Professional Documents
Culture Documents
Dear Valued Customer,
The Maxim Integrated (“Maxim”) products, software, or technical data (hereinafter referred to as “products”)
requested, purchased or that will be purchased by you or your company fall under U.S. export regulations
and laws. As such, Maxim must obtain certain information about the end‐use of the product in order to
comply with various U.S. trade regulations. For example, the U.S. Export Administration Regulations (15 CFR
Parts 730 to 774) may require an export license by the U.S. government for military end‐use or end‐users.
In order for Maxim to make a proper license determination and/or complete required export
documentation, it is essential that we receive the following information (included in page two of this letter)
regarding the end‐use and end‐user of the products being requested. All sections are required and must be
provided in English language.
Intended end‐use of the product being requested (all that apply): civil end‐use, military end‐use, and/or
for use by a government entity;
Specific end‐use application/product into which Maxim’s product will be incorporated;
The end‐use is defined as the final product into which Maxim’s product will be integrated (please
be specific and detailed)
General or vague statements should be avoided to prevent delays in processing your request
Buyer’s complete name and address ( including country), website, and contact information;
No abbreviations or acronyms
Ultimate Consignee complete name and address (including country), website, and contact information;
No abbreviations or acronyms
The Ultimate Consignee is the principle party receiving the product for incorporation into a
designated end‐use product
The Ultimate Consignee is not a distributor or forwarding agent but may be the end‐user
Printed name and signature/initials of authorized representative;
Form must be dated.
Please return the completed and signed (initialed) End‐User Statement to Maxim Global Trade Services via
email: tradecompliance@maximintegrated.com. Maxim will keep the Statement on file for two (2) years.
Please feel free to contact us at this email address with any questions or if we can be of assistance in any way.
Best Regards,
Global Trade Services
Maxim Integrated
www.maximintegrated.com
CIV‐EUS; Rev 05/02/2017
END‐USER STATEMENT
CUSTOMER (hereinafter referred to as “Buyer”) acknowledges the export/re-export of commodities, technical data, and/or
software that we have requested, purchased, or will purchase from Maxim may be subject to U.S. export control laws and
regulations, including the Export Administration Regulations (15 CFR 730‐774), and Embargo and Sanction Regulations
administered by the U.S. Department of Treasury, Office of Foreign Assets Controls (31 CFR 500‐590), among other rules and
regulations. We agree to comply with all applicable U.S. export control laws and regulations, and those of any country we
export Maxim’s products from. In particular:
1. Buyer certifies that we will use the product(s) for: (Please select all that apply)
2. Buyer certifies that the products: (Please select all that apply)
A. will be integrated into another product,
to be manufactured in the following country: ; or
B. will be resold in the form in which it was received.
3. PLEASE DESCRIBE THE ULTIMATE END‐USE PRODUCT OR APPLICATION. These products will be integrated or used in the
following end product(s) or system(s). Please be specific; provide a detailed description of the end‐use application, as
well as a detailed description of function/purpose of this part within the application :
CERTIFICATION
Buyer certifies that we will not use the product(s): in relation to military end uses as defined in the EAR; for nuclear, biological
or chemical weapons, or the missile systems that deliver them; for the design, development, production, testing, stockpiling or
use of any weapons of mass destruction; for use in proliferation related activity without prior authorization from the applicable
U.S. Government authority; or for any other use that the U.S. government prohibits.
Buyer will not export, re‐export, divert, or otherwise transfer any Maxim products, software, or Technical Data except in
accordance with the applicable export regulations; such provisions prohibit export or re‐export to an embargoed/sanctioned
country (including, but not limited to, Cuba, Iran, Syria, Sudan, North Korea) or transfer to persons or entities ineligible to
receive U.S. products.
ACKNOWLEDGEMENT
Buyer acknowledges that it is the Buyer’s responsibility to obtain any required license(s) to export/re‐export or to transmit
software or information regarding any of Maxim’s products, as may be required under export control laws or regulations of any
country Buyer exports Maxim’s products from.
STATEMENT OF ULTIMATE CONSIGNEE AND PURCHASER
We certify by our initials below that all facts contained in this statement are true and correct and we have fully disclosed the
end use and disclosed all parties of the transaction from the purchaser to the final end user. We shall promptly notify the U.S.
exporter to disclose any change of facts or intentions in this statement.
Company Name:
Address: _______________________________________________________________________
City, State/Province: _____________________________________________________________
Postal Code: Country:
Company Website:
Initials of Authorized Company Representative:
Printed Name:
Title: Date:
CIV‐EUS; Rev 05/02/2017