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Transaction Screening Form (TSF) - NEW1

This transaction screening form documents a purchase order from Dräger Safety AG & Co. KGaA in Germany to monitor a compressor that generates hydrogen for cooling a synchronous generator. The end use is listed as power generation. The form requests information on purchaser, consignee, end user, additional parties, end use details, and is completed by the reviewer.

Uploaded by

Mayur Gupta
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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224 views1 page

Transaction Screening Form (TSF) - NEW1

This transaction screening form documents a purchase order from Dräger Safety AG & Co. KGaA in Germany to monitor a compressor that generates hydrogen for cooling a synchronous generator. The end use is listed as power generation. The form requests information on purchaser, consignee, end user, additional parties, end use details, and is completed by the reviewer.

Uploaded by

Mayur Gupta
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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Transaction Screening Form (TSF)

Date: Purchase/Sales Order/RFQ Number: Project Name/Number:


23rd may 2021 21-5014

A. Purchaser B. Consignee/Ship To
Check if included on purchase order or complete below Check if same as A. Purchaser
Check if included on purchase order or complete below

Company Name Dräger Safety AG & Co. KGaA Company Name


Address line 1 Tejostrasse 1-9 Address line 1
Address line 2 Address line 2
City Raunheim City
State/Province State/Province
Postal Code Postal Code
Country Germany Country

C. End User/Ultimate Destination D. Additional Parties Click here for appendix to add additional parties

Check if same as A. Purchaser Check if included on purchase order or complete below

Check if same as B. Consignee/Ship To Bank Freight Forwarder

Check if included on purchase order or complete below Carrier Other

Company Name Company Name


Address line 1 Address line 1
Address line 2 Address line 2
City City
State/Province State/Province
Postal Code Postal Code
Country Country

E. End-Use Information
Explain in detail the end-use of the supplied product:
Monitoring of Compressor for Hydrogen Generation System. Hydrogen is further used for cooling of
Synchronous generator.

End-use: Chemical Weapons/Biological Weapons Military Rockets/Missiles Nuclear


Space Stock Other Power generation

F. Form Completed By
Name City
Company Name State/Province
Phone Country
Email Signature

For Emerson Internal Use Only

Reviewed By: Date:

EMR - ITCG - F1001 Page 1 of 1 Last Revised 26-Oct-2015

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