END USE CUM END USER CERTIFICATE IN CASE OF EXPORT OF SCOMET ITEMS
X X X X Extracts X X X X
X X X X Extracts X X X X
...._____________________ (g) End-User's Address ________________________________________________ (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 /Value^1 (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 i....
X X X X Extracts X X X X
X X X X Extracts X X X X
....is certificate. Signature: _____________________________ Date: ________________ (Signature of authorised signatory) Name: _____________________________________________ &nb....
X X X X Extracts X X X X
X X X X Extracts X X X X
....____________(name & address of the foreign buyer/end user/intermediary(ies)/consignee(s) certify that we are importing (name of the SCOMET item)____________________________ from (name and address of the exporter)_________________________________________/ through______________________________(name & address of the intermediary/consignee) against Purchase Order No/Contract No.________________ dated__________ as capital equipment/ component / raw material / other use (specify)_______________________________________ for the manufacture of (end product)____________________________which will be used for (state specific use)*____________________________________________________________. (* if more than one use then enclose self certified list) I....
TaxTMI