Short Term Express Insurance Application Prepare and file this application ONLINE! at EXIM Online

• Legal Form Number: EIB10-02
• Issuer: Export-Import Bank of the United States
• Section: Export-Import Bank of the United States

OMB No.: 3048-0031

04/30/2025

EIB 10-02 (Rev. 7/2021)Page 1 of 4

APPLICATION FOR EXPRESS INSURANCE

1. Primary reason for application:

How did you learn about EXIM?

*Exporter Legal Name:D&B#:Tradestyle:

Business Address:*Total Number of Employees:

*City:*State:*Zip + 4:

Country:Contact Person:

Position Title:Phone #:

E-mail:

*Primary Industry NAICS2:

Brokerage:

*Annual Sales Volume:

*Minority-owned business:

*Corporate Ownership:

YesNo

EXIM Regional OfficeBrokerBankU.S. Export Assistance Center

EXIM City/State PartnerOther(describe):

risk mitigationfinancingextend more competitive terms

YESNO

YESNOYESNO

EXIM

SBA

2. Do you have a credit line with a financial institution (exclude overdraft protection and credit cards)

3. Do you have a SBA export Working Capital Loan or EXIM Working Capital Loan?

4. Average total of annual export credit sales over the last three years for you and your affiliates:$

5. Do you wish to insure export credit sales made by your affiliates? (If yes, please attach names/business addresses of each)YESNO

Does each affiliate invoice export credit sales in its own name or trade style?

YESNO

YESNO

Are the credit decisions of each affiliate centralized with this applicant?YESNOIf ‘No,’ provide comment:

7. Are the products:

6. Product and/or services to be exported & NAICS (if known):

NewUsed

8. Do you sell Capital Goods to foreign manufacturers or producers?YESNO(if yes, attach explanation)

9. Are the Products to be covered under the policy:

Manufactured or reconditioned in the U.S.?YESNOAll made or reconditioned with more than 50% U.S.

content?

(If no, attach explanation)

YESNO

Shipped from the U.S.? YESNOUsed to support Nuclear Energy? YESNO

Sold to Military entities or Security Forces?YESNOOn the U.S. Munitions List?

(part 121 of title 22 of the Code of Federal Regulations)YESNO

Environmentally Beneficial?YESNOSupporting Renewable Energy? YESNO

Are the products of each affiliate the same as the applicant's? If no, list them in question #6.

*Veteran-owned business: YesNoDecline to Answer

YesNoDecline to Answer

Items marked with an asterisk (*) are required fields. Under corporate ownership, provide name of ultimate parent company, if there is a corporate owner. For

number of employees and sales volume, aggregate for the company and all its affiliates1, including corporate owners and subsidiaries.

*Does the exporter have any affiliates?

1Affiliations exist when one individual or entity controls or has the power to control another or when a third party or parties control or have the power to control

both. Factors such as common ownership, common management, previous relationships with or ties to another entity, and contractual relationships may cause

affiliation. The complete definition of affiliation is found at 13 C.F.R. § 121.103.

2A company’s Primary Industry NAICS codes is the NAICS that accounts for the largest share of sales for the most recently completed fiscal year. The full

definition of “primary industry” is set forth at 13 C.F.R. § 121.107.

*Disability-owned business: YesNoDecline to Answer

Race (One or more boxes may be selected.):

American Indian or Alaska NativeAsian

Black or African AmericanNative Hawaiian or Pacific Islander

WhiteOther

Ethnicity:Hispanic or LatinoNot Hispanic or Latino

YesNoDecline to Answer

*Woman-owned business:

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