OMB #3
048-0005
Expires 11/30/2021
Page 1 of 8
EIB Form 95-09
Revised 09/2017
Export-Import
Bank
of the
United
States (EXIM)
Letter of Interest Application
Please type. Processing of applications may be delayed if the requested information is not provided.
1. Applicant. The applicant may be any responsible individual, financial institution or non-financial enterprise.
☐ Check if applicant has been assisted by a city or state export agency and provide the name of the agency:
Applicant name: ________________________________ Duns #: __________________________________________
Contact pers
on: _________________________________ Phone #: _________________________________________
Position title: __________________________________ Fax #: ___________________________________________
Street Address: _________________________________________________ City: _____________________________
State/Province: ________________ Postal Code: _____________________ Country: _________________________
2. Exporter. The "exporter" is
the company which contracts with the buyer for the sale of the U.S. goods and services.
☐ Check if the exporter is also the applicant. If not, complete the information below.
Exporter name: _________________________________ Duns #: __________________________________________
Street address: _________________________________ Phone #: _________________________________________
City: ________________________ State: ___________________________ Postal Code: ______________________
Taxpayer ID #: ___________________________________________________________________________________
3. Supplier. The "supplier" is the U.S. company which manufactures the goods and/or performs the services to be exported.
☐ Check if the supplier is also the exporter. ☐ Check if the supplier is not determined. If neither applies, attach the sam
e
i
nformation for the primary supplier as requested above for the exporter. Information on additional suppliers is not required
for an LI.
4.
Borrower. The "borrower" is the company which agrees to repay the EXIM direct or guaranteed loan. Complete the
information below. Check the box for "public sector" if the borrower is at least 50% directly or indirectly owned by a
government. Check the box for "private sector" if the borrower is less than 50% owned by a government.
Contact person: _________________________________ Fax #: ___________________________________________
Borrower name: ________________________________ D uns #: __________________________________________
Street Address: __________________________ City: _______________ ☐ Public Sector Private Sector
Postal Code #: _________________________________ Email: _______________________________________
5.
Buyer and End-user. The "buyer" is the company which contracts with the exporter for the purchase of the U.S. goods and
services. The "end-user" is the foreign company which utilizes the U.S. goods and services in its business. Check if the
borrower, buyer, and end-user are not the same entity. If box is checked, attach the same information for the buyer and the
end-user as requested above for the borrower.
6.
Export Items The "export items" are the goods and services to be exported from the U.S.
6a. Large Aircraft
. ☐ Check if the export items include aircraft which, in a passenger configuration, contain more
than 70 seats. If box is checked, complete Attachment A.
6b. Military. ☐ Check if the buyer is associated in any way with the military, if any export items are to be used by the
military, or if any export items are defense articles or have a military application.
6c. Limited Recourse Project Finance. ☐ Check if you want a Letter o
f Interest issued by the Project Finance
Division. If box is checked, complete Attachment D.
6d. Description of Export Items. Briefly describe the princi
pal goods and services, including the type, quantity, model
number and capacity (if applicable), and SIC Code. For an aircraft transaction, include a description of the engines.
Taxpayer ID #: __________________________________
Email: ____________________________________________
Email:
