Medium-Term Insurance or Guarantee Application Prepare and file this application ONLINE! at EXIM Online

• Legal Form Number: EIB03-02
• Issuer: Export-Import Bank of the United States
• Section: Export-Import Bank of the United States

OMB3048-0014

Expires10/31/2025

EIB03-02(Rev.5/2022)

Page 1 of11

This application is to be used for insurance and guarantee transactions, including Domestic Financing,with financed

amounts of $25 million or less (excludingfinancedexposure fee/premium) andrepaymentterms between twelve months

and sevenyears.Anonlineversionof this application isavailable onEXIM’swebsite.EXIM encourages customers to

applyon-line,asit will facilitate our review and allow customers a faster response time. If you are requesting a medium-

term direct loan, please email a completed application to exim.applications@exim.gov. Please note that

applications must be a signed and dated PDF and include all required application attachments.

Please notethatif your financing request is between $20 and $25 million or a direct loan for any amount,

excluding exposure fee, the transaction will be subject to U.S. flagshipping requirements. For more information,

visit EXIM’s website:https://www.exim.gov/policies/us-flag-shipping-requirements.

FINANCING

TYPEREQUESTED

Product

☐

Loan Guarantee

☐

Sovereign

☐

Public Non-sovereign

☐

Private Sector

MGA No. (if known): ____________________

☐

Finance Lease Guarantee

☐

Sovereign

☐

Public Non-sovereign

☐

Private Sector

☐

Direct

Loan

☐

Sovereign

☐

Public Non-sovereign

☐

Private Sector

☐

Insurance

☐

Sovereign

☐

Public Non-sovereign

☐

Private Sector

Coverage Type

☐

Comprehensive Risk

☐

Political Risk

Conversionof a PreliminaryCommitmentor a LetterofInterest

☐

No

☐

YesThe EXIM reference number is:

Resubmission

☐Checkif thisis a resubmission of an applicationthatwaspreviouslydeemedincompleteor

was withdrawn for other reasons.The EXIM reference number is: _____________

Renewal

☐

MTR (Medium-Term Repetitive Insurance Policy)

PARTICIPANTS:

Itemsmarkedwithanasterisk(*)arerequiredfields.Undercorporateownership,providethe nameofthe ultimate

parentcompany,ifthereis 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.☐Checkif the applicant has been assisted by a city or state

export agency and provide thename 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 registeryour entity.Visit https://sam.gov/content/hometo 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 theBorrower

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 rev iew.]

Export-Import

Bank of the

United States

APPLICATION FOR

MEDIUM-TERM

INSURANCE, DIRECT

LOAN OR GUARANTEE