END USER STATEMENT FORMAT

 

A completed end-use statement is required for the completion of your order. Please complete the following end-use template on your Company Letterhead:

 

(COMPANY LETTERHEAD)

(Date)

 

Regarding:

Purchase Order or Quote Number: _____________

 

 

I certify to the following:

 

MCC products and technology obtained will be employed in the

 

 

 _____________________________(define application) of

 

 

 _____________________________(define end-product) in the field of  / to be used in

 

 

______________________________(define industry).

 

(See examples at end of template.)

 

(Company) will be the ultimate end user of MCC technology obtained.

 

Product will remain in at (Company)’s location specified on letterhead and will not be resold or transferred without approval from Measurement Computing. I acknowledge that these commodities, technology or software will be exported from the United States in accordance with the Export Administration Regulations and that diversion contrary to U.S. law is prohibited.

Furthermore, I acknowledge that Measurement Computing products will not be diverted to the following embargoed nations: Cuba, Iran, North Korea, Sudan and Syria, or to a military end-use in China.

 

MCC technology will NOT be employed for:

 

·         the design, development, fabrication, or testing of nuclear weapons or explosive devices; or design, construction, fabrication, or operation of facilities or components of facilities for chemical processing of irradiated special nuclear or source material, heavy water production, separation of isotopes of source and special nuclear material, or fabrication of nuclear reactor fuel containing plutonium, or unsafeguarded nuclear facilities.

 

 

 

I acknowledge that, based on the end-use information provided above, additional information/clarification may be required.

 

(Signature)

(Name)

(Title)

(Department)

(Company)

(Address)

 

Examples of an acceptable End Use Statement:

MCC products and technology obtained will be employed in the application of end-product in the field of  / to be used in industry.

MCC products and technology obtained will be employed in the development of test fixtures to be used in the testing of silicon chips.

MCC products and technology obtained will be employed in the automation of seat belt resistance testing in the field of commercial aircraft.

MCC products and technology obtained will be employed in the data acquisition of isotope decay rates in the field of molecular research.