EXPORT CONTROL FOLLOW-UP QUESTIONNAIRE Commodity Classifications To: Cc: From: Date: OTT Tech ID: Re: Frances Streeter, JD – Export Control Officer Matthew Grove, JD - MTA Attorney Dr. _____ _____ Additional Information Required for Export Control Commodity Classification Microorganisms- Category 1 Along with negotiating the collaboration agreement, the Office of Technology Transfer is conducting an export control review of the item, _____ or "item" that you intend to send to _____ "Recipient" in _____. To complete classification of the item in accordance with EAR and ITAR, additional information is required. Please check the appropriate box to each of the corresponding questions listed below. □ Yes or □ No Microorganisms are defined in Category 1 and 2 of the EAR as bacteria, viruses, mycoplasms, rickettsiae, chlamydiae or fungi, whether natural, enhanced or modified, either in the form of isolated live cultures or as material including living material which has been deliberately inoculated or contaminated with such cultures. Is your item a microorganism as defined above? □ Yes or □ No Does your item include any genetic elements or genetically-modified organisms which (1) contain any nucleic sequence that in itself or through its transcribed or translated products represents a significant hazard to human, animal or plant health or (2) contain any nucleic sequence that is known to enhance the ability of a micro-organism, or any other organism into which it may be inserted or otherwise integrated, to cause serious harm to human, animal or plant health? □ Yes or □ No Does your item include biological agents and/or biologically-derived substances specifically developed, configured, adapted, or modified for the purpose of increasing their capability to produce casualties in humans or livestock, degrade equipment or damage crops? Will your item be used for military or defense purposes by the Recipient? □ Yes or □ No I, _____, certify, that the information I supplied above is truthful and accurate in regards to the item. I also understand my obligations under U.S. export laws. Signed:__________________ Date:_______________ Guidance for the Export Regulations: EAR identifies pathogens and toxins in Category 1 of the Commerce Control List (CCL) with the following Export Control Classification Numbers (ECCN); 1C351, 1C352, 1C354, or 1C360 and the associated technology(ies) as ECCN 1E351. Genetic elements and genetically-modified organisms are controlled in ECCN 1C353. International Traffic in Arms Regulations (ITAR) controls certain military-related toxins and pathogens at Category XIV of the US Munitions List (USML). Office of Foreign Asset Control (OFAC) identifies individuals, entities, universities, and countries that are subject to economic and trade sanctions. Export Control Use Only Approved ECO Initials: ______ Not Approved Date:____________ Revised 2013