OMB No. 
Expire: 
0625-0237
11/30/2002

 

New York & New Jersey Metro US Export Assistance Center
Contact Request E-form


To learn more about international marketing, export sales opportunities or to get details on US Department of Commerce, Ex-Im Bank, or SBA export services, please complete and submit this easy form. Your local Export Assistance Center will contact you promptly.

Company :
   
Address 1:
Address 2:
City:
County
State:
Zip Code:
Country:
   
Telephone:
Fax:
E-Mail:
Home Page:
   
  Mr.
Ms.
Contact Name:
Contact Title:
Select All That Apply: Original Equipment Manufacturer (OEM)
Contract Manufacturer
Service Firm (Please Describe in Comments)
Distributor (Stocking, Maintains Inventory)
Value Added Reseller (VAR)
Manufacturer's Representative or Authorized Sales Agent
Trading Company
Product:
Service:
Year Established:
Annual Sales: (Numeric Values ONLY)
Full Time Employees:
Annual Export Sales: (Numeric Values ONLY)
Products Made in USA? Yes
No
Note: If not made in US, products must be at least 51% US content.
Comments:
   
Free Export Counseling
Agent Distributor Service ADS
Gold Key Service GKS
Commercial News USA
Trade Opportunities Program TOP

Specify Countries of Interest:

Comments:
   
Export Credit Insurance
Export Working Capital Loan Guarantees: Amounts Above $833,333.
Other:
   
Export Working Capital Loan Guarantees: Amounts Below $833,333.
SCORE New To Export Counseling
International Trade Loan
Other:
   
Public reporting for this collection of information is estimated to be 5 minutes per response, including the time for reviewing instructions, and completing and reviewing the collection of information. All responses to this collection of information are voluntary, and will be provided confidentially to the extent allowed under the Freedom of Information Act. Notwithstanding any other provision of law, no person is required to respond to nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Reports Clearance Officer, International Trade Administration, Department of Commerce, Room 4001, 14th and Constitution Avenue, N.W., Washington, D.C. 20230.
   
Select Local Export Assistance Center: