Form EIB92-51 Application for Special Buyer Credit Limited (SBCL) unde

Print Form
OMB #3048-0015
Pending 2019

EXPORT-IMPORT BANK OF THE UNITED STATES
APPLICATION FOR SPECIAL BUYER CREDIT LIMIT (SBCL) UNDER MULTI-BUYER EXPORT CREDIT INSURANCE POLICIES
App. No.______________________
(Please Print or Type)
(Ex-Im Bank Use Only)

1.Insured/Exporter Name:

2. Broker (If none, state “None”)

Policy No:

State:

Brokerage:

Broker No:

Attn:

Tel No:

Attn:

Tel. No:

Fax No:

E-Mail:

Fax No:

E-Mail:

3. Reason for Application on this Buyer:
Policy carries no Discretionary Credit Limit (DCL)
Amount requested exceeds DCL
Country Limitation Schedule restricts your DCL in this market
Other______________________________
Renewal/Increase/Amendment of existing SBCL-Existing Final Shipment Date
4.

Buyer Name and Address:

5.

Guarantor Name and Address (If any):

File No.________________________
(Ex-Im Bank Use Only)
File No.________________________
(Ex-Im Bank Use Only)

6. (a) Products
New
Used (if used, attach Used Equipment Questionnaire EIB92-63).
(b) Products Description____________________________________________________________________
(c) Is each product produced or manufactured in the United States?
Yes
No
(d) Has at least one-half of the value, exclusive of price mark-up, been added by labor or material exclusively of United States origin?
Yes

No

(e) Are products listed on the United States Munitions List? (part 121 of Title 22 of the Code of Federal Regulations)

Yes

No

7. (a) Exporter and/or manufacturer name and address if other than insured:____________________________________________
8. (a) Credit Limit requested $ __________________________________________________________________
(b) Payment terms requested _______________________________________________________________________________
9. (a) Summary of credit experience with this buyer during current year and past two years, including uninsured experience:
Total sales each year
Highest amount outstanding at any time during the period
Payment terms

$___________ $___________ $____________
$___________ $___________ $____________

(b) Describe buyer's payment history (check one)
No prior experience

Prompt/Discount

1-30 days slow

31-60 days slow

more than 60 days slow

(c) Amount now owing $____________, as of_________________(Date).
(d) Amount now past due (indicate maturity dates and explanation). $_____________________________________________
(e) If past dues are due to foreign exchange problem does insured have evidence of local currency deposit on all payments due?
Yes
No
Not Applicable
(f) If buyer is new account, indicate whether negotiating sales or $ value of orders already received $____________________

EIB 92-51
Revised 11/2019

Page 1 of 3

OMB #3048-0015
Pending 2019

10. Describe any direct or indirect ownership interest or family relationship which exists between the insured and the buyer (or
guarantor) or between the supplier and the buyer (or guarantor). If none, state "None".

11. CREDIT AND FINANCIAL INFORMATION REQUIREMENTS
See Short Term Credit Standards (EIB99-09) to determine the Credit And Financial Information Requirements in
connection with your application.

EIB 92-51
Revised 11/2019

Page 2 of 3

OMB No. 3048-0019
Pending 2019

CERTIFICATIONS AND SIGNATURE
Please refer to the “Standard Certifications and Covenants for EXIM Applications” set forth in Form EIB 18-CN,
posted on the EXIM website at https://www.exim.gov/tools-for-exporters/applications-forms/complete-list (the
“Standard Certifications”). THE STANDARD CERTIFICATIONS ARE INCORPORATED INTO THIS
APPLICATION AS IF FULLY AND DIRECTLY SET FORTH HEREIN. When signing this application in the
space provided below, the undersigned authorized officer signing on the applicant's behalf certifies and
represents that he or she is fully authorized to sign on the applicant's behalf, and that HE OR SHE HAS READ
the Standard Certifications referenced above AND IS CERTIFYING AND COVENANTING, as appropriate, to all
of the certifications, acknowledgments and covenants set forth in the Standard Certifications.
Applicant further certifies that the representations made and the facts stated in this application and its
attachments are true and Applicant has not misrepresented or omitted any material facts. Applicant further
covenants that if any statement set forth in this application or in the Standard Certifications, becomes untrue, or
is discovered to have been untrue when made, Applicant will promptly inform EXIM of all such changes or
discoveries. Applicant further understands that in accepting or approving this application, EXIM is relying upon
Applicant's statements set forth in the application and in the Standard Certifications, and all statements and
certifications to EXIM are subject to the penalties for false or misleading statements to the U.S. Government (18
USC § 1001, et. seq.).
I,

, do hereby certify that I am the duly appointed and qualified
(Title)

of

and that as such I am authorized to execute this application
(Name of Applicant)

on behalf of

.
(Name of Applicant)

In witness whereof, I have hereunto signed my name this

day of __

__

. 20

.

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 USC 635 et. seq.); provision of this information is mandatory and failure to provide the requested information may
result in EXIM being unable to determine eligibility for support. If any of the information provided in this application changes in any material
way or if any of the certifications made herein become untrue, the applicant must promptly inform EXIM of such changes. The information
provided will be reviewed to determine the participants’ ability to perform and pay under the transaction referenced in this application. EXIM
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). EXIM reserves the right to decline to process or to discontinue
processing of an application.
Paperwork Reduction Act Statement: We estimate that it will take you about 30 minutes to complete this form. This includes the time it will take to
read the instructions, gather the necessary facts and fill out the form. However, you are not required to provide information requested unless a valid
OMB control number is displayed on the form. If you have comments or suggestions regarding the above estimate or ways to simplify this form,
forward correspondence to EXIM and the Office of Management and Budget, Paperwork Reduction Project, OMB# 3048-0019 Washington, D.C. 20503.

EIB 92-51 (Rev. 11/2019)

Page 3 of 3