Acquisition List

• Legal Form Number: EBD M-59
• Issuer: Export-Import Bank of the United States
• Subject Matter: Guarantee, Loan
• Section: Export-Import Bank of the United States

Supply Contract/Purchase Order Number: __________________

RE: Ex-Im Bank Credit/Guarantee Number:

Authorized Party Providing Information: Signature:

Project Name/Identification:

Purchaser: Countr y:

To the best of our knowledge the following is true and accurate, representing the identifiable or most likely procurement (sources and description of goods and

services) covered under the Credit / Guarantee.

Section A - U.S. Procured Goods and Services

Reference

# Description of Goo ds a/o Serv ices (including model, #u nits if

applicable) SIC or NAICS code Manufacturer & address of

manufactur e, plus (if different)

Exporter & a ddress

USD U.S. Export

Value of described

Products a/o Services

(U.S. Contract Amount)

Est. Date

of

Shipping

or service

execution

$

$

$

$

(March 2001)

EXPORT-IMPORT BANK OF THE UNITED STATES

Long Term Credit / Guarantee - Acquisition List

Effective Date:

Exporter’s Name, U.S. Street Address, Tel./Fax. #s:

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