ࡱ> JLIM 2bjbj== "<WWd l((((xxx8L8tP L7 %''''''$ Kux [@ K'((''' (8xu' %''V @`xa, Pfo I a0U t1ta'(((( 91ɫƬ One-Time Certification in Support of EAR99 and/or No License Required (NLR) Form This template is used in circumstances where a research activity involves a one-time individual international shipment of a tangible item or items to an individual or organization in a foreign country, under the "EAR99 and/or No License Required" provision of the Export Administration Regulations. In addition to filing this one-time certification, departments must keep copies of the associated shipping documents in their project files for 5 years, and make these available to the Office of Research Compliance upon request. (TIN numbers must also be retained by you or the shipping company from the AES system.) Please note that just because a product is classified as EAR 99, it does not mean that a license is not required. Provide the information requested below to document the item's eligibility for export under EAR99 and/or NLR. Submit the form to  HYPERLINK "mailto:jzanella@umassd.edu" jzanella@umassd.edu and retain a copy in your project files. In addition to filing this annual certification, copies must be retained for 5 years of all individual shipping documents (including destination statements on commercial invoices) and provided to the Office of Research Compliance upon request.  The research and development being performed falls within the parameters of fundamental research exclusion for technology/technical data established by National Decision Security Directive 189, as implemented by the pertinent export control regulations. Describe briefly the item to be exported for this research activity: FORMTEXT       Project Title: FORMTEXT       PI Name: FORMTEXT       Department: FORMTEXT       Contact Information: FORMTEXT       Known end-user: FORMTEXT       End-user organization: FORMTEXT       Country of end-use: FORMTEXT       Description of research in support of fundamental research and purpose of export: FORMTEXT        Principal Investigator Assurance My signature below certifies that:  FORMCHECKBOX The item to be shipped outside the borders of the United States does not include encryption source code or software;  FORMCHECKBOX An exception is applicable (Refer to EAR Part 740). Check the appropriate exception:  FORMCHECKBOX LVS The net market value of this shipment in U.S. Dollars is: FORMTEXT       and thus conforms to the exception for shipments of limited value (LVS value limit)  FORMTEXT       per shipment for this item; or Other exceptions:  FORMCHECKBOX GBS-shipments to Country Group B  FORMCHECKBOX CIV-Civil end users  FORMCHECKBOX TSR-Technology and software under restriction  FORMCHECKBOX APP-Computers  FORMCHECKBOX KMI-Key management infrastructure  FORMCHECKBOX TMP-Temporary imports, exports, and reexports  FORMCHECKBOX RPL-Servicing and replacement of parts and equipment  FORMCHECKBOX GOV-Governments, international organization and international inspections under the Chemical Weapons Convention  FORMCHECKBOX GFT-Gift parcels and humanitarian donations  FORMCHECKBOX TSU-Technology and software-unrestricted  FORMCHECKBOX BAG-Baggage  FORMCHECKBOX AVS-Aircraft and vessels  FORMCHECKBOX APR-Additional permissive reexports  FORMCHECKBOX ENC-Encryption commodities and software  FORMCHECKBOX AGR-Agricultural commodities  FORMCHECKBOX The total value of exports per calendar year from my (Department/Center/Lab)  FORMTEXT       to (end-user organization)  FORMTEXT       does not exceed 12 times the LVS value limit for this item;  FORMCHECKBOX The item to be shipped will be used to carry out research in other than an embargoed, sanctioned, or prohibited country (see note below);  FORMCHECKBOX The shipments of any chemical or biological materials will conform to all applicable laws governing their handling;  FORMCHECKBOX The University's Export Control Officer will be notified of the intended end-user(s) and end-use organizations(s) in advance of the filing of this document in order that he may conduct an end-user screen for specific persons or entities subject to export prohibitions. Indicate below the person responsible for maintaining copies of all relevant shipping documents, including an end user statement for each shipment (records are to be retained for 5 years and provided upon request to the UMD Office of Research Compliance): Name: FORMTEXT       Position: FORMTEXT       Phone ext.: FORMTEXT       Email Address: FORMTEXT       Location: FORMTEXT       PI Signature: ___________ Date: FORMTEXT           cAB !   $ & ( 2 4 : H J L ` b wkwww_jCJUaJjtCJUaJjCJUaJ,jB*CJOJQJU^JaJphB*CJOJQJ^JaJph&jB*CJOJQJU^JaJphjCJUaJmHnHu 0JCJaJjCJUaJ5 5CJaJB*CJaJph33CJaJ 5OJQJ 5CJaJCJaJ%DcB " : v  R ) $0]0^a$ $]^a$$^a$^$@&]^a$^,0b d n p v    $ & ( < > @ J L R | ~ jCJUaJj.CJUaJjCJUaJjFCJUaJjCJUaJj\CJUaJ 5CJaJCJaJjCJUaJmHnHujCJUaJ: )*89:()*ghrs  ݾݭݜ݈ybM)jB*CJU^JaJmHnHphu,jrB*CJOJQJU^JaJphB*CJOJQJ^JaJph&jB*CJOJQJU^JaJph jB*CJUaJph jB*CJUaJph jB*CJUaJphjB*CJUaJphB*CJaJph 5CJaJCJaJjCJUaJmHnHuDFbdf   ;<JKL[\jkǰꑢꀢo^M j6B*CJUaJph jB*CJUaJph jJB*CJUaJph jB*CJUaJph j^B*CJUaJphjB*CJUaJph,jB*CJOJQJU^JaJphB*CJOJQJ^JaJph&jB*CJOJQJU^JaJphB*CJaJph6B*CJ]aJphB:Z/Zjn$]a$ $]^a$kl%&'!"#01?@A[\jr jp B*CJUaJph j B*CJUaJph j B*CJUaJph j B*CJUaJph j B*CJUaJph j" B*CJUaJph jB*CJUaJphB*CJaJphjB*CJUaJph'jkl   CXZ[ef BDFZضإؙ؅v_ؙ؅v,j B*CJOJQJU^JaJphB*CJOJQJ^JaJph&jB*CJOJQJU^JaJph6B*CJ]aJph jH B*CJUaJph j B*CJUaJph j\ B*CJUaJphB*CJaJphjB*CJUaJph j B*CJUaJphZ\j "xz̭̜̾̾̾̋zfW@,jB*CJOJQJU^JaJphB*CJOJQJ^JaJph&jB*CJOJQJU^JaJphCJaJ5B*CJ\aJph jB*CJUaJph jB*CJUaJph jB*CJUaJphjB*CJUaJphB*CJaJph&jB*CJOJQJU^JaJph,j2B*CJOJQJU^JaJph DFZ\j~ $تؓ|v_ZZZ jU,jRB*CJOJQJU^JaJph >*CJaJ,jB*CJOJQJU^JaJph,jfB*CJOJQJU^JaJph,jB*CJOJQJU^JaJph,jzB*CJOJQJU^JaJphB*CJOJQJ^JaJphCJaJ&jB*CJOJQJU^JaJph#nl"$(*,.02@&]$]a$$&02CJaJ jU 1h/ =!"#$%tDText1tDText2tDText3tDText4vDText14tDText5tDText6tDText7tDText8tDeCheck2tDeCheck3tDeCheck8vDText15vDText16vDeCheck11vDeCheck10vDeCheck12vDeCheck13vDeCheck15vDeCheck14vDeCheck16vDeCheck17vDeCheck18vDeCheck19vDeCheck20vDeCheck21vDeCheck22vDeCheck23vDeCheck24tDeCheck4vDText17vDText18tDeCheck5tDeCheck6tDeCheck7vDText10vDText11vDText12vDText13vDText19tDText9 i8@8 NormalCJ_HaJmH sH tH <A@< Default Paragraph FontRYR  Document Map-D M CJOJQJ^JaJ66  Footnote TextCJaJ8&@8 Footnote ReferenceH*(U@!( Hyperlink>*B*D^@2D Normal (Web)dd[$\$ B*ph:'@A: Comment ReferenceCJaJ4R4  Comment TextCJaJ8QR8 Comment Subject5\@r@  Balloon TextCJOJQJ^JaJ,, Header  !, , Footer  !tt< b kjZ$2n20dpv%?KQfrx)9 ) g s y  & I Y o    C S  K [   A Q p N^p &,P\btXFFFFFFFFFG$G$G FFG G G G G G G G G G G G G G G G$FFG$G$G$FFFFFF8@f(  bB  c $D>"?bB  c $D>"?B S  ? t,%T%T)Text1Text2Text3Text4Text14Text5Text6Text7Text8Check2Check3Check8Text15Text16Check11Check10Check12Check13Check15Check14Check16Check17Check18Check19Check20Check21Check22Check23Check24Check4Text17Text18Check5Check6Check7Text10Text11Text12Text13Text19Text9e@g* h  J p  D  L  B q OqQu  !"#$%&'(w&Ry:* z ' Z  T  \  R _-cu     8 A  ddffggijlmopqruvmnddffggijlmopqu33333Herr&?Rfy *  ' I Z o   C T  K \   A R ncddffggijlmopqqu voc_rvieraK\\Atmc-nt2-svr\common\Business Affairs\ATMC Marketing\New_Web\ORA\ear99.doc \wOe~]^HAAr^`o()^`.pLp^p`L.@ @ ^@ `.^`.L^`L.^`.^`.PLP^P`L.^`.^`.pp^p`.@ @ ^@ `.^`.^`.^`.^`.PP^P`.h^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHAr \wOe~]cudgnword-docGUIDdgnword-eventsink&{11CC0BC7-CDC0-4FB6-A7C8-EAFF2349847F}8629328@Bpt t t@@@ @@@@$@@@0@@@UnknownGz Times New Roman5Symbol3& z Arial7Georgia5& zaTahoma?5 z Courier New;Wingdings"0hӦӦ*ӆ* !!0dd2qHX*DRAFT: Memo to Ann George  Export ControlKaren V Kruger voc_rvieraOh+'0  4@ \ h t +DRAFT: Memo to Ann George Export ControldRAFKaren V KrugerAareareNormal  voc_rvierag2c_Microsoft Word 9.0G@F#@*@PUo@PUo*՜.+,D՜.+,x4 hp  #Stanford Linear Accelerator Center  +DRAFT: Memo to Ann George Export Control Title 8@ _PID_HLINKSAp~Jmailto:jzanella@umassd.edu  !"#$%&'(*+,-./012345678:;<=>?@BCDEFGHKRoot Entry F0tgoMData 1Table)tWordDocument"<SummaryInformation(9DocumentSummaryInformation8ACompObjjObjectPool0tgo0tgo  FMicrosoft Word Document MSWordDocWord.Document.89q