EIB 07-01C, Sectio Electronic Claim Filing System, Working Capital Guarante

Page 1 of 4

Claim Control No: CAP0001096 (Draft)

Working Capital Guarantee
Section A - Names and Addresses

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

Guaranteed Lender Making Demand for Payment
Master Guarantee Agreement (MGA)
Number:
Ex-Im Bank Transaction No.
( AP No.):
Name:

*

Address Line 1:

*

Address Line 2:

*

Address Line 3:

*

City:

*

State:

*

Zip Code:

*

Contact Name:

*

Phone:

*

Fax:

*

E-Mail:

*

*
*

Current Holder of Original Note
Who is the current holder of the original
note?

*

Same as the Guaranteed Lender
PEFCO

Borrower
Name:

*

Address Line 1:

*

Address Line 2:

*

Address Line 3:

*

City:

*

State:
Zip Code:
Country

*United States of America

Contact Name:

*

Phone:

*

https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/0/DBCD8535E5CB221A852572A40053... 3/20/2007

Page 2 of 4

Fax:

*

E-Mail:

*

First Guarantor
Click here if not applicable

Not Applicable

Name:
Address Line 1:
Address Line 2:

*

Address Line 3:

*

City:
State:
Zip Code:
Country
Federal Tax ID or SSN:
Contact Name:

*

Phone:

*

Fax:

*

E-Mail:

Second Guarantor
Click here if not applicable

Not Applicable

Name:
Address Line 1:
Address Line 2:

*

Address Line 3:

*

City:
State:
Zip Code:
Country
Federal Tax ID or SSN:
Contact Name:

*

Phone:

*

Fax:

*

E-Mail:

*

Third Guarantor
Click here if not applicable

Not Applicable

Name:

https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/0/DBCD8535E5CB221A852572A40053... 3/20/2007

Page 3 of 4

Address Line 1:
Address Line 2:

*

Address Line 3:

*

City:
State:
Zip Code:
Country
Federal Tax ID or SSN:
Contact Name:

*

Phone:

*

Fax:

*

E-Mail:

*

Fourth Guarantor
Click here if not applicable

Not Applicable

Name:
Address Line 1:
Address Line 2:

*

Address Line 3:

*

City:
State:
Zip Code:
Country
Federal Tax ID or SSN:
Contact Name:

*

Phone:

*

Fax:

*

E-Mail:

*

Fifth Guarantor
Click here if not applicable

Not Applicable

Name:
Address Line 1:
Address Line 2:

*

Address Line 3:

*

City:

https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/0/DBCD8535E5CB221A852572A40053... 3/20/2007

Page 4 of 4

State:
Zip Code:
Country
Federal Tax ID or SSN:
Contact Name:

*

Phone:

*

Fax:

*

E-Mail:

*

Note: If there are more than five guarantors for this transaction, please mail the name, address, and
contact information on these additional guarantors to Ex-Im Bank along with the other required
documentation at the following address:
Working Capital Claims
Asset Management Division
Export-Import Bank of the U.S.
811 Vermont Avenue, NW
Washington, DC 20571

To speed your claim, we recommend sending this via overnight mail.

https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/0/DBCD8535E5CB221A852572A40053... 3/20/2007