| DATA COLLECTION |
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TRANSACTION 1 (Multiple Shipments) |
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0 |
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1 |
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5 |
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| TRANSACTION ID |
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| Ex-Im APO # |
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| MarAd Reference |
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| US Exporter |
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| Shipper |
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| Borrower |
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| General waiver eligible |
(Yes/No) |
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| Loan or G'tee |
(L/G) |
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| CARGO DATA |
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| Date Shipments Began |
d/m/year |
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| Date Individual Shipment took place |
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d/m/year |
d/m/year |
d/m/year |
d/m/year |
d/m/year |
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| Estimated Shipments |
Value |
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| Est. tons |
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| Supplier Origin |
Origin of Supplier #1 |
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| Origin of Supplier #2 |
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| Origin of Supplier #3 |
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| Origin(s) Add'l Suppliers |
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| Port of Loading |
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| Destination Country |
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| Discharge Port |
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| Commodities |
Good Shipped |
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| Good Shipped |
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| Good Shipped |
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| Other Goods Shipped |
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| Special Handling (Mark X, if applicable) |
Critical Path Items |
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| Heavy Lift Requirement |
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| Hazardous |
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| Other |
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| Comments (incl., vessel type) |
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| COST DATA |
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| BIDS - Foreign Carriers |
Bid #1 - Offer |
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#DIV/0! |
#DIV/0! |
#DIV/0! |
#DIV/0! |
#DIV/0! |
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| Bid #2 - Offer |
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#DIV/0! |
#DIV/0! |
#DIV/0! |
#DIV/0! |
#DIV/0! |
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| Bid # 3 - Offer |
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#DIV/0! |
#DIV/0! |
#DIV/0! |
#DIV/0! |
#DIV/0! |
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| Source of Foreign Bid Cost |
Shipper or Marad (S or M) |
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| BIDS - U.S. Carriers |
Bid #1 - Offer |
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| Bid #2 - Offer |
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| Bid # 3 - Offer |
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| Relevant historical cost data |
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| MarAd guideline rate calc |
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| Commercial Rate* |
Actual Rate |
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| Base Rate |
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| Weighting |
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| Rate Differential Calculation |
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| Comment |
Factors for rate differential |
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| PROCESS DATA |
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| Date of Application to Ex-Im |
d/m/year |
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| Date U.S. Bids were requested |
d/m/year |
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| Advance Shipping Plan? |
(Y/N) |
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| Booking Subject to Completion? |
(Y/N) |
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| Service Contract? |
(Y/N) |
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| Good Faith Effort to Ship US? |
(Y/N) |
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| Were Foreign Bids Obtained? |
(Y/N) |
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| U.S. Carrier Responses to RFQ |
Comment Carrier 1 |
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| Comment Carrier 2 |
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| Comment Carrier 3 |
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| Comment Other Carriers |
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| MARAD Facilitation Requested? |
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(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
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| Date of Request |
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d/m/year |
d/m/year |
d/m/year |
d/m/year |
d/m/year |
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| Was the Shipper Asked to Change Some Aspect? (Mark X, if applicable) |
Shift Production |
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| Chg Delivery Schedule |
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| Chg Loading Port |
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| Chg Destination Port |
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| Transshipment |
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| Other |
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| Determination Requested? |
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(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
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| Date of Request |
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d/m/year |
d/m/year |
d/m/year |
d/m/year |
d/m/year |
d/m/year |
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| If Determination Requested (Mark X for type) |
Compensatory |
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| Reachback |
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| Determination Granted |
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(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
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| Conditions for Approval |
None |
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| Timeframe for Compensatory |
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| Other |
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| Certification Requested |
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(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
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Date of Request |
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d/m/year |
d/m/year |
d/m/year |
d/m/year |
d/m/year |
d/m/year |
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| Reason for Requesting Certification (Mark X for rationale) |
Vessel Availability |
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| Cost |
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| Certification Granted |
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(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
