RROI’S CUSTOMER END-USE/END-USER CERTIFICATION

RROI’s Customer End-use/End-user Certification

Reference RFQ or PO Number*
Our general type of business is*
The ultimate end-use location country is*
Our specific end-use of the product or service is*
Sales intermediaries used in this transaction are*
The ultimate end-user of the product or service is*
The ultimate end-use of the product or service is*
Is the requested product or service subject to the ITAR or subject to the EAR?*
- Yes, Subject to the ITAR
- Yes, Subject to the EAR
- No
- I Don’t Know
If subject to the ITAR, the category classification is
If subject to the EAR, the export control classification number (ECCN) is
If subject to the ITAR, what is the category classification?
If subject to the EAR, what is the export control classification number (ECCN)?
I will abide by all applicable United States and/or applicable foreign country export control laws and regulations for all products purchased and information transferred from/to RROI. I understand that RROI may need to obtain appropriate licenses before the transfer of technical information, manufacturing know-how, or products/services can begin.

I agree that my electronic signature is the legally binding equivalent to my handwritten signature, and that my electronic signature has the same validity and meaning as my handwritten signature. I agree that I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding.
Electronic Signature*
Your Name*
Your Title*
Consent*
I understand this data will not be retained for future access*
This data will be immediately removed from the website upon submission. No customer, client, or employee information will be retained for access in the future.
Comments
This field is for validation purposes and should be left unchanged.