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[Federal Register: March 15, 2010 (Volume 75, Number 49)]
[Notices]               
[Page 12238-12239]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr15mr10-53]                         

=======================================================================
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EXPORT-IMPORT BANK OF THE U.S.

[Public Notice 147]

 
Agency Information Collection Activities: Emergency Clearance; 
Comment Request

AGENCY: Export-Import Bank of the U.S.

ACTION: Submission for OMB Emergency Clearance Review and Comments 
Request.

-----------------------------------------------------------------------

FORM TITLE: EIB 10-01 Questionnaire Regarding Activities Related to the 
Islamic Republic of Iran--OMB 3048-XXXX.
SUMMARY: The Export-Import Bank of the United States (``Ex-Im Bank''), 
as a part of its continuing effort to reduce paperwork and respondent 
burden, invites the general public and other Federal Agencies to 
comment on the proposed information collection, as required by the 
Paperwork Reduction Act of 1995. Our customers will be able to submit 
this form on paper or electronically.
    The purpose of this questionnaire is to allow the Ex-Im Bank to 
comply with the Consolidated Appropriations Act of 2010 (Pub. L. 111-
117) (``the Act'') and ensure the Ex-Im Bank does not authorize 
transactions involving prohibited parties subject to the Iran sanctions 
language of the Act.

DATES: Comments should be received on or before March 25, 2010 to be 
assured of consideration.

ADDRESSES: Comments maybe submitted through http://www.regulations.gov 
or mailed to Office of Management and Budget, Office of Information and 
Regulatory Affairs, 725 17th Street, NW., Washington, DC 20038 
attention: OMB Number 3048-XXXX.

[[Page 12239]]


SUPPLEMENTARY INFORMATION: 
    Titles and Form Number: EIB 10-01.
    OMB Number: 3048-XXXX.
    Type of Review: Emergency Clearance.
    Need and Use:
    Affected Public: Borrowers, guarantors, sponsors, purchasers and 
end-users in proposed Ex-Im Bank transactions.
    Annual Number of Respondents: 485.
    Estimated Time per Respondent: 30 minutes.
    Government Annual Burden Hours: 122 hours.
    Frequency of Reporting or Use: As needed to request support for a 
long term or medium term export sale.

Faisal B. Siddiqui,
Assistant General Counsel for Administration.

Questionnaire Regarding Activities Related to the Islamic Republic of 
Iran

    The Export-Import Bank of the United States (``Ex-Im Bank'') is 
prohibited from supporting certain transactions involving parties that 
conduct business with the Iranian energy sector. To ensure compliance, 
Ex-Im Bank requires your company to complete this Questionnaire. In 
addition, Ex-Im Bank reserves the right to ask further questions as 
necessary.

Part A: General Information

    1. Company Information:

Company Name:----------------------------------------------------------
Address:---------------------------------------------------------------
-----------------------------------------------------------------------
-----------------------------------------------------------------------

Contact:
Name and Title:--------------------------------------------------------
Telephone:-------------------------------------------------------------
Email:-----------------------------------------------------------------


    2. Are you an energy producer \1\ or refiner? \2\ (Check ``yes'' if 
any part of your business involves energy production or refinery 
operations). If yes, please complete Part B of this Questionnaire.

    \1\ For purposes of this Questionnaire, an ``energy producer'' 
means a business that produces energy of any kind, including 
(without limitation) gas- or oil- fueled, coal, nuclear, hydro, 
chemical reaction, electromagnetic, wave or tidal action, biofuels-
based, geothermal and/or renewable energy production.
    \2\ For purposes of this Questionnaire, a ``refiner'' means a 
business that refines hydrocarbons into products of value or that 
refines matter into combustible fuel.

    [ballot] Yes
    [ballot] No
    3. Are you affiliated though common ownership with, or control by, 
an energy producer or refiner? (Check ``yes'' if any part of such 
person/entity's business involves energy production or refinery 
operations. Also check ``yes'' if you are owned either in part or in 
full by a sovereign and your sovereign owner has an ownership interest 
in an energy producer or refiner.) If yes, please complete Part B of 
this Questionnaire.

    [ballot] Yes
    [ballot] No
If yes, name(s) of energy producer or refiner:-------------------------
Address:---------------------------------------------------------------
-----------------------------------------------------------------------
-----------------------------------------------------------------------

Contact:
Name and Title:--------------------------------------------------------
Telephone:-------------------------------------------------------------
E-mail:----------------------------------------------------------------

Part B: Description of Business Dealings With Iran

    1. Does your company (or the energy producer/refiner named in A.3 
above) provide Iran or any Iranian entity with refined petroleum 
resources, or is your company (or the energy producer/refiner named in 
A.3 above) currently negotiating to do so? If yes, please provide 
detailed information about such arrangements, amounts, timeframes, 
counterparties and other details of the transaction or proposed 
transaction.
    2. Does your company (or the energy producer/refiner named in A.3 
above) contribute in any way to Iran's capability to import refined 
petroleum resources, or is your company (or the energy producer/refiner 
named in A.3 above) currently negotiating to do so? If yes, please 
provide a detailed explanation.
    3. Does your company (or the energy producer/refiner named in A.3 
above) have any role in allowing Iran to maintain or expand its 
domestic production of refined petroleum resources, including any 
assistance in refinery construction, modernization or repair, or is 
your company (or the energy producer/refiner named in A.3 above) 
currently negotiating to have such a role? If yes, please provide a 
detailed explanation.
    4. Please describe in detail any business dealings pertaining to 
the energy sector that your company (or the energy producer/refiner 
named in A.3 above) has had with Iran or any Iranian entity in the past 
5 years.

Part C: Certification

    Certification. The submitter of this questionnaire (``Submitter'') 
certifies that the facts stated and the representations made above and 
in any attachments to this Questionnaire are true, to the best of the 
Submitter's knowledge and belief after due diligence, and that the 
Submitter has not misrepresented or omitted any material facts. The 
Submitter further understands that this is an official submission to 
the United States Government and this Certification is subject to the 
penalties for fraud against the U.S. Government (18 U.S.C. 1001, et 
seq.). The Submitter further certifies that it will provide additional 
information with respect to any of the matters covered in this 
Questionnaire upon Ex-Im Bank's request. The authorized officer or 
employee signing below is fully authorized to certify the answers in 
this Questionnaire on behalf of the Submitter.

Company Name:----------------------------------------------------------

By:--------------------------------------------------------------------

     (Authorized Officer or Employee)
Name:
Title:

[FR Doc. 2010-5615 Filed 3-12-10; 8:45 am]
BILLING CODE 6690-01-P
```