Assignment Form - Short Term Multi-Buyer Insurance Policy

• Legal Form Number: EIB 92-31
• Issuer: Export-Import Bank of the United States
• Section: Export-Import Bank of the United States

Export

-

Import Bankofthe United

States

NotificationbyInsuredofAmountsPayable

under

Multi-BuyerExportCreditInsurancePolicy

Date:

A.GeneralInformation

Policy

No.

Insured:

Assignee:

B.Notification

The Insured hereby notifies the Export-Import Bankof the UnitedStates(EXIM Bank)that,inaccordancewith

theinformationcontainedherein,ithasassignedits interesttoclaim payment(s)whichmay become due under

thePolicy.

ThisAssignment relates to:

1.Alltransactionscoveredby the Policy:

2.

All

transactions

with

buy

e

rs

in

th

e

following

coun

tries:

3.

All

transactions

with

the

following

buyers:

4.The following specifictransaction(s):(Useadditional sheetsifnecessary).

CountryBuyer

ContractPriceof

Sale

or

Gross

InvoiceValue of

Shipment

Invoice

Date or

Number

Date

Reported on

Monthly

Report Form

5.Other. Ifthis No. 5 is checked,the Insured and the Assigneeagreethat:

C.ConditionsofNotification

1.TheAssigneeagreesthat:

EIB-92-31

Revised 11/22Page 1 of2

(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".

(a) there may be multiple assignments made to various assignees under this policyand EXIM Bank does not

determinewhich assignee, if any, may have an interest inany particular claim payment; and

(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;