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Apply | Applications and Forms
Insurance Applications and Forms
Instructions: Most of these forms can be filled in on line, then printed, signed and mailed to the Ex-Im Bank, but they cannot be saved to your computer. Some forms, however, can be saved to your computer. Savable forms are labeled with this graphic: 
More information about fillable forms is available in the Guide for Fillable Forms.
| APPLICATIONS | Exporter Short-Term | PDFs |
File Size | Word Files |
File Size |
| EIB92-50 | ST Multi-Buyer Policy Application, ESC/ENB/ENVIRONMENT Prepare and file this application ONLINE! at Ex-Im Online |
|
331 Kb | (doc) | 94 Kb |
| EIB92-51 | Special Buyer Credit Limit Application for ST Multibuyer Policies Prepare and file this application ONLINE! at Ex-Im Online |
|
83 Kb | ||
| EIB92-64 | Application for Exporter Short-Term, Single-Buyer Insurance |
|
695 Kb | (doc) | 156 Kb |
| Exporter Medium-Term | |||||
| EIB03-02 | Medium-Term Insurance or Guarantee Application (Adobe PDF format) |
|
1101 Kb | ||
| EIB03-02g | Medium-Term Application Guidelines |  |
65 Kb | ||
| EIB03-02gd | Spreading Guidelines for Financial Statements | |
56 Kb | ||
| Lender Short-Term | |||||
| EIB92-34 | ST Bank Policy Application (ELC, EBD, EBS, EBM) Prepare and file this application ONLINE! at Ex-Im Online |
|
151 Kb | (doc) | 298 Kb |
| EIB92-36 | Issuing Bank Credit Limit Application under a ST Bank Letter of Credit (ELC) Policy | |
228 Kb | ||
| EIB92-41 | Application for Financial Institution Short-Term, Single-Buyer Insurance Prepare and file this application ONLINE! at Ex-Im Online |
|
489 Kb | (doc) | 185 Kb |
| EIB92-31 | Assignment under ST Multi-Buyer Policies (no enhancements) | |
94 Kb | ||
| EIB92-53 | Enhanced Assignment for ST Small Business (ENB), Small Business Environmental (ENV) Policies | |
86 Kb | ||
| EIB99-17 | Enhanced Assignment under Exporter Short-Term Single-Buyer Policy | |
133 Kb | ||
| EIB92-32 | Assignment under Exporter Short-Term Single-Buyer Policy | |
91 Kb | ||
| Lender Medium-Term | |||||
| EIB03-02 | MT Term Insurance or Guarantee Application Prepare and file this application ONLINE! at Ex-Im Online |
|
1101 Kb | ||
| EIB94-08 | Assignment by Insured to Financial Institution of a Medium-Term Policy ("(doc)umentary") | |
302 Kb | ||
Foreign Dealer Insurance Policy |
|
12 Kb | |||
| Lender's Guide to the Foreign Dealer Insurance Policy | |
28 Kb | |||
| Attachment J: Supplemental Information Requirements for Foreign Dealer Insurance Policy | |
72 Kb | |||
| Leases | |||||
| EIB92-45 | - Temporarily Not Available - | ||||
| FORMS | |||||
| EIB92-27 | Report of Overdue Accounts under Short-Term Policies | |
410 Kb | ||
| EIB92-28 | Report of Overdue Accounts under Medium-Term Policies | |
36 Kb | ||
| EIB92-29 | Report of Premiums Payable for Exporters | |
493 Kb | ||
| EIB92-30 | Report of Premiums Payable for Financial Institutions Only | |
383 Kb | ||
| EIB94-01 | Report of Insured Shipments of Items on the Munitions List | |
139 Kb | ||
| EIB94-07 | Exporter Certificate (Short-Term) | |
177 Kb | ||
| EBD-M-56 | Exporter's Certificate for Loan Guarantee & MT Insurance Programs | |
118 Kb | (doc) | 78 Kb |
| EIB01-01 | Approved Exporter Notification under Financial Institution Supplier Credit Policies | |
226 Kb | ||
| EBD-M-25 | Used Equipment Questionnaire | |
471 Kb | (doc) | 37 Kb |
| EIB99-14 | Trade Reference Form | |
88 Kb | ||
| LLL | Disclosure of Lobbying Activities | |
145 Kb | ||
| EIB92-30 | Report of Premiums Payable for Financial Institutions | |
383 Kb | ||
| EIB92-37 | Beneficiary Certificate & Agreement for Banks and Financial Institutions | |
151 Kb | (doc) | 290 Kb |
| EIB92-61 | Defense Products Questionnaire | |
58 Kb | ||
| EIB92-58A,B | Promissory Notes, Fixed or Floating | ||||
| A: Single Disbursement/Consolidation | |
58 Kb | (doc) | 59 Kb | |
