Assignment Form - Short Term Single Buyer Insurance Policy

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

EIB-92-32

Revised 11/22

Export – Import Bank of the United States

Notification by Insured of Amounts Payable Under

Single Buyer Export Credit Insurance Policy

Date:

A.

General Information

Policy No. ______________________________________________________ __

Insured: ______________________________________________________

Buyer: ______________________________________________________

Assignee: ______________________________________________________

B.

Notification

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

information contained herein, it has assigned its interest to claim payment(s) which may become due under the

Policy.

This Assignment relates to:

___ 1. All transactions covered by the Policy.

___ 2. The following specific transaction(s): (Use additional sheets if necessary).

Country

Buyer

Contract Price of

Sale or Gross

Invoice Date or

Number

Invoice Value of

Shipment

___ 3. Other. If this No. 3 is checked, the Insured and the Assignee agree that:

C.

Conditions of Notification

1.

The Assignee agrees that:

(a) this notification is not an assignment of the Policy, does not give the Assignee any right to file a claim

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

forth in subparagraph 2 below;

_______________

(a) there may be multiple assignments made to various assignees under this policy, and EXIM Bank does

not determine which assignee, if any, may have an interest in any particular claim payment; and

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

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