Long-Term Loan or Guarantee

• Legal Form Number: EIB95-10
• Issuer: Export-Import Bank of the United States
• Section: Export-Import Bank of the United States

OMB 3048-0013

Expires 10/31/2025

Export-Import

Bank of the

United States

APPLICATION FOR

CREDIT GUARANTEE

FACILITY AND LONG-

TERM DIRECT LOAN

OR GUARANTEE

This application is for requesting financing of a Credit Guarantee Facility (any dollar amount and tenor) and direct loan

and guarantee transactions with financed amounts over $25 million (excluding financed

exposure fee), typically with

tenors over seven years. It may also be used for Large Aircraft, Limited Recourse Project and Structured Financing,

Domestic Financing, and Tied Aid.

Additional information on how to apply for an EXIM transaction can be found at

EXIM's website: https://www.exim.gov/resources/applications-forms/applying.

Email this completed application to exim.applications@exim.gov. Please note that applications must be a signed and

dated PDF and include all required application attachments

.

COMMITMENT OR FINANCING TYPE REQUESTED

Product

☐

Comprehensive Guarantee

☐

Sovereign

☐

Public Non-sovereign

☐

Private Sector

☐

Political Risk Guarantee

☐

Sovereign

☐

Public Non-sovereign

☐

Private Sector

☐

Direct

Loan

☐

Sovereign

☐

Public Non-sovereign

☐

Private Sector

☐

Credit Guarantee Facility

☐

Sovereign

☐

Public Non-sovereign

☐

Private Sector

☐

New

☐

Renewal

For more information: https://www.exim.gov/solutions/loan-guarantee/credit-guarantee-facility

☐

Preliminary Commitment

☐

Sovereign

☐

Public Non-sovereign

☐

Private Sector

A justification for a Preliminary Commitment needs to be attached.

Conversion of a Preliminary Commitment or a Letter of Interest

☐

No

☐

Yes The EXIM reference number is: __________________

Resubmission

☐Check if this is a resubmission of an application that was previously deemed incomplete

or

was withdrawn for other reasons. The EXIM reference number is: _____________

PARTICIPANTS:

Items marked with an asterisk (*) are required fields. Under corporate ownership, provide the name of the ultimate parent

company, if there is a corporate owner. For number of employees and sales volume, aggregate for the company and all

its affiliates, including corporate owners and subsidiaries.

Applicant: The applicant may be any exporter, financial institution, supplier, the primary borrower, buyer or controlling

sponsor associated with the transaction. ☐Check if the applicant has been assisted by a city or state export agency

and provide the name of the agency: __________________________________________________

*Applicant Name: ________________________________________________________________________________

Tradestyle: _____________________________________________________________________________________

*Business Address: ______________________________________________________________________________

*City: _______________________ *State: _____________ *Zip/Postal Code: _________ *Country: ____________

Contact Person: _________________________________ Position Title: ________________________________

Phone: ________________________________________ Email: ______________________________________

Duns No. ___________________ UEI No.1 __________________ Taxpayer ID No. ________________

1A Unique Entity Identifier (UEI) No. is a 12-character unique number assigned to all entities (public and private companies, individuals, institutions or

organizations) who must register in SAM.gov to do business with the federal government. If your entity is registered in SAM.gov, your UEI has already been

assigned and is viewable in SAM.gov. If you do not have a UEI No., then you must register your entity. Visit https://sam.gov/content/home to see if your

entity has a UEI No. or to register your entity. A UEI No. is required for the Applicant at time of application and is also required for the Borrower and

Lender(s). [NOTE: As the UEI No. process becomes fully clarified, EXIM’s instructions will be updated accordingly and more information will be added to

assist an Applicant and any other affected transactional parties with this process, but it was not ready prior to submission for OMB r eview.]

EIB 95-10 (Rev. 5/2022)

Page 1 of 11