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End User and End Use Declaration Form: (No Abbreviation)

Mistras Group Inc. is required to collect end user and end use information from customers to comply with US export regulations. The form collects contact and shipping information for the purchaser, reseller if any, and end user/consignee. The purchaser, Enerprec in Colombia, declares the end use is for oil and gas NDT/engineering services and signs the form, assuming responsibility for complying with US export laws for any export or re-export of products.

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yisela arrieta cortez
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89 views1 page

End User and End Use Declaration Form: (No Abbreviation)

Mistras Group Inc. is required to collect end user and end use information from customers to comply with US export regulations. The form collects contact and shipping information for the purchaser, reseller if any, and end user/consignee. The purchaser, Enerprec in Colombia, declares the end use is for oil and gas NDT/engineering services and signs the form, assuming responsibility for complying with US export laws for any export or re-export of products.

Uploaded by

yisela arrieta cortez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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195 Clarksville Road, Princeton Junction, NJ 08550, USA

Tel: 609 716 4000, Fax: 609 716 0706


Email: sales.systems@mistrasgroup.com
Web: www.mistrasgroup.com

End User and End Use Declaration Form


Under the guideline of US export control regulations imposed by Directorate of Defense Trade Controls (DDTC) of
US Department of State, Bureau of Industry and Security (BIS) of US Department of Commerce and Office of
Foreign Assets Control (OFAC) of Department of Treasury, MISTRAS Group Inc. obligates to comply with the
regulations and to collect end user and end use information before quoting or selling products to customers. By
signing this form, you are assuming to know the end user and the end use of the products and you will take the
responsibility to comply with the U.S. Export Administration Regulations should the products are for export or re-
export. For more detail information about the US export control regulation laws, please visit following web sites:
BIS web site: http://www.bis.doc.gov
DDTC web site: http://www.pmddtc.state.gov/index.html
OFAC web site: http://www.treasury.gov/resource-center/sanctions/Pages/default.aspx

Purchaser Reseller (if any) End User or Consignee


Wendy Paola Navarro Ariza
*Company Name Enerprec (Energía, Predicción y Control Automático)
(No Abbreviation) Régimen Simplificado

*Address Transversal 3B # 22-246


Horizontes de Villa Campestre, Villa Campestre
Barranquilla, Atlántico

*Country Colombia

*End Use Info Aerospace X NDT/Engineering/Test Services


(check all boxes
where applicable) Automotive Nuclear power

Chemical X Oil & Gas, Offshore

Computer/Electronics Plants/Agriculture

Defense/Military Power (non-nuclear)

Food/Beverage Pressurized Equipment/Crane/Elevator

Infrastructure/Civil Engineering Rocks/Mines/Geoscience

Manufacturing/OEM Transportation (Air, Rail, Marine)

Materials/Metals Universities/Research Institutes

Medical/Dental/Pharmacy Others (Specify)

*Purchaser Name of Person: Signature:


Declaration Wendy Paola Navarro Ariza
Email (No free email, e.g. Gmail, Hotmail, Yahoo etc.): Date (MM/DD/YYYY):
enerprec@gmail.com 07/05/2019

MISTRAS Internal Use Only

Quote/Order Ref. #: Reviewed By: Date:

(Info with * must be provided.)

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