[Letterhead of the end-user/consignee in the country of final destination]

End-Use Certificate
for presentation to the Ministry for Foreign Affairs of Iceland
(Export Control Authority)

Certificate No. (if applicable): ....................

A. Parties

1. Exporter (name, address and contact details)

2. Consignee (name, address and contact details)

3. End-User (if different from consignee)

4. Country of Final Destination

B. Items

1. Items (detailed description of items, including contract number and date)

2. Quantity (Units) / Weight

3. End-Use (specific purpose for which the items will be used)

4. Specification of the End-Use Location of the Items

C. Certification of foreign consignee

C.1. Consignee acts as end-user

The consignee undertakes to confirm the receipt of the items listed above upon request by the Ministry
for Foreign Affairs of Iceland and / or allow an on-site inspection by its authorized representatives.

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The consignee certifies, with regard to the items described in Section B, or any replica thereof,
technology, sub-systems, parts or components supplied by the exporter named in Section A 1, that:

1. he (or any third party) will not re-export the items to third countries without the consent of the
Ministry for Foreign Affairs of Iceland. Re-exportation to EEA countries of dual-use items does not
require any consent of the Ministry;

2. the items will only be used for the purposes described in Section B 3 and that they are intended for
final use in the country named in Section A 4;

3. the items will not be used in any nuclear explosive activity or unsafeguarded nuclear fuel-cycle
activity;

4. the items will not be used for any purpose connected with chemical or biological or nuclear weapons,
or missiles capable of delivering such weapons;

5. the items will only be used for civil end-uses (delete if not applicable) and

6. as far as technology is concerned, he will treat the technology as strictly confidential and neither pass
the technology on to a third party nor will he make knowledge available to a third party. In case of items
produced by the help of transferred technology, these items will only be delivered to a third party on
condition that this third party accepts the commitments of this declaration as binding for itself and on
condition that this third party is known to be trustworthy and reliable in the observance of such
commitments.

C.2. Consignee acts as producer, trader, wholesaler or re-seller (if applicable)

The consignee further certifies, with regard to the items described in Section B, or any replica thereof,
technology, sub-systems, parts or components supplied by the exporter named in Section A 1, that:

1. the items will only be delivered to a third party on condition that the third party accepts the
commitments of this declaration as binding for itself and

2. on condition that the third party is known to be trustworthy and reliable in the observance of such
commitments.

D. Additional information (if applicable)

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Place, date

____________________ _______________
(Original signature of consignee) (Company stamp / Official seal)

____________________________________
(Name and title of signer in block letters ) (Chamber of Commerce stamp or other
legalizing authority, if applicable)

E. Certification of competent national authority (if applicable)

The undersigned certifies that the consignee named in Section A 2 is authorized to import the items
named in Section B for their specified use.

Place, date

____________________ ______________________
(Original signature of competent national authority)

__________________________________________
(Name, title and contact details) (Official Seal)

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