OMB No. 3048-0005
LETTER OF INTEREST  Expires __/__/200_ APPLICATION 
Please type. Processing of applications may be delayed if the requested information is not provided. 
	1. Applicant. The applicant may be any responsible individual, financial institution or non-financial enterprise. ~ Check if applicant has 

been assisted by a city or state export agency and provide the name of the agency: 
Applicant name: Duns #: 
Contact person: Phone #: 
Position title: Fax #: 
Street Address: City: 
State/Province: Postal Code: Country: Taxpayer ID #: 
	2.	Exporter. The “exporter” is the company which contracts with the buyer for the sale of the U.S. goods and services. ~ Check if the exporter is also the applicant. If not, complete the information below. 

Exporter name: Duns #: 
Street address: Phone #: 
City: State: Postal code: 
Taxpayer ID #: 
	3.	Supplier. The “supplier” is the U.S. company which manufactures the goods and/or performs the services to be exported. ~ Check if the supplier is also the exporter. ~ Check if the supplier is not determined. If neither applies, attach the same information for the primary supplier as requested above for the exporter. Information on additional suppliers is not required for an LI. 
	4.	Borrower. The “borrower” is the company which agrees to repay the Ex-Im Bank direct or guaranteed loan. Complete the information below. Check the box for “public sector” if the borrower is at least 50% directly or indirectly owned by a government. Check the box for “private sector” if the borrower is less than 50% owned by a government. 

Contact person: Fax #: 
Borrower name: Duns #: 
Street address: City: ~ public sector ~ private sector 
State/Province: Postal Code: Country: 
	5.	Buyer and End-user. The “buyer” is the company which contracts with the exporter for the purchase of the U.S. goods and services. The “end-user” is the foreign company which utilizes the U.S. goods and services in its business. ~ Check if the borrower, buyer, and end-user are not the same entity. If box is checked, attach the same information for the buyer and the end-user as requested above for the borrower. 
	6. Export Items. The “export items” are the goods and services to be exported from the U.S. 

6a.	Large Aircraft. ~ Check if the export items include aircraft which, in a passenger configuration, contain more than 70 seats.If box is checked, complete Attachment A. 
6b.	Military. ~ Check if the buyer is associated in any way with the military, if any export items are to be used by themilitary, or if any export items are defense articles or have a military application. 
6c.	Limited Recourse Project Finance. ~ Check if you want a Letter of Interest issued by the Project Finance Division. If box is checked, complete Attachment D. 
6d.	Description of Export Items. Briefly describe the principal goods and services, including the type, quantity, model numberand capacity (if applicable), and SIC Code. For an aircraft transaction, include a description of the engines. 
EIB Form 95-9
Revised 04/99 1
OMB No. 3048-0005
LETTER OF INTEREST Expires: 10/31/2004 APPLICATION 
6e.	Utilization of Export Items. Briefly describe the principal business activity of the end-user. If the export items are to beused in a project, also provide the name, location, purpose, and scope of the project. 
	7. Financing Type Requested.	 Check applicable box(es). You may request both a direct loan and a guarantee. If both financing options are acceptable to Ex-Im Bank, they will be indicated in the LI as options. Refer to Attachment A if the transaction involves the export of new large aircraft. 

~ Direct Loans ~ Comprehensive Guarantee ~ Political Risk Guarantee 
	8. Contract Price. The “contract price” is the amount to be shown in the supplier’s invoice related to goods to be exported from theU.S. and services to be performed by U.S. companies. If there is more than one supplier, the contract price is the sum of thesuppliers’ invoice amounts. The “eligible foreign content” is the portion of the contract price representing components to bepurchased by the sup-plier outside the U.S. and incorporated in the U.S. into the items to be exported. Costs to be incurred in the end-user’s country are not considered eligible foreign content. Note that the eligible foreign content, if any, is part of the contractprice. 

