Form EIB 92-50 EIB 92-50 Application for Short-Term Multi-Buyer Export Credit Ins

APPLICATION FOR SHORT-TERM MULTI-BUYER
EXPORT CREDIT INSURANCE POLICY

OMB No. 3048-0023
01/31/2025

PPRINT
R INT

An online version of this application is available on EXIM’s web site. EXIM encourages customers to apply online to facilitate our review and
allow customers a faster response time. Additional information on how to apply for EXIM insurance can be found at EXIM’s web site
www.exim.gov
Send this completed application to EXIM, 811 Vermont Ave NW, Washington, D.C. 20571. EXIM will also accept E-mailed PDF and faxed
applications. EXIM will not require the originals of these applications to be mailed. The application must be PDF scan of the original
application and all required documents.(Fax number: 202.565.3380, E-mail: [email protected])
Items marked with an asterisk (*) are required fields. Under corporate ownership, provide the name of the ultimate parent company if there
is a corporate owner. For number of employees and sales volume, aggregate for the company and all its affiliates1, including corporate
owners and subsidiaries.

Exporter
Tradestyle Name:

*Exporter Legal Name:
*Business Address:

*Zip + 4:

*State:

*City

Country:
Fax:

E-mail:
*DUNS #:

*UEI #:

*Primary Industry NAICS1:

*Total Number of Employees:

*Annual Sales Volume: $
*Does the Exporter have any

Phone #:

Title:

Contact Person:

affiliates2?

*Is there corporate ownership?:

No

Yes

No

Yes

Name of ultimate parent company:
*Woman-owned Business:

Yes

No

*Minority-owned Business:

Yes

No

*Veteran-owend Business:

Yes

No

*Disabiity-owned Business:

Yes

No

Race and/or Ethnicity (Select all that apply):
American Indian or Alaska Native

Asian

Middle Eastern or North African

Native Hawaiian or Pacific Islander

Black or African American

Hispanic or Latino
White

Decline to answer

1A

company’s Primary Industry NAICS codes is the NAICS that accounts for the largest share of sales for the most recently completed fiscal year. The full definition of “primary industry” is set forth at
13C.F.R. § 121.107.
exist when one individual or entity controls or has the power to control another or when a third party or parties control or have the power to control both. Factors such as common ownership,
common management, previous relationships with or ties to another entity, and contractual relationships may cause affiliation. The complete definition of affiliation is found at 13 C.F.R. § 121.103.

2Affiliations

Brokerage:
General Questions
1. How did you learn about EXIM?

EXIM Regional Office

Broker

Bank

EXIM REPP

U.S. Export Assistance Center

Other (explain):
2. Primary reason for application:

Risk Mitigation

3. Coverage Type Requested:

Comprehensive (Commercial & Political)

Financing

Extend more competitive terms

Political Only

4. Do you have a credit line with a financial institution (exclude overdraft protection and credit cards)?
5. Do you have an (a) SBA Working Capital Loan?

Yes

6. Do you wish to insure export credit sales made by your affiliates?

No

(b) EXIM Working Capital Loan?

Yes

No

Yes
Yes

No

No

(If yes, please refer to “additional named insured” eligibility criteria on page 3 under Special Coverages. Answers to all remaining questions must include
eligible affiliates you wish to add)

Products

1. Products and/or services to be exporter:
2. Products NAICS code (if known):
Note: Your buyers, their guarantors (if any), and end users of the products must be in countries where EXIM is able to provide support, see EXIM's Country Limitation Schedule (CLS) at
http://www.exim.gov. There may not be trade measures or sanctions against the good produced with the
U.S. export under Section 201 of the Trade Act of 1974. For a list of products and countries with Anti-Duping or Countervailing Duty sanctions, see section AD/CVD Orders available at
http://www.usitc.gov/trade_remedy/731_ad_701_cvd/investigations/active/index.htm. Trade sanctions are product and country specific (i.e., all firms within a country are subject to the

EIB-92-50 (Rev. 7/2024)

Page 1 of 6

*PLEASE NOTE THAT YOU MAY ANSWER 'YES' TO EITHER OR BOTH (b) AND (c) BELOW.

OMB No. 3048-0023
01/31/2025

3(a). For SBA defined Small Businesses Only: Was each of the products to be covered under the policy manufactured
or reconditioned with more than 50% U.S. content (comprised of all direct and indirect costs including but not limited
to, labor, materials, research and administrative costs, but excluding net profit)?

Yes

No

3(b). If the answer to 9(a) is “No” because one or more of your products contains less than 50% U.S. content then
coverage is available for the U.S. content only in each product with less than 50% U.S. content. Please indicate if
you are seeking coverage for products with less than 50% U.S. content.

Yes

No

3(c).

