Appendix A to Part 233 - Application for Compensation United States Agency for International Development Washington, DC 20523
22:1.0.2.22.28.0.30.17.29 : Appendix A
Appendix A to Part 233 - 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 § 233.02 of the Standard
Terms and Conditions of the above-mentioned Guarantee) was due on
______, 20__, on $___Principal Amount of Notes issued by Hashemite
Kingdom of Jordan (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 § 233.08 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: