Form EIB 99-14 EIB 99-14 EXIM TRADE REFERENCE FORM

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OMB 3048-0042
PENDING 2025

EXPORT- IMPORT BANK TRADE REFERENCE FORM

Note: This Trade Reference Form should be completed, signed, and dated by the person obtaining the information.
It should not be completed by any individual closely associated with the Foreign Buyer, including any shareholders,
employees or related companies of the Foreign Buyer.
Foreign Buyer name & address

Name and address of company giving reference:
Name of individual giving the reference:
Title:

Phone:

Fax:

Email:

Years of trade experience with Foreign Buyer:
Estimated current annual sales to Foreign Buyer (specify currency):
Credit Limit (specify currency):

Payment Terms:

Highest amount owed at one time and paid in the past 12 months (specify currency):
Please describe security, if any, such as a standby letter of credit, guarantees or collateral. If there is no security, so state.

Date of last sale (MM/DD/YYYY):
Current outstanding balance (specify currency):
Past due balance, if any (specify currency):

Number of days past due:

Payment Experience:
Prompt:

1-30 days slow:

31-60 days slow:

61-90 days slow:

91+ days slow:

Comments/Reasons for Past Dues:
Name of company taking reference:
Name of person taking reference:
Signature of person taking reference:

Title:

Phone:

Fax:

Email:

Date (MM/DD/YYY):
EIB 99-14 (Rev. 12/2024)

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EXPORT- IMPORT BANK TRADE REFERENCE FORM

OMB 3048-0042
PENDING 2025

EXIM and its officers and employees are subject to the Trade Secrets Act (18 U.S.C. 1905), which requires EXIM to
protect confidential business and commercial information, and 12 CFR 404.7, which provides that EXIM will not
disclose information provided in confidence without the submitter's consent, and except as required by law. EXIM
will endeavor to restrict disclosure of all information provided in this form to the fullest extent permissible under
federal information disclosure laws, including the Freedom of Information Act (5 U.S.C. 552), the Privacy Act of
1974 (5 U.S.C. 522a), or under any other law or court order.

NOTICES
The applicant is hereby notified that information requested by this form is done so under authority of the ExportImport 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 being unable to determine eligibility for support. EXIM 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 (see upper right of each page).
Paperwork Reduction Act Statement: We estimate that it will take you about 15 minutes to complete this form.
This includes the time it will take to read the instructions, gather the necessary facts and fill out the form. However,
you are not required to provide information requested unless a valid OMB control number is displayed on the form.
If you have comments or suggestions regarding the above estimate or ways to simplify this form, forward
EIB 99-14 (Rev. 12/2024)

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