Administration Export Compliance Form
Administration Export Compliance Form
Date: [Month, Day, Year]
Exporter Information
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Exporter Name: |
[Your Company Name] |
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Exporter Address: |
[Your Company Address] |
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Exporter Contact Number: |
[Your Company Number] |
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Exporter Email: |
[Your Company Email] |
Exported Item Information
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Exported Item Information: |
[High-performance microprocessors] |
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Export Control Classification Number (ECCN) or Commodity Classification Automated Tracking System (CCATS): |
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Quantity: |
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Unit Value: |
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Total Export Value: |
End-User Information
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End-User Name: |
[Your Partner Company Name / Second Party] |
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End-User Address: |
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End-User Contact Number: |
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End-User Email: |
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End-Use: |
Destination Information
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Destination Country: |
[Canada] |
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Final Destination Address (if different from End-User Address): |
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Intended Date of Export: |
Export Control Information
If yes, please specify the applicable regulations:
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Certification:
I, [Your Name], certify that the information provided in this Administration Export Compliance Form is accurate and complete to the best of my knowledge. I understand that any false or misleading statements may result in penalties under U.S. export control laws and regulations.
[Month, Day, Year]
