions fully for the entities that are or will be subject to MiCA

  • Where a question is not relevant to your business, please respond N/A rather than leaving this blank.
  • Please ensure this is completed by Senior Management or someone who is responsible for arranging the insurance.
  • If there is insufficient space to answer a question, please answer on your company letterhead clearly referencing the question(s) to which it refers.
  • Completion of this Proposal Form does not automatically bind you or insurers to effect a contract of insurance.
  • A copy of this Proposal Form should be retained for your own records.