END USE CUM END USER CERTIFICATE IN CASE OF EXPORT OF CHEMICALS

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....ame of Buyer _________________________________________________________ (c) Buyer's Address _________________________________________________ (d) Name of Consignee_________________________________________________________ (e) Consignee's Address _________________________________________________________ (f) Name of End-User _________________________________________________________ (g) End-User's....

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....;                      PART 3: DECLARATION a) The item(s) indicated in PART 2 will be used for    _______________________________________________________________________ b) I/we certify that the above-mentioned items (as detailed in the referenced purchase order) shall not be used ....

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....delivering such weapons and that the chemical(s) will only be used for purposes not prohibited under the Chemical Weapons Convention (CWC). e) 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. Signature:    ____....

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....nbsp;                       ____________________________________________    Email: ____________________________ PART 4 - CERTIFICATION ON BEHALF OF THE RECEPIENT STATE1 As an authorised signatory for the government of the recipient state, I confirm that the chemical(s) describ....