END USE CUM END USER CERTIFICATE IN CASE OF EXPORT OF SCOMET ITEMS
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....____________________________________________ (h) Specific Location where the items will be used (if different from (g))__________________________________________ PART 2: ITEMS (goods, software, technology) (a) Description of the item(s) (e.g. Name of Model, Class, Type, Serial Number) (b) Quantity/Weight /Value1 (c) Purchase order Number & Date of signature of contract___________________________________________________ PART 3: DECLARATION a) The item(s) indicated in PART 2 will be used as capital equipment/ component / raw material / other use for_______________________________ b) The item(s) indicated in PART 2 are being processed or incorporated into another product2 (as detailed in 3a above), for sale to ultimate end users locate....
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...._______ Designation: ______________ Address: ____________________________________________ ____________________________________________ Email: ____________________________________________ Telephone number: _______________________________________ [To be submitted by all entities in the chain of supply on the letterhead of the respective entity. Any additional pages must be signed by the same person who signs this form. For Category 1 items, use Appendix 2S(ii) 1: For Technology exports, value should be mentioned in Part 2(b) 2: Cross this line if it is not applicable]] ------------------- Notes:- 1. Substituted vide Public Notice No. 4/2015-20, dated 24-04-2017, before it was read as:- "APPENDIX- 2 S END USE CUM END USER CERTIF....
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.... another, cause the items, or replicas, or derivatives thereof to be re-transferred / sold without the consent of the Government of India, to any party within (name of the country)___________________________________ or outside it. I/We also certify that the above items imported by us shall not be used for any purpose that relate to the development of Weapons of Mass Destruction. 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. Place: Date: Seal Signature of end-user / authorised signatory of the end-user with stamp and seal Name:____________________________ Desi....