| B: MultiDisbur/Grid | |
76 Kb | (doc) | 66 Kb | |
| EIB92-67A, B | Brazil Promissory Notes: | ||||
| A. Single Disbursement/Consolidation | |
59 Kb | (doc) | 71 Kb | |
| B. Mulitple Disbursement/Grid | |
59 Kb | (doc) | 72 Kb | |
| EIB02-02A, B | Dominican Republic Promissory Notes: | ||||
| A: Single Disbursement/Consolidation | |
73 Kb | (doc) | 51 Kb | |
| B: Multiple Disbursement/Grid | |
163 Kb | (doc) | 52 Kb | |
| EIB92-59A, B, C, D | Mexican Promissory Notes: | ||||
| A: FIX PRIV | |
74 Kb | (doc) | 79 Kb | |
| B: FLOAT PRIV-6/01 | |
85 Kb | (doc) | 88 Kb | |
| C: FIX PUB | |
14 Kb | |||
| D: FLOAT PUB-8/95 | |
18 Kb | |||
| EIB92-60A, B | Russia, Ukraine, and Kazakhstan Debt Instruments | ||||
| A: Single Disbursement/Consolidation | |
52 Kb | (doc) | 54 Kb | |
| B: Multiple Disbursement/Grid | |
55 Kb | (doc) | 58 Kb | |
| EIB97-9A, B | Venezuelan Promissory Notes: | ||||
| A: FLOATING | |
59 Kb | |||
| B: FIXED | |
49 Kb | |||
| EIB01-03 | Venezuelan Sovereign Promissory Notes: | ||||
| SOVEREIGN, FLOATING | |
43 Kb | (doc) | 37 Kb | |
| EIB01-02 | Content Report Form | |
207 Kb | ||
| EIB01-02-A | Cause Report Form | |
165 Kb | (doc) | 24 Kb |
| EBD-M-56 | Exporter Certificate for Loan Guarantee & MT Insurance Programs | |
118 Kb | (doc) | 78 Kb |
| EIB99-22 | Participant Information Form | |
91 Kb | ||
| EIB92-43 | Notice of Claim and Proof of Loss Financial Institution Buyer Credit Policy (FB,FV) | |
489 Kb | (doc) | 196 Kb |
| Brokers only | |||||
| EIB92-79 | Broker Registration, Standards of Service, Automatic Deposit Form/Commission Schedule | |
255 Kb | ||
| DETAILS | |||||
| Reference # | Title | PDFs |
File Size |
Word |
File Size |
| Lender Referral List including Potential Assignees |
|
197 Kb | |||
| Short Term Credit Standards | |
270 Kb | |||
| Medium-Term Credit Standards | |
182 Kb | (doc) | 325 Kb | |
| EIB01-05 | Small Business Export Credit Insurance Premium Rate Table | |
23 Kb | ||
| EIB92-10 | Guide to Claims | |
156 Kb | ||
| EIB92-18 | ST Multi-Buyer Extending Credit (DCL) [FACT SHEET] | |
43 Kb | ||
| EIB99-08 | List of Credit Reports | |
79 Kb | ||
| EIB99-21 | Short-Term Insurance Foreign Content Policy | |
15 Kb | ||
| EBD-INS-04 | Short-Term Multi-buyer Export Credit Insurance Policy for Exporters (Policy Text) | |
303 Kb | ||
| EBD-INS-05 | Short-Term Single-Buyer Export Credit Insurance Policy for Exporters (Policy Text) | |
189 Kb | ||
| EBD-INS-06 | Medium-Term, Single Buyer, Single Sale, Single Shipment, Multiple Shipments or Repetitive Sales (Policy Text) | |
290 Kb | ||
| EIB99-10 | Medium-Term Bank-to-Bank Credit Line Export Insurance | |
45 Kb | ||
| EIB99-16 | MT Starting Points for Debt Obligations | |
19 Kb | ||
| EBD-M-26 | Standard Repayment Terms | |
67 Kb | ||
| EIB-06-01 | Filing claims on Multi-buyer Insurance Policies: Mistakes to Avoid | |
27 Kb | ||
| FLY-INS-01 | Compare Multi-Buyer Policies |
|
572 Kb | ||
| FLY-INS-02 | Compare Single-Buyer and Small Business Multi-Buyer Policies |
|
573 Kb | ||
| FLY-INS-03 | Compare Single-Buyer and Multi-Buyer Policies |
|
543 Kb | ||
| BDG-INS-01 | Small Business Multi-Buyer Insurance |
|
75 Kb | ||
| BDG-INS-02 | Multi-Buyer Insurance |
|
74 Kb | ||
| FLY-ECI-02 | Short-Term Single-Buyer Insurance | |
1501 Kb | ||
| EXOL-01 | Ex-Im Online User Guide - New Multi-Buyer Insurance Policyholders | |
2957 Kb | (doc) | 2803 Kb |
| EXOL-02 | Ex-Im Online User Guide - Existing Multi-Buyer Insurance Policyholders |
|
2958 Kb | (doc) | 2804 Kb |
*The attached list contains contact information for insurance brokers that are registered with Ex-Im Bank. The list, organized by city and state, contains both headquarters and regional offices of registered brokers. Updates and other revisions to the list should be sent to Ms. Shontelle Bragg, Business Development, at
Page updated: January 30. 2008
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