APPENDIX-2 S(i)
END USE CUM END USER CERTIFICATE FOR EXPORT OF SCOMET ITEMS
(For SCOMET Categories 2,3,4,5 & 8 and re-export from Stockist to ultimate end
user under Stock & Sale for all eligible categories other than Category 1 -
chemicals)
[To be filled by all entities in the chain of supply e.g. foreign buyer /
consignee / end user / intermediary(ies), if any on the letterhead of the
respective entity, duly signed in ink by authorised signatory]
Note : [Please read
carefully]
1. The word 'items' imply goods, software, technology
2. For Technology exports, value should be mentioned in Part 2
3. Please indicate full details of end use under declaration in Part 3(a)
4. Strike out, if any entry is not applicable
5. Any additional sheet must be on the letterhead of the company and signed by
the same person who signs this form
6. For SCOMET Category 1 items, EUC proforma Appendix 2S(ii) and for Stock &
Sale proforma Appendix 2S(iii) will apply
PART 1: DETAILS OF THE ENTITIES
(a) Name of Exporter
(b) Name of Buyer
(c) Buyer's Address
(d) Name of Consignee
(e) Consignee's Address
(f) Name of End-User
(g) End-User's Address
(h) Specific Location where the items (goods, software, technology) 1will
be finally used (if different from (g)) *
*Remarks: The items will be installed at the premises of the end-user or will be
used only by the end-user.
PART 2: ITEMS (goods, software, technology)
Description of the item(s) (e.g. Name of Model, Class, Type, Serial Number for goods and technical details in case of technology transfer) | Quantity/Weight /Value2 | SCOMET Category and sub category | Purchase order No. & Date / Contract Number, date of issue and validity |
PART 3: DECLARATION
a) The item(s) indicated in PART 2 will be used
as capital equipment/ component / raw material / other3
(select one) for use as (indicate full details of end use):
b) The item(s) indicated in PART 2 are being processed or incorporated into
another product (as detailed in 3a above), for sale to ultimate end users
located in
c) l/we certify that the above-mentioned items (as detailed in the referenced
purchase order) shall not be used for any purpose other than the purpose(s)
stated above and that such use shall not be changed nor the items modified or
replicated without the prior consent of the Government of India.
d) The items are for end-use of bona-fide customers in one or more of the
following countries, either in their current state or after incorporation and
the items will not be re-exported or sold for export without following the
export control regulations of the said country of end-use:
(names of countries);
1For definition of software and technology refer to the
glossary of SCOMET Appendix-Ill. Also refer to the general technology note and
general software note and the general information security note of SCOMET
Appendix-Ill
2For Technology exports, value should be mentioned (if applicable) in
Part 2
3Please indicate the use
e) Post shipment verification of the items at end users site shall be allowed if
required by the Government of India, as may be applicable. In case the
above-mentioned item(s) include(s) technology, we certify that it will be
treated as strictly confidential;
f) The end-user shall not himself, or through another, cause the items, or
replicas, or derivatives thereof to be re-exported / transshipped/ sold without
the consent of the Government of India, to any party within (country of final
destination)
or outside it unless specifically exempted in the export
authorization/policy.
g) The items listed at Part 2 imported by us shall not be used to develop,
acquire, manufacture, possess, transport, transfer or use, chemical, biological,
nuclear weapons or for missiles capable of delivering such weapons if it is
known or suspected that they are intended or likely to be used for such
purposes.
h) It is also certified that all the facts contained in this certificate are
true and correct to the best of my knowledge and belief and that l/we do not
know of any additional facts that are inconsistent with this certificate.
PART 4: SPECIFIC DETAILS OF AUTHORIZED SIGNATORY (mandatory):
a. Name (in capital letters only):
b. Designation:
c. Complete office address (with room No. area, city, district, state, country):
d. Pin/Zip/Postal Code :
e. Telephone number (with ISD code):
or
f. Mobile No.:
Alternate mobile number (if any):
g. Fax No with ISD Code. :
(if any)
h. Primary Email:
Alternate email:
Specific details of alternate contact person authorized for the purpose
(optional):
Same as (a) to (h) above
Signature (authorised signatory):
Official seal / stamp:
Date of issue:
Validity date (specify the period, if any):
Explanatory note
for export of software and technology: |