Transcription of APPLICATION FOR A SOUTH AFRICAN END-USER …
1 C:\websitesnew\cppweb\CPPFILES\forms\EUC on 2/19/2007 12:45:00 PM APPLICATION FOR A SOUTH AFRICAN END-USER certificate No Question Response Contact Person: 1 Name and address of the supplier? Telephone No: 2 Name and address of Original Equipment Manufacturer (OEM) if not the same as the supplier. 3 Name of country requiring this EUC? 4 Is the country of the OEM and the supplier country the same? Yes No 5 If "NO" state the country of the OEM 6 Has the OEM country requested an END-USER statement from the supplier? Yes No 7 Are the items listed in the EUC destined for a SOUTH AFRICAN contractor? Yes No Contact Person: 8 If the answer to question 7 is "YES" furnish full details of the contractor Telephone No: 9 Order No or Contract Reference? 10 Date: No Description of Goods Serial No's Quantity Name: Telephone: Applicant: Signature Facsimile.
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