Professional Documents
Culture Documents
Priloha 001
Priloha 001
END-USE DECLARATION
(goods which could be used for torture – consignee*)/end-user*) undertaking)
1. Czech exporter:___________________________________________________________
(name and address)___________________________________________________________
2. Consignee:________________________________________________________________
(name and address)___________________________________________________________
3. End-user:________________________________________________________________
(name and address)___________________________________________________________
or sold for export or otherwise transferred from the country where we are based.
We certify that the goods will not be used for the purpose of capital punishment or for the
purpose of torture or other cruel, inhuman or degrading treatment or punishment.
___________________________________________________________________________
(Place and date) (Type or print name and title of authorized official)
__________________________________________________________________________________________
(Original signature and rubberstamp)
*)
use only the appropriate option