Form EIB 92-29 EIB 92-29 Export-Import Bank Report of Premiums Payable for Export

SEE REVERSE SIDE FOR ADDITIONAL NOTES AND

INSTRUCTIONS ON COMPLETING THIS REPORT

COVERAGE TYPES (see Note C. on next page) CODE

Comprehensive A

Political Only ……………B

Sales to Your Subsidiaries or Affiliates…………………………………………………….. B

BUYER TYPES CODE

Private Sector Buyer or Guarantor 3

Government Sector (Non-Sovereign) Buyer or Guarantor 2

Government Sector (Sovereign) Buyer or Guarantor 1

(A "sovereign" is a national government or government entity that the insurer has determined carries the full faith and credit of the national government. Most government sector companies and/or agencies do not carry the full faith and credit of their government and are therefore considered "non-sovereign" and should be reported as such unless the insurer has determined otherwise.)

TRANSACTION TYPE CODE

Letters of Credit (deferred payment or sight) A

Do not use this code B

Do not use this code C

Bank-Guaranteed (if applicable, use in lieu of any other code) D

Drafts/Promissory Notes/CAD or SDDP* E

Open Account F

Pre-Shipment (selective contracts) G

Consignment H

TERM (corresponding to Transaction Type being reported) CODE

Sight Letters of Credit 1

CAD or SDDP** 2

1-60 Days 3

61-120 Days 4

121-180 Days 5

181-270 Days 6

271-360 Days 7

1 1/2 Years 8

2 Years 9

2 1/2 Years 10

3 Years 11

3 1/2 Years 12

4 Years 13

4 1/2 Years 14

5 Years 15

Over 5 Years 16

** CAD = Cash Against Documents

SDDP = Sight Draft Documents Against Payment

EXPORT-IMPORT BANK--REPORT OF PREMIUMS PAYABLE FOR EXPORTERS ONLY

(please type or print all information) IF NO PREMIUMS PAYABLE, CHECK HERE

POLICY NUMBER :( ) - Report for period: ___________________________ ________________________

(Prefix) (Number) (Month) (Year)

POLICYHOLDER:____________________________________________

Contact:_________________________________

Tel:__________________ Fax: ________________E-mail:_______________

BROKER:________________________________

Date Received

USING SAME CODE? If same for all transactions check these code and rate boxes instead of those in the reporting columns below

Coverage Type
Buyer Type
Transaction Type
Term Code
Premium Rate		$

I T E M	BUYER NAME (refer to Step 1. on back)	CITY	COUNTRY	Cover- age Type Code	Buyer Type Code	Trans- action Type Code	Term Code	TRANSACTION AMOUNT	Premium Rate Per $100	PREMIUM DUE
1.
2.
3.
4.
5.
6.
7.
8.
			PAGE TOTALS
	complete only on last page		REPORT TOTALS

We hereby certify that this report is a complete and accurate declaration of all transactions required to be reported under the terms of the policy and that premiums have been correctly computed and remitted. We understand that Ex-Im Bank's acceptance of this report or the premium due is not an acknowledgement of coverage and does not constitute a waiver of any policy condition or limitation. Unless otherwise specified by us in this report, we understand Ex-Im Bank will assume that short term transactions were made with private-sector obligors on six-month open account terms, and that premium rates will be calculated accordingly. We understand that, for purposes of policy compliance, this report is not received by Ex-Im Bank until both this report and the premium due hereunder are received. We further understand that these certifications are subject to the penalties for fraud against the U.S. Government (18 U.S.C. 1001, et seq.).

Name of Preparer: ________________________________________ Phone: ( ) _________-_____________________

Signature: _______________________________________________ Date Prepared: __________________________, ___ Page No.____ of ____ pages

(Month) (Day) (Year)

EIB-92-29 (04/07)

MAKE CHECKS PAYABLE TO: EXPORT-IMPORT BANK OF THE UNITED STATES OR EX-IM BANK

MAIL THIS REPORT WITH YOUR PAYMENT TO: EXPORT-IMPORT BANK OF THE UNITED STATES

DEPT. 22

WASHINGTON, D.C. 20055

INSTRUCTIONS FOR REPORTING PREMIUMS PAYABLE

Complete the page heading on the front of this report-form, then follow the steps shown below to report each transaction.

(If NO premiums are payable, check the appropriate box on the front of this report-form.)

STEP 1. Enter the FOREIGN BUYER NAME, or if you are reporting a letter of credit transaction, the name of the bank issuing the letter of credit. (please avoid using acronyms if possible.)

STEP 2. Enter the CITY and COUNTRY in which the foreign buyer is located, or if you are reporting a letter of credit transaction, the CITY and COUNTRY in which the bank issuing the letter of credit is located. (Abbreviate if necessary.)

STEP 3. Enter the applicable COVERAGE TYPE CODE from the list given on the front of this report-form. (see Note A and Note C below.)

STEP 4. Enter the applicable FOREIGN BUYER TYPE CODE from the list given on the front of this report-form. (see NOTE A below.)

STEP 5. Enter the applicable TRANSACTION TYPE CODE from the list given on the front of this report-form. (see NOTE A and NOTE B below.)

STEP 6. Enter the applicable TERM CODE from the list given on the front of this report-form. (Note that the term should correspond only to the particular TRANSACTION TYPE you are recording. For example, if you are reporting a "pre-shipment" or "consignment" transaction indicate the length of the "pre-shipment" or "consignment" period only.) (see NOTE A and NOTE B below.)

STEP 7. Enter the AMOUNT of the transaction. (Use the contract price for short-term transactions. Use contract price, less down payment for medium term transaction.)

STEP 8. Enter your PREMIUM RATE. (if your policy has more than one premium rate, or if your premium rate is taken from a rate schedule, be sure to use the correct premium rate.) (see NOTE A below.)

STEP 9. Enter the PREMIUM DUE by applying the AMOUNT you have declared under Step #7 to the applicable PREMIUM RATE. (if you are using the same premium rate for all transactions reported on this form and have checked the box marked "USING SAME CODE", you need only show total premium due at the end of your report.)

STEP 10. Enter PAGE TOTALS and REPORT TOTALS for AMOUNT and for PREMIUM DUE.

STEP 11. Read the paragraph at the bottom of the report-form, then enter your SIGNATURE and DATE PREPARED.

ADDITIONAL NOTES

NOTE A. If you expect to use the same code (or rate) for each transaction recorded on this page, check the box on the front of this report-form marked "USING SAME CODE" then enter the appropriate code (or rate) in the space provided. You need not enter the code (or rate) for each transaction thereafter.

NOTE B. Be certain that your policy allows you to use the TRANSACTION TYPE or TERM being reported.

NOTE C. "Comprehensive" means commercial and political risks coverage.

"Political Only" means that coverage is restricted to political risks. Insured transactions with your subsidiaries or affiliates are covered on a "political only" basis.

SPECIAL POLICIES--REPORTING ADDITIONAL INFORMATION (If your policy has been endorsed to require you to report information not included on the front of this report-form, you may use the space provided below to report that information. Numbers to the left refer to line-item numbers on the front of this form.) ITEM

1. __________________________________________________________________________________________________________

2. __________________________________________________________________________________________________________

3. __________________________________________________________________________________________________________

4. __________________________________________________________________________________________________________

5. __________________________________________________________________________________________________________

EIB-92-29 (10/05)