CERTIFICATE OF END-USE ASSURANCE FOR DUAL-USE ITEMS AND TECHNOLOGY

TO BE ISSUED ON COMPANY LETTER HEADED PAPER

1. Exporter

Name:
Address:

2. Consignee

Name:
Address:

3. End-User (if different to consignee)

Name:
Address:

4. Goods

(a) Detailed description of goods
(b) Quantity
(c) Value (€/$US)

5. End-Use

Specific purpose for which the goods will be used

6. Undertaking

We certify that: -

We are the end-user of the goods described in Section 4, which are to be supplied by the exporter named in Section 1;

We further certify that we shall use the goods for the purposes described in Section 5;

The goods will not be used for any purpose connected with chemical, biological or nuclear weapons, or missiles capable of delivering such weapons;

The goods will not be re-exported or otherwise re-sold or transferred if it is known or suspected that they are intended or likely to be used for such purposes;

The goods will not be diverted to another destination; and,

in the event of the goods being so re-exported, the export will be conducted in accordance with the regulations of the national licensing authority in ...... [insert name of country].

Signed:______

Name in block letters______

Position in end-user company:______

Date:______Company Stamp/official seal

Instructions for completing the End User Certificate

An End User Certificate (EUC) must be completed in full, signed and stamped by the end user. Before submitting your EUC please carefully review the following details.

  • Please note that we will only accept EUCs signed within the last six months.
  • All information must be clearly legible and in English. Please type or use block capitals.
  • The EUC must be on the End User’s headed paper.
  • Box 1 “Exporter”
  • This must contain the exporter name and address.
  • Box 2 “Consignee”
  • This box must contain the name and address of the consignee.
  • Box 3 “End user”
  • This box must contain the name and address of the end user.
  • The end user may be the same as the consignee and this should be stated on the EUC. The end user is the person or entity who usesthe particular product.
  • Box 4 “Goods”
  • This section must contain a detailed description of the goods, along with the quantity and value in Euro.
  • Box 5 “End Use”
  • This box must contain specific detail on how the goods will be used by the end user.
  • Please note that basic descriptions of goods will not be accepted. The description must be specific and explain in simple terms how the goods will be used by the end user.
  • Box 6 “Undertaking”
  • The end user must agree to all the conditions contained in box 6.
  • Please insert the country where in the event of the goods being re-exported, the export will be conducted in accordance with the regulations of that national licensing authority.
  • The application must be signed and dated, the name in clear block capitals, position held and stamped with the end users company seal.

Please Note: Failure to complete the EUC correctly will result in delays in processing license application