8a. Contract Price: $ (including eligible foreign content) 
8b. Eligible Foreign Content: $ 
	9. Foreign Competition. ~ Check if, to the best of your knowledge, there is at least one entity offering non-U.S. goods and/or services indirect competition for this specific export sale. 
	10. Other U.S. Government Agencies. ~ Check if an application for support of this export contract or related project has been filed withthe Agency for International Development, Maritime Administration, Overseas Private Investment Corporation or Trade DevelopmentAgency. 
	11. Environmental Effects. If 85% of the contract price exceeds $10,000,000, complete Attachment B. Attachment B is not required foraircraft transactions. 
	12. Tied Aid Capital Projects Fund. If you want Ex-Im Bank to preclude or counter a tied aid offer, complete Attachment C. 
	13. Certifications. The undersigned certifies that the facts stated and the representations made in this application and any attachmentsto this application are true, to the best of the applicant’s knowledge and belief after due diligence, and that the applicant has notomitted any material facts. 

The undersigned further certifies that it is not currently, nor has it been within the preceding three years: 1) debarred, suspended or declared ineligible from participating in any Federal program; 2) formally proposed for debarment, with a final determination still pending; 3) voluntarily excluded from participation in a Federal transaction; or 4) indicted, convicted or had a civil judgment rendered against it for any of the offenses listed in the Regulations Governing Debarment and Suspension (Governmentwide Nonprocurement Debarment and Suspension Regulations: Common Rule), 53 fed. Reg. 19204 (1988).   The undersigned is not listed  on any of the publicly available debarment lists of the following international financial institutions: World Bank Group, African Development Bank, Asian Development Bank, European Bank for Reconstruction and Development and the Inter-American Development Bank.
 
	In addition, the undersigned certifies that neither the undersigned nor anyone acting on its behalf, such as agents, has engaged, or will engage,  in any activity in connection with this transaction that is a violation of the Foreign Corrupt Practices Act of 1977, 15 U.S.C. 78dd-1, et seq. (which provides for civil and criminal penalties against companies and individuals who directly or indirectly make or facilitate corrupt payments to foreign officials to obtain or keep business).  

Further, neither the undersigned nor anyone acting on its behalf in connection with this transaction is currently under charge or have been, within the past 5 years, convicted in any court or been subject to national administrative measures of any country for bribery of foreign public officials.

Applicant (company) name: 
Name and title of authorized officer: 
Signature of authorized officer: Date: 
Payment, payable to the Export-Import Bank of the U.S., must accompany application; please indicate: ~ Visa ~ Mastercard ~ Check Account #: Expiration Date: 
Signature: 
Ex-Im Bank would be pleased to assist you in applying for financial support. If you have any questions, please contact the Business Development Division (Telephone: 202-565-3946 or Fax: 202-565-3931). For information concerning financing of large aircraft and ancillary equipment, please contact the Aircraft Finance Division (Telephone: 202-565-3550 or Fax: 202-565-3558). 
Taxpayer Identifying Numbers: Ex-Im Bank intends to use the taxpayer identifying numbers furnished on this application for purposes of collecting and reporting on any claims arising out of such persons’ or business entities’ relationships with the U.S. government. 
EIB Form 95-9
Revised 04/99 2
OMB No. 3048-0005
LETTER OF INTEREST Expires: 10/31/2004 APPLICATION 
Notices

The applicant is hereby notified that information requested by this application is done so under authority of the Export-Import Bank Act of 1945, as amended (12 U.S.C. 635 et seq.); provision of this information is mandatory and failure to provide the requested information may result in Ex-Im Bank being unable to issue the Letter of Interest. Ex-Im Bank may not require the information and applicants are not required to provide information requested in this application unless a currently valid OMB control number is displayed on this form (see upper right of each page). 
Public Burden Statement: Public burden reporting for this collection of information is estimated to average 20 minutes per response, including time required for searching existing data sources, gathering the necessary data, providing the information required, and reviewing the final collection. Send comments on the accuracy of this estimate of the burden and  recommendations for reducing it to: Office of Management and Budget, Paperwork Reduction Project (#3048-0004), Washington, D.C. 20503. 

