Section |
Instruction |
General Instructions – This form must be printed on the foreign party’s letterhead and signed. If portions of the requested information are classified then complete as much as possible and provide the name, title, organization and contact information for person to be contacted by the U.S. Government.
Purchasers company name and address |
Purchasers company name and address Type out entire legal name and physical address. |
Purchasers role in transaction |
List out the purchaser |
Ultimate End User |
If this your company list information here, if not put the full legal name and address |
Country (ultimate destination) |
Here you will list the country where the component/part or item will ultimately be exported to. |
End Use Application |
Be very specific provide information about the application and where it will be used. |
Platform |
List out the platform the goods will be used in be very specific |
Purchase Order/ Contract Number: |
The number of the related Purchase Order or Contract. |
Purchased Item(s) |
In this section you will fill out exactly what is listed on the purchase order made out to Sonoran Electronics Inc. |
Name/Model Number: |
The name and/or model number of the purchased item(s). Must correspond with the name and/or model number of the items as listed in the related Purchase Order/Contract. |
Quantity |
This information must match the purchase order |
Value |
This information must match the purchase order |
PO or Contract # |
I recommend the purchase order number given this is what is submitted to the USG for license approval. |
Parties to the Transaction |
In this section you will list all parties who will be physically handling or receiving the component. |
Purchaser |
In this section you will list all parties who will be physically handling or receiving the component. |
Foreign Consignee |
This are all non-U.S. parties who will handle the US items or receive data – if the additional rows are not required delete them. |
Foreign Intermediate |
Foreign intermediate consignees are non-U.S. entities such as custom brokers freight forwarders and warehouses. Please list any U.S. Consignors separately and explain their role. |
Ultimate Consignee |
This is only applicable if there will be a party to the transaction who will receive the items for storage, modification, or to incorporate into another end-item. |
End-User |
The party who actually uses the good(s). |
Certification |
The party filling out the form must provide a wet signature, print name, title with the company, date, phone number and a work email. |