If the answer to 9(a) is “No” you may also obtain coverage on an aggregated basis for all products on an invoice,
provided that a Content Report is submitted at the time of shipment (please see applicable Fact Sheet for
information on aggregation). Please indicate if you are seeking coverage on an aggregated basis.

Yes

No

3(d).

For Non-SBA Defined Small Businesses: Was each of the products to be covered under the policy manufactured or
reconditioned with more than 50% U.S. content (labor, materials and direct overhead, but excluding net profit)?

Yes

No

Yes

4. Do you sell Capital Goods to foreign manufacturers or producers? (if Yes, attach explanation)

No

5. Are the Products to be covered under the policy:
Manufactured of reconditioned in the U.S.?

Yes

No

Environmentally Beneficial?

Yes

No

New?

Yes

No

Sold to Military entities or Security forces?

Yes

No

Supporting Renewable Energy?

Yes

No

Used?

Yes

No

Used to support Nuclear Energy?

Yes

No

On the U.S. Munitions List?

Yes

No

(Part 121 of title 22 of the Code of Federal Regulations)

Exporter Portfolio and Experience
1. Policy Payment Limit Requested (total export receivables outstanding at any one time, NOT total sale for the year): $
2. Buyer Types (percentages must total 100%):
% Manufacturers

% Government Agency

%Service Providers

% Retailers

%Wholesalers/Traders

3. Projected number of buyers to whom you will offer export credit terms:
4. Average total of annal export credit sales over the last three years for you and your affiliates:

$

5. Enter the percentage of export credit sales by payment and term type projected for the next 12 months:
Terms (# of days)
Sight

1-30

Unconfirmed L/C

0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

0.00%

Open Account/Drafts

31-60

61-90

91-120

121-180

Payment Type

181-270

271-360

Enter "Cash Against Documents" in the "Sight" column" and "Open Account/Drafts" row.
6. Export Credit Portfolio: Enter amounts for the projected top 10 countries to which you will have export credit sales over the next 12 months:

Credit Sales

Country

Country

Credit Sales

1.

$

6.

$

2.

$

7.

$

3.

$

8.

$

4.

$

9.

$

5.

$

10.

$

EIB-92-50 (Rev. 7/2024)

Page 2 of 6

OMB No. 3048-0023
01/31/2025

7. Identify your three (3) largest buyers:

Name

Country

Export Credit Sales (next 12 months)

1.

$

2.

$

3.

$

8. Highest average amount of export receivables outstanding over the last twelve months: $
(date should be within 30 days of application)

as of

9. Total export receivables outstanding: $

When calculating the age of receivables, use the due date of payment rather than the invoice date.
Outstanding Credit Sales (enter 0 if none for the period):
$

$

$
(Current)

(61 - 90 days past due)

(1 - 60 days past due)

$

$
(91 - 80 days past due)

(181+ days past due)

10. For the last three years, what were your total export credit (include factored or insured receivables and attach any comments):
# of accounts written off:

Write-offs: $

Sales: $

11. Number of buyers past due more than 60 days for $10,000 or more:
12. For each buyer over 60 days past due for $10,000 or more, attach an explanation, including the buyer's name, country, amount past due, due date, and
reason for past due.
13. Year you began:

Exporting:

Exporting on credit terms (other than cash in advance or confirmed letters of credit):

14. Name(s) of export credit decision maker(s):

Years of Credit
Experience

Title(s):

Years of Foreign
Credit Experience

15. Please submit the following as Attachments:
• Your financial statements for the most recently completed fiscal year (with notes if available)
• Descriptive product brochures (if available).
• Other pertinent information you wish to include.

Special Coverages Required (If none, check here):

Not applicable

Insure Sales by Affiliates (Additional Named Insured): Export credit sales of the applicant’s verified subsidiaries, affiliates, or tradestyles are eligible
for addition under a policy. “ANI’s” must invoice export credit sales in their own name. Policyholders and their approved ANI’s have equal policy rights
and requirements. However, policy and buyer coverage limits are not duplicative. Any claim payments are made only to the policyholder. EXIM may
require additional financial, credit or credit procedures information to assess insurance risk when qualifying ANIs. The “Additional Named Insured
Endorsement” formally documents ANI additions.
Does each affiliate invoice export credit sales in its own name or tradestyle?
Are the credit decisions of each affiliate centralized with this applicant?

Yes

Yes

No

No

If "No", please comment:
Are the products of each affiliate the same as the applicant's products described in the Products section on page 1 of this application?

Yes

No

If "No", please list the products in the Products section on page 1 of this application.

