Appendix A to Part 232 - Application for Compensation
22:1.0.2.22.27.0.30.17.28 : Appendix A
Appendix A to Part 232 - Application for Compensation United States
Agency for International Development Washington, DC 20523 Ref:
Guarantee dated as of ___, 20__:
Gentlemen:
You are hereby advised that payment of $____ (consisting of
$____ of principal, $____ of interest and $____ in Further
Guaranteed Payments, as defined in § 232.02(1) of the Standard
Terms and Conditions of the above-mentioned Guarantee) was due on
20__, on $____ Principal Amount of Notes issued by Banque Centrale
de Tunisie, acting on behalf of the Republic of Tunisia (the
“Borrower”) held by the undersigned. Of such amount $____ was not
received on such date and has not been received by the undersigned
at the date hereof. In accordance with the terms and provisions of
the above-mentioned Guarantee, the undersigned hereby applies,
under § 232.08 of said Guarantee, for payment of $____,
representing $_____ the Principal Amount of the presently
outstanding Note(s) of the Borrower held by the undersigned that
was due and payable on ____ and that remains unpaid, and $____, the
Interest Amount on such Note(s) that was due and payable by the
Borrower on ____ and that remains unpaid, and $____ in Further
Guaranteed Payments, 1 plus accrued and unpaid interest thereon
from the date of default with respect to such payments to and
including the date payment in full is made by you pursuant to said
Guarantee, at the rate of __% per annum, being the rate for such
interest accrual specified in such Note. Such payment is to be made
at [state payment instructions of Noteholder].
1 In the event the Application for Compensation relates to
Further Guaranteed Payments, such Application must also contain a
statement of the nature and circumstances of the related loss.
All capitalized terms herein that are not otherwise defined
shall have the meanings assigned to such terms in the Standard
Terms and Conditions of the above-mentioned Guarantee.
[Name of Applicant] By: Name: Title: Dated: