Buyer Assistance Application Form

BUYER ASSISTANCE APPLICATION FORM

A SEPARATE FORM SHOULD BE FILLED OUT FOR EACH TYPE OF ASSISTANCE REQUESTED

Date of application
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I.GENERAL INFORMATION
Company/individual’s name: / This should coincide with the name that appears on the bank account into which the funds are to be deposited. The same name should also be used on all forms and documents requested hereafter.
Address: / MANDATORY
Street, Building number, Apartment number, District, State or province, zip code
OPTIONAL (whichever applies in your country)
District, Department, Delegation, Municipality
Website:
Facebook page:
Twitter account:
Information on the company CEO or board chairman applying for assistance: / NAME
Telephone E-mail Title
Contact information for two people who will follow up on the application: / NAME OF FIRST CONTACT
Telephone E-mail Title
NAME OF SECOND CONTACT (OPTIONAL)
Telephone E-mail Title

BUSINESS AND OPERATING INFORMATION ON THE COMPANY

Please state the main productive sector(s) the company is engaged in (e.g. distribution, IT, automotive, etc.)
In which sector (s)and for which product(s) or service(s) is assistance being requested? / Main products and services:
Value of imports in thousands of USD: / Annual sales in thousands of USD:
International presence? Yes No
If yes, please indicate in which countries the company has a business and productive presence: / Investment in thousands of USD:
¿Does the company currently import products from Mexico?
If so, please list the top five products imported: / ¿Does the company have a sales rep in Mexico?
Yes No

INFORMATION ON THE PRODUCT/SERVICE OF INTEREST

Name of the product(s)/service(s) requested: / Product specifications:
Tariff item for the product(s): / Estimated amount to be purchased per period in thousands of USD:
Frequency of purchase (one-time, monthly, bimonthly, annual, etc.): / Does the product need to be custom designed?
Yes No
What are the basic production processes potential suppliers should be able to provide? / ¿Does the product in question require certification to enter the country of destination? Yes No
If so, please specify:
I authorize ProMéxico to use the information provided on this form to contact me and/or send me information. Yes No

MISSION SPECIFICATIONS

Name of the event or mission:
Date of the event or mission: from / / to//
Country:City:
Amount requested in Mexican pesos:

BANK INFORMATION

The bank details established in this format are the responsibility of the applicant, so that in case of any inconsistency in the information, ProMéxico will be free from any commission, rejection or refund that may be generated when making the electronic transfer.
ASIA
Name of the bank the funds will be deposited into:
Account number:
Transit number: 9 digits, the first 4 identify the bank and the remaining 5 the branch.
SWIFT/BIC: Society Worldwide Interbank Financial Telecommunication, comprised of between 8 and 11 digits.
CANADA
Name of the bank the funds will be deposited into:
Account number:
Transit number: 9 digits, the first 4 identify the bank and the remaining 5 the branch. / -
SWIFT/BIC: Society Worldwide Interbank Financial Telecommunication, comprised of between 8 and 11 digits.
Chip participant: number that refers to the intermediary bank.
EUROPE
Name of the bank the funds will be deposited into:
SWIFT/BIC: Society Worldwide Interbank Financial Telecommunication, comprised of between 8 and 11 digits.
IBAN: International Bank Account Number, composed of between 16 and 27 digits, varies depending on the country the funds are being sent from.
Chip participant: number that refers to the intermediary bank.
LATIN AMERICA (CENTRAL AND SOUTH AMERICA)
Ask your bank for instructions on how to receive funds from a foreign bank. These should include the following information:
Name of the final/local bank the funds will be deposited into:
SWIFT/BIC of the local/final bank: Society Worldwide Interbank Financial Telecommunication, comprised of between 8 and 11 digits.
Local bank account number:
Name of the intermediary bank:
SWIFT/BIC of the intermediary bank: Society Worldwide Interbank Financial Telecommunication, composed of between 8 and 11 digits.
Account number of intermediary bank:
OCEANIA
Name of the bank the funds will be deposited into:
Account number:
Chip participant: number that refers to the intermediary bank.
SWIFT/BIC: Society Worldwide Interbank Financial Telecommunication, comprised of between 8 and 11 digits.
UNITED STATES
Name of the bank the funds will be deposited into:
Account number:
ABA/Routing number: American Bankers Association, comprised of 9 digits.

TERMS AND CONDITIONS

Financial assistance is subject to the availability of ProMéxico funds and established eligibility criteria.
Submitting this application form in no way implies the funding requested will be authorized or granted.
ProMéxico reserves the right to request additional information when deemed necessary to corroborate the information provided herein at any phase in the verification process.
The information provided herein shall be treated pursuant to the provisions of the Federal Law on Transparency and Access to Public Information.
Any personal information provided herein may only be used by ProMéxico, except under scenarios stipulated in the Articles113 y 117 of the Federal Law on Transparency and Access to Public Information (LFTAIP).
ProMéxico hereby agrees to take the necessary measures to protect all applicant information deemed confidential, pursuant to the applicable provisions of the law. Notwithstanding, ProMéxico shall be under no obligation to protect the confidentiality of any other information provided by the applicant that does not fall under any of the scenarios set forth in the Articles 3,110, 113 y 117 of the Federal Law on Transparency and Access to Public Information(LFTAIP) in relation with Title Six, Chapter III of the General Law on Transparency and Access to Public Information or any other related regulations, regardless of whether said information was provided on registering on the website or at a later date, and including all information contained in e-mails, provided on forms and/or in the form of appendices.
ProMéxico is a government agency that is funded by taxpayers’ money. It is not sponsored or promoted by any political party and it resources come from the budget of the Federation's expenditures. Consequently, it is prohibited to grant support for political or electoral motives, for profit or for any other unjustifiable reason is strictly prohibited. Improper use of ProMéxico funds should be reported and will be sanctioned pursuant to the applicable laws by the competent authority.

LETTER OF COMMITMENT

I, the undersigned applicant or applicant’s proxy, do hereby agree to comply with all the applicable provisions of the law, specifically those set forth in ProMéxico’s Operating Guidelines for Assistance and Services, and do hereby expressly agree to:

Comply with all Criteria for the granting of assistance as stipulated in the applicable technical specifications.
Sign the instructions for participation where applicable.
Applicants shall have 30 business days (please consult the schedule for the verification and reimbursement of assistance posted on the ProMéxico website) as of the business day immediately after the date on which the assisted activity ends to complete the verification process via the ProMéxico information system and/or Office for the Control and Follow-up of Assistance and Services (DCSAS), and should furnish all the information requested in the forms and documents section.
Applicants who submit false and/or doctored information or who omit information during any phase in the process shall be banned from applying for assistance again for anywhere between one and five years, depending on the seriousness and circumstances of the offense, in keeping with the Administration and Control Rules for the Evaluation and Enforcement of Bans on Applicants who Submit False and/or Doctored Information (available for consultation on the ProMéxico website).
Fill out the evaluation and satisfaction questionnaire on the standard of the services rendered once all required information has been submitted via the ProMéxico information system and/or the DCSAS.
In the event the applicant fails to comply with any of the requisites stipulated in the technical specifications and/or applicable laws, ProMéxico may withdraw its assistance pursuant to Article 33 of the Operating Guidelines for Assistance and Services.
Refrain from requesting federal and/or state assistance for the same purpose for which the assistance of ProMéxico has been requested.
Provide ProMéxico with all information and/or documents required to assess the effectiveness of the assistance received.
Allow ProMéxico inspectors to visit the company to verify and/or assess the application of the assistance received.
Rectify any omissions or inconsistencies detected during said inspections within 15 business days as of notification by ProMéxico or the person designated by the latter for such purpose.

I do hereby swear that to the best of my knowledge, the information submitted on this form is correct and authorize ProMéxico to corroborate it.

Name of the applicant or proxy:

Signature of the applicant or proxy:______

The person whose signature appears above shall be required to sign all forms and/or documents requested hereafter.
Signed in:
Name of the ProMéxico promoter following up on the application:
BUYER ASSISTANCE APPLICATION FORM / Comes into force as of November7, 2017