EIB-92-50 (Rev. 7/2024)

Page 3 of 6

OMB No. 3048-0023
01/31/2025
Affiliate Company/Tradestyle Name

Business Address/City/State/Country

Services (please attach a copy of your sample services contract). Export credit sales of services and charges for materials and equipment necessary
to render services are eligible for addition under the policy. The sale of services and related charges must be set forth in a written contract of sale between
the policyholder and buyer with invoiced billings to be made no later than 30 days following the month the services were performed.
Services must be performed by the policyholder’s (or its ANIs) personnel headquartered in the U.S. or those headquartered in the U.S. but temporarily
assigned in the buyer’s country. Services coverage does not include cancellation of the written contract of sale, any services that were not performed,
charges relating to use of foreign made equipment, or confiscation of the policyholder’s (or ANIs) U.S. or foreign equipment by any party. The “Services
Endorsement” formally documents the addition of services under the policy. A Services Endorsement is not required for product sales whose invoices
build-in nominal ancillary services.
Overseas Warehouse Export credit insurance is available for sales to foreign buyers from your overseas warehouse(s) used to store inventory. The
warehouse must be bonded and either owned or controlled by the policyholder through either its agent, branch, subsidiary or itself. The policyholder is
required to retain title to the warehoused products. For most products, the sale out of the warehouse must occur no later than 180 days from the date of
shipment from the U.S.
The Warehouse Endorsement does not provide any property or casualty coverage on the products while they are in the warehouse. Specific political riskonly coverage can be purchased for the warehousing period if you also elect to add the Consignment Endorsement coverage. This additional coverage
protects against the following events which prevent you from fulfilling a foreign buyer’s purchase order:
-Buyer cannot import the products into its country due to the imposition of a law or cancellation/non-renewal of a license;
-War, insurrection or a government’s confiscation or other arbitrary action against the buyer’s (or guarantor’s) business;
-Imposition of any law or regulation preventing the export of the products from the country in which the products are held in consignment.
Please provide the following information:
(a) Select the warehouse type:

Bonded warehouse

Owned or controlled by the applicant

Neither

(b) Warehouse location:
Country:

State (If U.S.)

City:

State/Province (non-U.S.)

Exclusions (specify transactions you wish to exclude from coverage):
UILC (Unconfimed Irrevocable Letters of Credit)

Invoices Under $10,000

SDDP/CAD (Sight Draft Documents Against Payment or Cash Against Documents)
Sales to Subsidiaries and/or Affiliates

Sales to Canada
Sales of Samples

Other (please specify)

Other Special Coverages (specify specify):

China and Transformational Exports Program
To determine if your transaction is eligible for Sec. 402 consideration, the answer to at least one of the following two questions
must be "Yes":
Is your transaction facing competition from an entity backed by the People's Republic of China (PRC) - Section 402(A)?

Yes

No

Is your transaction one of the ten Transformational Export Areas or a related service - Section 402(B)?

Yes

No

At least one Transformational Export Area value must be selected in the table below if you have responded "Yes" to the 402(B)
question immediately above.

EIB-92-50 (Rev. 7/2024)

Page 4 of 6

OMB No. 3048-0023
01/31/2025

Transformational
Export Areas

Artificial Intelligence

Biotechnology
Biomedical Sciences

Wireless communications
equipment

Quantum computing

Export Value
The value of the export
largely consists of
technology used to...

Buyer End Use
The foreign buyer
will use the exports
to...

Justification

...make the best decision given changing
circumstances using computerized system,
without direct human input or intervention
...use biological processes for industrial and
other purposes
..diagnose and/or treat medical conditions in
humans with advanced medical equipment and
processes
...distribute information by means of digital
electromagnetic transmission without the
need for wires, optical fibers, or
othersynthesized materials
...facilitate the implementation and use of
quantum computers (application of qubit
superposition processing)

Renewable energy, energy
efficiency, energy storage
1. Renewable energy
2. Energy efficiency
3. Energy storage

...generate or use of energy produced from a
naturally renewable source
...reduce energy loss or consumption in a
system or application
...store energy with a capacity of 1kWh

Semiconductor and
semiconductor
manufacturing

...make use of semiconductors or the U.S.
semiconductor industry

Emerging financial
technologies

...improve or automate the delivery and use
of financial services

Water treatment and
sanitation

...produce or distribute potable water for
human consumption, or collect and/or treat
wastewater, regardless of origin

High-performance
computing

...process more than 500 terabytes/day or
exceed a speed of 500 teraflops/second

No
Yes
Does this transaction require flexibilities to move forward?
If yes, please provide a brief description below and your request will be reviewed by EXIM's CTEP division. If necessary, you
can directly contact the CTEP team by sending an email to [email protected]

Comments:

Page 5 of 6
EIB-92-50 (Rev. 7/2024)

CERTIFICATIONS AND SIGNATURE

OMB No. 3048-0023
01/31/2025

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

(Name of Applicant)

on behalf of

and that as such I am authorized to execute this application
.

(Name of Applicant)

In witness whereof, I have hereunto signed my name this

day of

. 20

.

Signature:

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 0.5 hour(s) 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# 3048-0023 Washington, D.C. 20503.

EIB-92-50 (Rev. 7/2024)

Page 6 of 6