EIB Form 95-9
Revised 04/99 3

OMB No. 3048-
LETTER OF INTEREST APPLICATION 0005 
Expires
ATTACHMENT A: Large Aircraft Transactions 
07/31/2001 
	1.	Financing Type Requested. Three financing options are available for new large aircraft transactions under the Large Aircraft Sector Understanding (LASU), contained in the OECD Arrangement. Check the option(s) you are requesting. For used large aircraft transactions, complete No. 7 of the Letter of Interest Application. 

~ Option 1: An Ex-Im Bank guarantee for up to 85% of the contract price. 
~	Option 2: An Ex-Im Bank guarantee for 42.5% of the contract price coupled with an Ex-Im Bank direct loan at the applicable LASU interest rate for 42.5% of the contract price. The Ex-Im Bank direct loan is repaid during the later maturities. 
~	Option 3: An Ex-Im Bank guarantee for 22.5% of the contract price coupled with an Ex-Im Bank direct loan at the applicable LASU interest rate for 62.5% of the contract price. The Ex-Im Bank guaranteed loan and direct loan are repaid on a paripassu basis. 
	2.	Spare Parts Financing. Indicate in No. 6d. of the Letter of Interest Application if any spare parts or spare engines are included in the export sale. Provide the requested information on these items. 
	3.	Transaction Information. Include with your application a background summary on the airline, the reason for the purchase, proposed routes, and delivery dates. This information replaces the information requested in No. 6e. of the Letter of Interest Application. 
	4.	Contract Price. If credit memoranda information is available, deduct all airframe and engine credit memoranda, if any, from the aircraft price when calculating the contract price to be entered in No. 8a. of the Letter of Interest Application. 

If you have questions about this attachment, please contact the Aircraft Finance Division at 202-565-3550. 
EIB Form 95-9 Revised 04/99 

OMB No. 3048-0005
LETTER OF INTEREST APPLICATION Expires 07/31/2001 
ATTACHMENT B: Ex-Im Bank Environmental Screening Document 
Limited Recourse Project Financing and Long-Term Programs Only 
Ex-Im Bank will screen project finance and long-term transactions into three categories, as defined in Ex-Im Bank’s Environmental Procedures. The information you provide will help Ex-Im Bank to determine the proper category for your application. This information is crucial to the appropriate and timely review of your application. Check the boxes that apply to your application. 
	1.	Project Identification. ~ Check if the goods and/or services described in your application are destined for an identified project. If checked, identify the project: 

If not checked, explain: 
	2.	Project Location. Is the project located in or sufficiently near to have perceptible environmental effects in any of the following areas? Check all that apply. 

~ 	Tropical Forest 	~ 	Nationally designated seashore areas 		
~ 	Nationally designated wetlands or protected wildlands 	~ 	Habitat of endangered species 		
~ 	National parks 	~ 	Large scale resettlement 		
~ 	Nationally designated refuges 		(How many persons? 	) 	
~ 	Coral reefs or mangrove swamps 	~ 	Properties on the World Heritage List 		

	3.	Project Sector or Industry. Which classification describes the project for which the exports are destined? Check all that apply. ~ Airport construction ~ Nuclear power plant ~ Consulting services ~ Chemical plant ~ Oil & gas field development ~ Hospitals and medical equipment ~ Forestry ~ Petrochemical plant or refinery ~ Pre-project services (feasibility & 

environmental studies) 
~ Geothermal Power ~ Pharmaceutical project 
~ Railway signaling 
~ Hydropower plant ~ Pulp & paper plant 
~ Telecommunications or satellites 
~ Iron & steel plant ~ Smelter 
~ Transportation carriers (aircraft, 
~ Large infrastructure project ~ Thermal power plant locomotives, boats) 
~ Large-scale water reservoir ~ Waste management ~ Other (describe) 
~ Mining & mineral processing plant ~ Air traffic control systems or 
navigational aids 
Name of Applicant 
Date 
If you have questions about this attachment, please contact the Engineering and Environment Division at 202-565-3570. 
EIB Form 95-9 
Revised 04/99 
“ANNEX B” to Ex-Im Bank’s Feb. 1995 Environmental Procedures 

OMB No. 3048-0005
LETTER OF INTEREST APPLICATION Expires 07/31/2001 
ATTACHMENT C: Tied Aid Capital Projects Fund 
	1. ~ Check if you are requesting appropriate Ex-Im Bank support to preclude or counter foreign tied aid offers. 
	2. ~ Check if one or more foreign governments are offering, or planning to offer, unusually long repayment periods, unusually low interest 

rates, and/or mixed grant-credit financing for the specific contract for which Ex-Im Bank support is sought. Attach available documen
tary evidence of a foreign tied aid credit offer. If such evidence is not available, specify your reasons for suspecting foreign tied aid. 
	3.	~ Check if you authorize Ex-Im Bank to ask the OECD Secretariat to issue a confidential “no aid” common line request to OECD member governments. Acceptance of this request would preclude future foreign and U.S. aid financing for the project. 
	4.	~ Check if you believe that loss of this contract will jeopardize follow-on sales opportunities for similar sales in the same market. Provide the type and estimated value of potential follow-on sales. 

5. Provide the following information, if known, for each foreign government’s tied aid offer. 
	Foreign Offer #1 Foreign Offer #2 Donor government 

Foreign exporters supported 
Total offer amount 
Currency of offer 
Credit portion amount 
Credit portion interest rate 
Credit portion grace period 
Credit portion repayment period Grant portion, if any 
If you have questions about this attachment, please contact the Credit Applications and Processing Unit at 202-565-3800. 
EIB Form 95-9 Revised 04/99 
OMB No. 3048-0005LETTER OF INTEREST APPLICATION Expires 07/31/2001 
ATTACHMENT D: Project Finance Transactions, Executive Summary 
Ex-Im Bank’s analysis of potential limited recourse project finance transactions differs from routine export trade finance transactions. Therefore, we require additional information from applicants for a Project Finance Letter of Interest. Please provide the information outlined below to the best of your ability. It is highly recommended that you provide as much information as possible at this stage of the application process. 
	1.	Project Name: _____________________________________________________________________________________ 
	2. Type of Project: ___________________________________________________________________________________ 
	3. Project Location: __________________________________________________________________________________ 

4.	Project Description: _______________________________________________________________________________ _________________________________________________________________________________________________ 
	_________________________________________________________________________________________________ _________________________________________________________________________________________________ 
	5. Project Participants 
	a. Sponsors: _____________________________________________________________________________________ _________________________________________________________________________________________________ 
	b. EPC Contractor: _______________________________________________________________________________ _________________________________________________________________________________________________ 
	c. Project Input Supplier(s): _______________________________________________________________________ _________________________________________________________________________________________________ 

d. Off-taker(s): 
	____________________________________________________________________________________ _________________________________________________________________________________________________ 
	6.	Estimated Debt to Equity Ratio: ______________________________________________________________________ 
	7.	Other Potential Financing Sources: ___________________________________________________________________ 
	8.	Is this an international tender? 9 Yes 9 No Bid due date: ________________________________________ 

9. Estimated Project Timeline: (e.g. financial close, construction start date, etc.) 
	______________________________ ________________________________________________________________________________________________ 
	10.	Project Status: (e.g. signed EPC contract, status of offtake contract, etc.) __________________________________ _________________________________________________________________________________________________ 

EIB Form 95-9 Revised 12/99 OMB No. 3048-0005
LETTER OF INTEREST APPLICATION Expires 07/31/2001 
ATTACHMENT D: Project Finance Transactions, Executive Summary 
	11.	Other Relevant Factors: ____________________________________________________________________________ _________________________________________________________________________________________________ 

_________________________________________________________________________________________________ 
If you have questions about this attachment, please contact Business Development Divisionat 202-565-3946. 
EIB Form 95-9 Revised 12/99