Read SingaporeEUS.pdf text version

To: Director-General, Singapore Customs

Attn: Strategic Goods Control Branch Fax: 6355 2156 END-USER STATEMENT

I/we, (name, address, and e-mail address of end-use

have requested SCHENKER SINGAPORE PTE LTD on behalf of Cisco Systems International BV

r)

Phone #: _____________________ Fax #: _______________________ Email: _____________________

NO. 51 ALPS AVENUE, LEVEL 5, SINGAPORE 498783. ATTN: CISCO SUPPORT, LOGISTICS OPERATIONS

Product Description

Category Code HS Code Brand Model

1 Find in Trade Tool, top blue bar, e.g. 3845 Voice Bundle,PVDM2-64,SP Serv,64F/256D ECCN# xxxx (e.g. 5A002)

2

Type Quantity Value Sales Order No. (SO#) Ship Set No. (SS#) Company Website

(Find in Trade Tool, US HTS Number) Cisco (Find in Hold Report, item, e.g. CISCO3845V/K9) (e.g. Cisco 3845) (Find in Status Tool) (Find in Status Tool) USD 9,097.00 (Find in Hold Report) 9352527 (Find in Hold Report-) (-Verify in Status Tool)

3 e.g. Preloaded Software for items 1 and 2 Cisco 3845 IOS SP SERVICES ECCN# xxxx (e.g. 5D002) n/a

Cisco S384SPSK9-12311T

Cisco Software 2 See items 1 and 2 9352527 20, 23

which is intended for:

(provide specific detailed end-use of the goods identifying the specific operations to be performed by the goods in support of the end-user's business activities) in ( )

I/we confirm that the goods will not be used in relation to nuclear, biological or chemical weapons, or missiles capable of delivering these weapons. I/we also confirm that the goods will not be re-exported or sold to a third party who is known or suspected to be involved in relation to nuclear, biological or chemical weapons, or missiles capable of delivering these weapons, or to any sanctioned entities.

This form must be printed on company letterhead Pg. 1 of 2

I/We also confirm that any re-export or sale to a third party, is carried out in compliance with the originating/supplying and receiving countries' export control laws, as applicable. Name (in block letters): __________________________________________________________ Designation/Position of Submitter at Company: _______________________________________ Date: ____________________________ Authorized Signature: _______________________ Company Stamp

This form must be printed on company letterhead

Pg. 2 of 2

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