Export Credit Insurance Applications and Forms


page last updated  2012-Sep-25  

Instructions: Most of these forms can be filled in on line, then printed, signed and mailed to the Ex-Im Bank, but they cannot be saved to your computer. Some forms, however, can be saved to your computer. Savable forms are labeled with this graphic: Icon for PDF fill and save forms

More information about  fillable forms is available in the Guide for Fillable Forms.

APPLICATIONS Exporter Short-Term
PDFs
File Size
EIB92-50 ST Multi-Buyer Policy Application, ESC/ENB/ENVIRONMENT
Prepare and file this application ONLINE! at Ex-Im Online
Icon for PDF fill and save forms 331 Kb
EIB10-02 Application for Express Insurance
Prepare and file this application ONLINE! at Ex-Im Online
Icon for PDF fill and save forms 1,446 Kb
EIB92-51 Special Buyer Credit Limit Application for ST Multibuyer Policies
Prepare and file this application ONLINE! at Ex-Im Online
Icon for PDF fill and save forms 83 Kb
EIB92-64

Application for Exporter Short-Term, Single-Buyer Insurance  
Prepare and file this application ONLINE! at Ex-Im Online

     
Icon for PDF fill and save forms 695 Kb
  Exporter Medium-Term    
EIB03-02

Medium-Term Insurance or Guarantee Application (Adobe PDF format)             
Prepare and file this application ONLINE! at Ex-Im Online

   
Icon for PDF fill and save forms 1101 Kb
  Lender Short-Term    
EIB92-34 ST Bank Policy Application (ELC, EBD, EBS, EBM)
Prepare and file this application ONLINE! at Ex-Im Online
PDF file 151 Kb
EIB92-36 Issuing Bank Credit Limit Application under a ST Bank Letter of Credit (ELC) Policy Icon for PDF fill and save forms 228 Kb
EIB92-41 Application for Financial Institution Short-Term, Single-Buyer Insurance
Prepare and file this application ONLINE! at Ex-Im Online
Icon for PDF fill and save forms 489 Kb
EIB92-31 Assignment under ST Multi-Buyer Policies (no enhancements) Icon for PDF fill and save forms 94 Kb
EIB92-53 Enhanced Assignment for ST Small Business (ENB), Small Business Environmental (ENV) Policies Icon for PDF fill and save forms 86 Kb
EIB99-17 Enhanced Assignment under Exporter Short-Term Single-Buyer Policy Icon for PDF fill and save forms 133 Kb
EIB92-32 Assignment under Exporter Short-Term Single-Buyer Policy Icon for PDF fill and save forms 91 Kb
  Lender Medium-Term    
EIB03-02 MT Term Insurance or Guarantee Application
Prepare and file this application ONLINE! at Ex-Im Online
Icon for PDF fill and save forms 1101 Kb
EIB94-08 Assignment by Insured to Financial Institution of a Medium-Term Policy ("(doc)umentary") Icon for PDF fill and save forms 302 Kb
FORMS      
EIB92-27 Report of Overdue Accounts under Short-Term Policies Icon for PDF fill and save forms 410 Kb
EIB09-01 Report of Overdue Accounts under all other Programs
Prepare and file this report ONLINE! at Ex-Im Online
Icon for PDF fill and save forms 262 Kb
EIB92-29 Report of Premiums Payable for Exporters Icon for PDF fill and save forms 493 Kb
EIB94-07 Exporter Certificate (Short-Term) Icon for PDF fill and save forms 177 Kb
EIB11-05 Exporter's Certificate for Loan Guarantee & MT Insurance Programs PDF Fillable 118 Kb
CERT-12-001 Certifications and Notices for Exporter Certificates Icon for PDF fill and save forms 118 Kb
EIB11-03 Used Equipment Questionnaire Icon for PDF fill and save forms 471 Kb
EIB99-14 Trade Reference Form Icon for PDF fill and save forms 88 Kb
LLL Disclosure of Lobbying Activities Icon for PDF fill and save forms 145 Kb
EIB92-30 Report of Premiums Payable for Financial Institutions Icon for PDF fill and save forms 383 Kb
EIB92-37 Beneficiary Certificate & Agreement for Banks and Financial Institutions Icon for PDF fill and save forms 151 Kb
EIB92-61 Defense Products Questionnaire Icon for PDF fill and save forms 58 Kb
GUIDANCE DOCUMENTS
Guide-12-001 Promissory Note Single Disbursement or Consolidation Note
Medium Term Single Buyer Insurance Policy   
PDF file 30 Kb
Guide-12-002 Promissory Note Multiple Disbursment Grid Note
Medium Term Single Buyer Insurance Policy   
PDF file 31 Kb
Guide-12-003 Brazil Promissory Note Single Disbursement or Consolidation Note
Medium Term Single Buyer Insurance Policy   
PDF file 33 Kb
Guide-12-004 Brazil Promissory Note Multiple Disbursment Grid Note
Medium Term Single Buyer Insurance Policy   
PDF file 32 Kb
Guide-12-005 Dominican Republic Promissory Note Single Disbursement or Consolidation Note
Medium Term Single Buyer Insurance Policy   
PDF file 28 Kb
Guide-12-006 Dominican Republic Promissory Note Multiple Disbursment Grid Note
Medium Term Single Buyer Insurance Policy   
PDF file 28 Kb
Guide-12-007 Mexican Promissory Note Fixed Rate Single Disbursement    PDF file 32 Kb
Guide-12-008 Mexican Promissory Note Floating Rate Single Disbursement    PDF file 39 Kb
Guide-12-009 Mexican Promissory Note Fixed Rate Definitive - All Credits Public    PDF file 10 Kb
Guide-12-010 Mexican Promissory Note Floating Rate Definitive - All Credits Public    PDF file 14 Kb
Guide-12-011 Russian, Ukraine, and  Kazaksthan Promissory Note Single Disbursement or Consolidation Note   
Medium Term Single Buyer Insurance Policy   
PDF file 30 Kb
Guide-12-012 Russian, Ukraine, and  Kazaksthan Promissory Note Multiple Disbursment Grid Note   
Medium Term Single Buyer Insurance Policy   
PDF file 31 Kb
Guide-12-013 Venezuelan Promissory Note Floating Rate Serial - All Credits    PDF file 46 Kb
Guide-12-014 Venezuelan Promissory Note Fixed Rate Serial Note - All Credits    PDF file 41 Kb
Guide-12-015 Venezuelan Promissory Note Floating Rate Global Note   
Medium Term Sovereign Insurance Transactions   
PDF file 20 Kb
EIB11-05 Exporter Certificate for Loan Guarantee & MT Insurance Programs Icon for PDF fill and save forms 118 Kb
  Brokers only    
EIB92-79 Broker Registration, Standards of Service, Automatic Deposit Form/Commission Schedule Icon for PDF fill and save forms 255 Kb
INSTRUCTIONAL DOCUMENTS
Inst-12-001 Medium-Term Application Guidelines PDF file 196 Kb
Inst-12-002 Spreading Guidelines for Financial Statements PDF file 228 Kb
Inst-12-003 Lender Referral List including Potential Assignees PDF file        660 Kb

