Appendix 10J (iii)

END USE CUM END USER CERTIFICATE FOR EXPORT OF SCOMET ITEMS FOR STOCK & SALE PURPOSE [for export from Indian exporter to stockist abroad]

[To be filled by all entities in the chain of supply e.g. foreign buyer / consignee / end user / intermediary, if any on the letterhead of the respective entity, duly signed in ink by authorised signatory] __________________________________________________________________________________________________
Note :[Please read carefully]

1. Stock and Sale is not permitted for SCOMET Category 0, Category 3A4001, Category 6 and transfer of technology in any category
2. Please indicate full details of end use under declaration in Part 3(a)
3. Strike out, if any entry is not applicable
4. Any additional sheet must be on the letterhead of the company and signed by the same person who signs this form
5. Other than Stock and Sale purposes, EUC proforma Appendix 10J(i) or Appendix 10J(ii), as applicable,will apply __________________________________________________________________________________________________

PART 1: DETAILS OF THE ENTITIES

(a) Name of Exporter in India :
(b) Name of Stockist entity:
(c) Address of the Stockist entity :
(d) Details of relationship between exporter and stockist :
(e) Specific Location where the items will be held in stock/assembled [if different from (c)]* :
(f) List of countries to which goods are to be transferred on receipt of orders:

*Remarks: The goods will be stocked at the premises of the Stockist and shall not be re-transferred / sold without the consent of the Government of India, unless specifically exempted in the export authorization/policy.

PART 2: ITEMS

PART 3: DECLARATION
a)   The item(s) indicated in PART 2 will be used as capital equipment/ component / raw material / other9 __________(select one) for use as (indicate full details of end use): ____________

b)   I/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.

c)  Post shipment verification of the items at end users site shall be allowed if required by the Government of India, as may be applicable.

d)   The stockist shall not himself, or through another, cause the items, or replicas, or derivatives thereof to be retransferred / sold without the consent of the Government of India, to any party within (country of the stockiest entity) ________________ or outside it unless specifically exempted in the export authorization/policy.

e)   I/We further certify that the goods are intended for stock to be held against future orders and that the consent of the Government of India will be obtained for any transfer to end-users in the countries mentioned in Part 1

(f)   above unless specifically exempted in the export authorization/policy. We undertake that we shall follow the conditions laid down in the export authorization granted to entity at 1(a) above by the Government of India.

f)   I/We also certify that the above items 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.
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9} Please indicate the use

g)   I/we also certify that all the facts contained in this certificate are true and correct to the best of my knowledge and belief and that I/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 of the entity:

Date of issue:
Validity date (specify the period, if any):