Assignment Form - Short Term Single Buyer Insurance Policy

• Legal Form Number: EIB 92-32
• Issuer: Export-Import Bank of the United States
• Section: Export-Import Bank of the United States

EIB-92-32

Revised11/22

Export – Import Bank of the United States

NotificationbyInsuredofAmountsPayableUnder

Single BuyerExport Credit InsurancePolicy

Date:

A.

GeneralInformation

PolicyNo.________________________________________________________

Insured: ______________________________________________________

Buyer: ______________________________________________________

Assignee:______________________________________________________

B.

Notification

The Insured hereby notifies the Export-Import Bank of the United StatesEXIM Bank) that, in accordance with the

informationcontainedherein,ithasassigneditsinteresttoclaimpayment(s)whichmaybecomedueunderthe

Policy.

ThisAssignmentrelatesto:

___ 1.AlltransactionscoveredbythePolicy.

___2. Thefollowingspecifictransaction(s):(Useadditionalsheetsifnecessary).

Country

Buyer

ContractPrice of

Sale or Gross

InvoiceDateor

Number

InvoiceValueof

Shipment

___3. Other.If thisNo. 3 ischecked,theInsuredandtheAssigneeagreethat:

C.

ConditionsofNotification

1.

TheAssigneeagreesthat:

(a)thisnotificationisnotanassignmentofthePolicy,doesnotgivetheAssigneeany righttofile aclaim

or sue under the referenced Policy,and does not create any duty or obligation to the Assigneeexcept as set

forth in subparagraph 2 below;

_______________

(a)theremaybemultipleassignmentsmadetovariousassigneesunderthispolicy,andEXIMBankdoes

notdeterminewhichassignee,ifany,mayhaveaninterestinanyparticularclaimpayment;and

(b)in the event EXIM Bank approvesthe Insured's claim for payment, a wire transfer willbe made to an

assignee designated by the Insured on the "Notice of Claim and Proof of Loss".