Form EIB 10-02 EIB 10-02 EIB 10-02, APPLICATION FOR SHORT-TERM EXPRESS EXPORT CRE

APPLICATION FOR SHORT-TERM EXPRESS
EXPORT CREDIT INSURANCE POLICY

OMB No.

PPRINT
R INT

3048-0031

PENDING 2025

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 a 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:

*UEI #:

*DUNS #:
*Does the Exporter have any

Phone #:

Title:

Contact Person:

affiliates2?:

Yes

No

*Primary Industry NAICS1:

*Is there corporate ownership?:

No

Yes

*Name of ultimate parent company:
*Total number of employees:

*Annual sales volume:
*Woman-owned Business:

Yes

No

Decline to Answer

*Minority-owned Business:

Yes

No

Decline to Answer

*Veteran-owend Business:

Yes

No

Decline to Answer

*Disabiity-owned Business:

Yes

No

Decline to Answer

Ethnicity

Race (one or more boxes may be selected)
American Indian or Alaska Native

Asian

Black or African American

Hawaiian Native or Pacific Islander
Middle Eastern of North African

Hispanic or Latino
Decline to answer

White

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.
2Affiliations 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.

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

Broker

EXIM Regional Office

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 Export 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

No

Yes
Yes

No

If 'Yes', answer the following questions:

(a) Does each affiliate invoice export credit sales in its own name or tradestyle?

Yes

No

(b) Are the credit decisions of each affiliate centralized with this applicant?

Yes

No

If "No", please comment:
(c) Are the products of each affiliate the same as the applicant's products described in the Products section on page 2 of this application?

Yes

No

If "No", please list the products in the Products section on page 2 of this application.
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-10-02 (Rev. 11/2024)

Page 1 of 5

OMB No. 3048-0031
PENDING 2025

Products
1. Products and/or services to be exporter:
2. Products NAICS code (if known):
3. For SBA defined Small Businesses Only: Please note that you may answer "Yes" to either or both (b) and (c) below.
(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

(b). If the answer to 3(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

Yes

No

Yes

No

New?

(c).

(d).

If the answer to 3(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.
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)?

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

Yes

No

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

Yes

No

All made or reconditioned with more than 50% U.S.

Yes

No

Content?Sold to military entities or security forces?

Yes

No

Used to support nuclear energy?

Yes

No

Used?

Environmentally beneficial?

Yes

No

Supporting renewable energy?

Yes

No

Yes

Yes

On the U.S. Munitions List?

Yes

No

No

No

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

Shipped from the U.S.?

Yes

No

Exporter Portfolio and Experience The following responses should include amounts attributable if you are insuring export credit sales made by your affiliates.
1. Policy Payment Limit Requested (maximum export receivables outstanding at any one time, NOT total sales for the year): $
2. Year you began:

Exporting:

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

3. Total export credit sales for the last three years: $
4. Total export credit losses for the last three years: $
5. Number of export credit accounts (buyers) written off over the last three years:
6. How many foreign buyers do you currently sell to on credit terms?
7. Amount of credit sales outstanding: $

as of
(date should be within 30 days of the current date)

8. Total amount of export receivables past due by more than 60 days: $

Applicant's Financial Highlights
1. Is the financial data parent-consolidated or combined with any other entity?
2. Statement dates from (mm/dd/yyyy)
3. Statement type:

Company Prepared

Net Sales:

$

Operating Profit:

$

to
CPA Compiled

CPA Reviewed with Notes

CPA Audited

Tax Return

NET Profit of (Loss): $
Total Assets:
Equity:

EIB-10-02 (Rev. 11/2024)

$
$
Page 2 of 5

OMB No. 3048-0031
01/31/2025

Buyer Information

You can submit credit limit requests for up to 5 buyers. Answer the questions below for the first buyer. Attach separate sheets for any additional buyers.
Check here if you do not want to submit any buyer credit limit requests with this application.
1. Buyer Name:
Business Address:
State/Province:

City:

Postal Code:

Country:
2. Requested Credit Limit: $
3. Requested Terms:

Open Account

Cash Against Documents

Documents Against Acceptance
4. Requested Maximum Tenor:

Unconfirmed Irrevocable L/C

Promiossory Note

Documents Against Payment
91-120 Days

61-90 Days

Sight Payments

1-30 Days

31-60 Days

121-180 Days

181-270 Days

271-360 Days

5. Do you have any ownership interest in or familial ties with the buyer?

Yes

No

If 'Yes', comment below:

6. Will the products be shipped directly to the buyer in the buyer's country?

Yes

No

If 'Yes', comment below:

Yes

7. Is the buyer purchasing product(s) for resale to another country/countries?

8. Any prior sales to the buyer?

If 'Yes', comment below:

9. Year of your first sale to the buyer (YYYY):

No

Yes

No

Yes

10. Any prior sales to the buyer on credit terms? Exclude any Cash-in-Advance or Letter of Credit sales.

No

11. Year of your first sale to the buyer on credit terms. Exclude any Cash-in-Advance or Letter of Credit sales:
12. Total sales made to the buyer on credit terms over the last three years. Enter '0' if the buyer is new to you: $
Payment Terms Extended to the Buyer Over the Last 12 Months
13. Transaction Type:

Sight Payments

1-30 Days
181-270 Days

121-180 Days

Promiossory Note

Documents Against Payment

Documents Against Acceptance
14. Maximum Tenor:

Unconfirmed Irrevocable L/C

Cash Against Documents

Open Account

61-90 Days

31-60 Days

91-120 Days

271-360 Days

15.. What is the highest amount outstanding over the last 12 months for which you have been paid?: $
16. Describe the buyer's history over the last 12 months:

Prompt

1-30 Days Slow

90+ Days Slow

31-60 Days Slow

61-90 Days Slow

No Experience

17. What is the amount now owed to you by the buyer? Enter '0' if none: $
18. What is the total amount now more than 60 days past due? Enter '0' if none: $
19. What is the reason for the buyer being past due to you?
20. Do you hold security on the amount past due?

EIB-10-02 (Rev. 11/2024)

Yes

No

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OMB No. 3048-0031
PENDING 2025

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

Yes

No

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.
Transformational
Export Areas

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

Artificial Intelligence

...make the best decision given changing
circumstances using computerized system,
without direct human input or intervention

Biotechnology

...use biological processes for industrial and
other purposes

Biomedical Sciences

..diagnose and/or treat medical conditions in
humans with advanced medical equipment and
processes

Wireless communications
equipment

...distribute information by means of digital
electromagnetic transmission without the
need for wires, optical fibers, or
othersynthesized materials

Quantum computing

...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

1...generate or use of energy produced from
a naturally renewable source
2...reduce energy loss or consumption in a
system or application
3...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]

Please provide additional comments if your business, products or selling terms are unique and require any special coverages or exclusions:

EIB-10-02 (Rev. 11/2024)

Page 4 of 5

CERTIFICATIONS AND SIGNATURE

OMB No. 3048-0031
PENDING 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-10-02 (Rev. 11/2024)

Page 5 of 5