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
EIB10-02	Application for Express Insurance Prepare and file this application ONLINE! at Ex-Im Online		1,446 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   Prepare and file this application ONLINE! at Ex-Im Online		695 Kb	(doc)	156 Kb
	Exporter Medium-Term
EIB03-02	Medium-Term Insurance or Guarantee Application (Adobe PDF format) Prepare and file this application ONLINE! at Ex-Im Online		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
FORMS
EIB92-27	Report of Overdue Accounts under Short-Term Policies		410 Kb
EIB09-01	Report of Overdue Accounts under all other Programs Prepare and file this report ONLINE! at Ex-Im Online		262 Kb
EIB92-29	Report of Premiums Payable for Exporters		493 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
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
GUIDANCE DOCUMENTS
Guide-12-001	Promissory Note Single Disbursement or Consolidation Note Medium Term Single Buyer Insurance Policy		30 Kb
Guide-12-002	Promissory Note Multiple Disbursment Grid Note Medium Term Single Buyer Insurance Policy		31 Kb
Guide-12-003	Brazil Promissory Note Single Disbursement or Consolidation Note Medium Term Single Buyer Insurance Policy		33 Kb
Guide-12-004	Brazil Promissory Note Multiple Disbursment Grid Note Medium Term Single Buyer Insurance Policy		32 Kb
Guide-12-005	Dominican Republic Promissory Note Single Disbursement or Consolidation Note Medium Term Single Buyer Insurance Policy		28 Kb
Guide-12-006	Dominican Republic Promissory Note Multiple Disbursment Grid Note Medium Term Single Buyer Insurance Policy		28 Kb
Guide-12-007	Mexican Promissory Note Fixed Rate Single Disbursement		32 Kb
Guide-12-008	Mexican Promissory Note Floating Rate Single Disbursement		39 Kb
Guide-12-009	Mexican Promissory Note Fixed Rate Definitive - All Credits Public		10 Kb
Guide-12-010	Mexican Promissory Note Floating Rate Definitive - All Credits Public		14 Kb
Guide-12-011	Russian, Ukraine, and Kazaksthan Promissory Note Single Disbursement or Consolidation Note Medium Term Single Buyer Insurance Policy		30 Kb
Guide-12-012	Russian, Ukraine, and Kazaksthan Promissory Note Multiple Disbursment Grid Note Medium Term Single Buyer Insurance Policy		31 Kb
Guide-12-013	Venezuelan Promissory Note Floating Rate Serial - All Credits		46 Kb
Guide-12-014	Venezuelan Promissory Note Fixed Rate Serial Note - All Credits		41 Kb
Guide-12-015	Venezuelan Promissory Note Floating Rate Global Note Medium Term Sovereign Insurance Transactions		20 Kb
EBD-M-56	Exporter Certificate for Loan Guarantee & MT Insurance Programs		118 Kb	(doc)	78 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
BDG-INS-03	Short-Term Single-Buyer Insurance		1501 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 Shontelle.bragg@exim.gov

Page updated August 29, 2011