APPENDIX 36
END USE
CUM END USER CERTIFICATE IN CASE OF EXPORT OF SCOMET ITEMS
I /We (name of
the end user)_______________________________________________________________
Certify that we
are importing (name of the SCOMET item)________________________________________
From (name and
address of the exporter) ____________________________________________________
Against our
purchase order No _____________date___________________________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/we further
certify that that the items detailed in the referenced purchase order will 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. And further, if required, post installation
verification shall be allowed.
The end-user
shall not himself , or through another
, cause the items , or replicas , ore derivatives thereof to be re-transferred
/ sold without the knowledge / consent of the Government of India, to any
party within (name of the
country)___________________________________/ or outside it.
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: ___________________________________
Signature
of end-user / authorised signatory
of the end-user with stamp and seal
Date:
Name
:____________________________
Designation:_______________________
Address
& e-mail:___________________
CERTIFICATION ON BEHALF OF THE
RECEPIENT STATE
(For Schedule 3 Chemicals of CWC ,
viz . Category 1 C of SCOMET list)
(To be filled for transfers of
Schedule 3 Chemicals to states not party to the Convention)
It is hereby certified that the
transferred Chemical referred to above will be used only for purposes not
prohibited / disallowed under the Chemical Weapons Convention and shall not be
transferred to any other person or re-exported from the recipient country.
|
Name of the
chemical (IUPAC nomenclature) |
Quantity |
Signature:_________________________
Name:____________________________
Position:__________________________
Organisation
/ State:_________________
Address:__________________________
IMPORT CERTIFICATE TO BE
ACCOMPANIED WITH END-USE CUM END-USER CERTIFICATE
(To be filled when the import is
by a third party)
I /We (name of
the end user ) ______________________________________________________________
Certify that we
are importing (name of the SCOMET item ) _______________________________________
From (name and
address of the exporter) ____________________________________________________
Against our
purchase order No ________________________date_____________ as capital
equipment and which will be transferred to :___________in ________________
(country ) For the manufacture of (end
product)_______________________________________________________ which will be
used for (state specific use )
__________________________________________________ (the end use cum end user
certificate from the ultimate end user is also enclosed) as component and will
be used for assembling of another equipment ___________________________ and
will be transferred to ______________________________in
_________________________(country ) for the manufacture of (end product)
________________________________________________________ which will be used for
( state specific use ) ___________________________________________________ (the
end use cum end user certificate from the ultimate end user is also enclosed
)____________________ will be used as raw material for the manufacture of (end
product ) _____________________________ and will be transferred to
___________________________________in ____________________(country ) which will
be used for ( state specific use ) ___________________________________________________
( the end use cum end user certificate from the ultimate end user is also
enclosed ) which will be used for purposes other than the above ( specify ).
(NB :
export of 1C Chemicals shall be allowed only when buyer and end-user are in the
same country)
I/We further
certify that that the items detailed in the referenced purchase order will 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. And further, if required, post installation
verification shall be allowed.
The end-user
shall not himself , or through another
, cause the items , or replicas , ore derivatives thereof to be re-transferred
/ sold without the knowledge / consent of the Government of India, to any
party within (name of the country
)____________________________________/ or outside it.
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 and am also enclosing the end
use cum end user certificate
Place:
Signature
of end-user / authorised signatory
of the end-user with stamp and seal
Date:
Name
:____________________________
Designation:_______________________
Address
& E-mail:___________________
CERTIFICATION ON BEHALF OF THE
RECEPIENT STATE
( For Schedule 3 Chemicals of CWC
, viz . Category 1 C of SCOMET list)
( To be filled for transfers of
Schedule 3 Chemicals to states not party to the Convention )
It is hereby certified that the
transferred Chemical referred to above will be used only for purposes not
prohibited / disallowed under the Chemical Weapons Convention and shall not be
transferred to any other person or re-exported from the recipient country.
|
Name of
the chemical (IUPAC nomenclature) |
Quantity |
Signature:_________________________
Name:____________________________
Position:__________________________
Organisation
/ State:_________________
Address:__________________________