EIB 07-01A, Sectio Electronic Claim Filing System, Short-Term Insurance

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Insurance Claim - Short-term Multi-buyer
Policy
Section E - Schedule of Shipments

Claim Control No.:CAP0001091 (Draft)

( * An asterisk denotes that a field is a required entry)

Instructions
1. Insured Shipments. All Outstanding insured shipments made to the buyer must be reported and included with this claim whether or not a
shipment is presently eligible for coverage. For example, if there are two insured invoices outstanding to a buyer and only one is eligible for
claim filing, the second invoice should be included as a part of this claim filing. Interest calculations reflecting the dollar amount of the
contract interest due for each invoice, when applicable, must be included in the chart below. Please note that you will need to MAIL to Ex-Im
bank the invoice, bill of lading, debt instruments and other related documents, grouped for each shipment. The bill of lading is the date of
shipment for purposes of the schedule.
2. Applicable Interest. Not all Short Term, Muli-Buyer insurance allows for the collection of interest. Please answer these questions to
determine whether interest applies:
Are you claiming ordinary or past due interest?

Yes

No

You have answered "No" to the question above. You are not entitled to collect interest on past-due payments this
claim. Please enter "0%" under the "Interest if Applicable" column.

*Shipment
*Invoice No(s)

Date(s)
00/00/0000

*Due
Date(s)
00/00/0000

*Amount
of Invoice(s)

%
Interest
(Prime
minus
1/2%)

*Amount of

*Payments and

Interest to
Due Date(s)

Credits

Outstanding
(plus interest
if eligible)

https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/0/ECDFEC57D327C818852572A4004D4A39?EditDocument&Login

3/20/2007

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For additional invoices click here

https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/0/ECDFEC57D327C818852572A4004D4A39?EditDocument&Login

3/20/2007