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5462 LOUIE LANE RENO, NV 89511775-851-3580 FAX: 775-851-3582
EXPORT CONTROL STATEMENT
LETTER OF INTENT
Thank you for your recent quote or purchase order. Please understand that we will require the following information to process your quote or order in accordance with the export laws of the United States. Please note that incomplete or non-specific answers will delay correspondence or order processing!
1. DATE:
2. QUOTE# OR PO#:
3. PART(S) #:
4. NAME AND ADDRESS OF FOREIGN END-USER(S):
*NAME
*ADDRESS
*CITY
*COUNTRY
*IF ADDITIONAL FOREIGN END-USERS ARE APPLICABLE, PLEASE USE ADDITIONAL SHEET PROVIDED ON PAGE 4.
5. NAME AND ADDRESS OF FOREIGN (PURCHASER) CONSIGNEE:
(e.g.: the person who will receive the shipment for modification, storage, or for incorporation into another end-item, and for subsequent forwarding to the foreign end-user)
*NAME
*ADDRESS
*CITY
*COUNTRY
6. NAME AND ADDRESS OF FOREIGN INTERMEDIATE (DISTRIBUTOR) CONSIGNEE: (e.g.: the person who will receive the CalRamic parts for onward movement to the foreign purchaser or foreign end-user)
*NAME
*ADDRESS
*CITY
*COUNTRY
*ROLE IN THE TRANSACTION
7. SPECIFIC PURPOSE FOR WHICH THE MATERIAL IS REQUIRED AND SPECIFY PROGRAM, APPLICATION, AND END ITEM THE PARTS WILL BE USED IN:
********PLEASE CIRCLE: MILITARY OR NON-MILTARY USE********
NOTE: The export, foreign sale, or foreign distribution of our products and related technology may be subject to the export control laws of the United States and other countries. Unless otherwise agreed by us in writing, buyer agrees to comply with all such laws and to secure any licenses or other permissions required by such laws.
Orders requiring an Export License may be subject to an additional charge.
Buyer herby states that these devices will not be used for military, nuclear, or any other programs that violate the laws of the United States.
NAME (PRINT) / SIGNATURETITLE / DATE
CONT. 4. NAME AND ADDRESS OF FOREIGN END-USER(S):
*NAME
*ADDRESS
*CITY
*COUNTRY
CONT. 4. NAME AND ADDRESS OF FOREIGN END-USER(S):
*NAME
*ADDRESS
*CITY
*COUNTRY
CONT. 4. NAME AND ADDRESS OF FOREIGN END-USER(S):
*NAME
*ADDRESS
*CITY
*COUNTRY
CRForm 166 Export Control