DIRECTOR-GENERAL OF TRADE AND INDUSTRY
STRATEGIC TRADE CONTROLS BRANCH
TRADE AND INDUSTRY DEPARTMENT
TRADE AND INDUSTRY DEPARTMENT TOWER
700 NATHAN ROAD
KOWLOON
HONG KONG
END USER STATEMENT
(IN SUPPORT OF STRATEGIC COMMODITIES EXPORT LICENCE APPLICATION)
WE,
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(ENTER NAME, ADDRESS, TELEPHONE AND FAX NUMBER OF END USER)
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HAVE REQUESTED SCHENKER INTERNATIONAL (H.K.) Ltd., 4/F, Phase II, Fountain Set
Building, 3A Hung Cheung Road, Tuen Mun Industrial Estate, Tuen Mun NT, Hong Kong, Attn: George
Chau / Zuki Hui(Cisco account), TO EXPORT:
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(DESCRIBE GOODS - BRAND, MODEL, TYPE, QUANTITY, VALUE)
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WHICH WE INTEND TO USE FOR:
INTERNAL IT CONNECTION
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(SPECIFIC DETAILED END-USE OF THE GOODS IDENTIFYING THE SPECIFIC OPERATIONS TO BE
PERFORMED BY THE GOODS IN SUPPORT OF THE END-USERS BUSINESS ACTIVITIES)
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IN _________________________________________.
(COUNTRY OF ULTIMATE DESTINATION)
WE CONFIRM THAT THE GOODS WILL BE USED SOLELY BY CIVIL ENDUSERS FOR CIVIL
END USE AND WILL NOT BE USED IN RELATION TO NUCLEAR, BIOLOGICAL, OR
CHEMICAL WEAPONS OR MISSILES CAPABLE OF DELIVERING THESE WEAPONS. WE
ALSO CONFIRM THAT THE GOODS WILL NOT BE RE-EXPORTED OR SOLD TO A THIRD
PARTY.
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SIGNATURE
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DATE OF SIGNATURE
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NAME OF SIGNATORY (IN BLOCK LETTERS)
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COMPANY POSITION
COMPANY CHOP