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| Comments (including rationale) |
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| OUTCOME DATA |
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| RECONSIDERATION REQUESTED |
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(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
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| Date of Request |
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d/m/year |
d/m/year |
d/m/year |
d/m/year |
d/m/year |
d/m/year |
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| MarAd's Initial Decision Upheld? |
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(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
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| Comments (incl. rationale for final decision) |
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| SHIPMENT OCCURRED |
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(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
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| Shipped U.S Flag |
Value |
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| % under Compensatory |
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| Original Est. Value |
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| Revenue Earned |
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| Transhipment Occurred |
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| - Transhipment Port |
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| - Length of Delay |
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| Shipped Foreign Carrier |
Value |
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| Ex-Im Request Reduced b/c Shipping |
Value |
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| Comments (circumstances not mentioned above) |
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| EX-IM Bank Subset |
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TRANSACTION 1 (Multiple Shipments) |
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1 |
2 |
3 |
4 |
5 |
| TRANSACTION TRACKING |
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| Ex-Im APO # |
0 |
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0 |
0 |
0 |
0 |
0 |
| Destination Country |
0 |
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0 |
0 |
0 |
0 |
0 |
| US Exporter |
0 |
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| Loan or G'tee |
(L/G) |
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| Date of Application to Ex-Im |
d/m/year |
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| Date Shipments Began |
d/m/year |
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| Date Each Shipment Occurrred |
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d/m/year |
d/m/year |
d/m/year |
d/m/year |
d/m/year |
| CARGO DATA |
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| Estimated Shipments |
Value |
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0 |
0 |
0 |
0 |
0 |
| Tons |
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0 |
0 |
0 |
0 |
0 |
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| Goods |
Good Shipped |
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0 |
0 |
0 |
0 |
0 |
| Good Shipped |
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0 |
0 |
0 |
0 |
0 |
| Good Shipped |
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0 |
0 |
0 |
0 |
0 |
| Other Goods Shipped |
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0 |
0 |
0 |
0 |
0 |
| Comments (incl., vessel type) |
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0 |
0 |
0 |
0 |
0 |
| COST DATA |
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| BIDS - Foreign Carriers |
Bid #1 - Offer |
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0 |
0 |
0 |
0 |
0 |
| Bid #2 - Offer |
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0 |
0 |
0 |
0 |
0 |
| Bid #3 - Offer |
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0 |
0 |
0 |
0 |
0 |
| BIDS - U.S. Carriers |
Bid #1 - Offer |
|
0 |
0 |
0 |
0 |
0 |
| Bid #2 - Offer |
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0 |
0 |
0 |
0 |
0 |
| Bid #3 - Offer |
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0 |
0 |
0 |
0 |
0 |
| Commercial Rate |
Actual Rate |
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0 |
0 |
0 |
0 |
0 |
| Base Rate |
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0 |
0 |
0 |
0 |
0 |
| Weighting |
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0 |
0 |
0 |
0 |
0 |
| PROCESS DATA |
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| Facilitation Requested? |
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(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
| Date of Request |
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d/m/year |
d/m/year |
d/m/year |
d/m/year |
d/m/year |
| If Facilitation was requested: |
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| Was the Shipper Asked to Change Some Aspect? (Mark X, if applicable) |
Shift Production |
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0 |
0 |
0 |
0 |
0 |
| Chg Delivery Schedule |
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0 |
0 |
0 |
0 |
0 |
| Chg Loading Port |
|
0 |
0 |
0 |
0 |
0 |
| Chg. Destination Port |
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0 |
0 |
0 |
0 |
0 |
| Transshipment |
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0 |
0 |
0 |
0 |
0 |
| Other |
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| Determination Requested? |
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(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
| Date of Request |
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d/m/year |
d/m/year |
d/m/year |
d/m/year |
d/m/year |
| Type of Determination Requested (Mark X, if appropriate) |
Compensatory |
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0 |
0 |
0 |
0 |
0 |
| Reachback |
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0 |
0 |
0 |
0 |
0 |
| Determination Granted? |
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(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
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| Certification Requested? |
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(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
| Date of Request |
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d/m/year |
d/m/year |
d/m/year |
d/m/year |
d/m/year |
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| Reason for Requesting Certification (Mark X for rationale) |
Vessel Availability |
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0 |
0 |
0 |
0 |
0 |
| Cost |
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0 |
0 |
0 |
0 |
0 |
| Certification Granted |
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(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
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| Reconsideration Requested? |
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(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
| Date of Request |
|
d/m/year |
d/m/year |
d/m/year |
d/m/year |
d/m/year |
| Initial MarAd decision upheld |
|
|
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
| OUTCOME DATA |
|
|
|
|
|
|
|
| SHIPMENT OCCURRED |
|
|
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
(Y/N) |
| Shipped U.S Flag |
Value |
|
0 |
0 |
0 |
0 |
0 |
| Revenue Earned |
|
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
| - Transhipment Port |
|
0 |
0 |
0 |
0 |
0 |
| - Length of Delay |
|
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
| Shipped Foreign Carrier |
Value |
|
0 |
0 |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
| Ex-Im Request Reduced b/c Shipping |
Value |
|
0 |
0 |
0 |
0 |
0 |