Form EIB 07-01, Section EIB 07-01, Section Electronic Claim Filing System, Medium-Term Guarantee

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Medium Term Bank Guarantee
Section H - Certifier Information

Claim Control No.:
(Draft)

( * An asterisk denotes that a field is a required entry)

Certifier is the Guaranteed Lender:

Yes

Name of Authorized Certifier

*

Lender

*

Street Address

*

City

*

State

*

Zip Code

*

Phone Number

*

Fax Number

_

Email Address

_

No

Submit Claim
EIB 07-01B
The applicant is hereby notified that information requested by this form is done so under authority of the Export-Import Bank Act of 1945, as
amended (12 USC 635 et. seq.); provision of this information is mandatory and failure to provide the requested information may result in ExIm Bank being unable to determine eligibility for support. Ex-Im Bank may not require the information and applicants are not required to
provide information requested in this application unless a currently valid OMB control number is displayed on this form.
Public Burden Statement: Reporting for this collection of information is estimated to average 1 hour per response, including reviewing
instructions, searching data sources, gathering information, completing, and reviewing the application. Send comments regarding the burden
estimate, including suggestions for reducing it, to Office of Management and Budget, Paperwork Reduction Project OMB# 3048, Washington,
D.C. 20503.

https://apps.exim.gov/apps/ecfs/ecfsprod.nsf/FormGtee1SectionH?openform

8/23/2007