Inst-12-004

Short Term Credit Standards PDF file 447 Kb
Inst-12-005 Medium-Term Credit Standards PDF file 297 Kb
Inst-12-006 Small Business Export Credit Insurance Premium Rate Table PDF file 207 Kb
Inst-12-008 ST Multi-Buyer Extending Credit (DCL)  [FACT SHEET] PDF file 324 Kb
Inst-12-009 List of Credit Reports PDF file 106 Kb
Inst-12-010 Short-Term Insurance Foreign Content Policy PDF file 21 Kb
Inst-12-011 Short-Term Multi-buyer Export Credit Insurance Policy for Exporters (Policy Text) PDF file 108 Kb
Inst-12-012 Short-Term Single-Buyer Export Credit Insurance Policy for Exporters (Policy Text) PDF file 379 Kb
Inst-12-013 Medium-Term, Single Buyer, Single Sale, Single Shipment, Multiple Shipments or Repetitive Sales (Policy Text) PDF file 592 Kb
Inst-12-014 Medium-Term Bank-to-Bank Credit Line Export Insurance PDF file 26 Kb
Inst-12-015 MT Starting Points for Debt Obligations PDF file 19 Kb
Inst-12-016 Standard Repayment Terms PDF file 137 Kb
Inst-12-017 Filing claims on Multi-buyer Insurance Policies: Mistakes to Avoid PDF file 296 Kb
Inst-12-018

Compare Multi-Buyer Policies

     
PDF file 398 Kb
Inst-12-019

Compare Single-Buyer and Small Business Multi-Buyer Policies

     
PDF file 364 Kb
Inst-12-020

Compare Single-Buyer and Multi-Buyer Policies

     
PDF file 101 Kb
Inst-12-021 Small Business Multi-Buyer Insurance
PDF file 347 Kb
Inst-12-022 Multi-Buyer Insurance
PDF file    243 Kb
Inst-12-023 Short-Term Single-Buyer Insurance PDF file 216 Kb

*The attached list contains contact information for insurance brokers that are registered with Ex-Im Bank.  The list, organized by city and state, contains both headquarters and regional offices of registered brokers.  Updates and other revisions to the list should be sent to Ms. Shontelle Bragg, Business Development, at Shontelle.bragg@exim.gov

Page updated August 29, 2011