Cyber Liability Insurance Statement of Facts

1. Company Details

Company Name Company Address Contact Person Email Address Phone Number

2. Business Information

Nature of Business Number of Employees Annual Revenue

3. Cyber Security Details

Do you have a documented cyber security policy? Are regular data backups performed? Do you use antivirus and firewall protection? Do you provide cyber security training to employees?

4. Claims and Incidents

Have you experienced any cyber incidents in the past 5 years? If yes, please provide details

5. Additional Information

Other relevant information