EIB 15-04 Exporter’s Certificate For Co-Financed Loan, Guarantee & MT Insurance Programs

Forms and Documents

Document Name	Status
Form EIB 15-04 Exporter's Certificate for Co-Financed Loan, Guarantee & MT Insurance Programs. Form and Instruction	Modified
EIB 15-04 Supporting Statement_2025.docx Supporting Statement A	2025-12-02

IC Document Collections

IC ID	Document Title	Status
221077	Exporter's Certificate for Co-Financed Loan, Guarantee & MT Insurance Programs. Form and Instruction	Modified

ICR Details

OMB Control No: 3048-0052	ICR Reference No: 202512-3048-004
Status: Received in OIRA	Previous ICR Reference No: 202211-3048-004
Agency/Subagency: EXIMBANK	Agency Tracking No: EIB 15-04
Title: EIB 15-04 Exporter’s Certificate For Co-Financed Loan, Guarantee & MT Insurance Programs
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/02/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	01/31/2026
Responses	30	30
Time Burden (Hours)	15	15
Cost Burden (Dollars)	0	0

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Abstract: EXIM Bank’s borrowers, financial institution policy holders and guaranteed lenders provide this form to U.S. exporters, who certify to the eligibility of their exports for EXIM Bank support. For loan guarantees, the completed form is required to be submitted at time of disbursement and held by either the guaranteed lender or EXIM Bank. For MT insurance, the completed forms are held by the financial institution, only to be submitted to EXIM Bank in the event of a claim filing. EXIM Bank uses the referenced form to obtain exporter certifications regarding the export transaction, content sourcing, and their eligibility to participate in USG programs with respect to co-financed transactions. These details are necessary to determine the value and legitimacy of EXIM Bank financing support and claims submitted. It also provides the financial institutions a check on the export transaction’s eligibility at the time it is fulfilling a financing request.

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Authorizing Statute(s): US Code: 12 USC 635 Name of Law: Export Import Bank Act of 1945
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 43603	09/10/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 51755	11/18/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Exporter's Certificate for Co-Financed Loan, Guarantee & MT Insurance Programs.	EIB 15-04	Exporter’s Certificate for Co-Financing Transactions

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	30	30	0	0	0	0
Annual Time Burden (Hours)	15	15	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $127

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/02/2025

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