United States Export Regulation Compliance
End Use / End User Certificate
To Whom It May Concern:
It is Sorkness Aviation, Inc. policy to verify the end use and end user in all sales and repairs of Sorkness
Aviation, Inc. supplied products and in all transfers of technical data or software to ensure compliance with
applicable U.S. export control laws and regulations. Because the products you are purchasing may be exported
and used outside of the United States, please confirm the following:
1. I (We) will not export or re-export any Sorkness Aviation, Inc. supplied products, technology or software
to Cuba, Iran, Iraq, Libya, North Korea, Sudan, or Syria, unless otherwise authorized by the United
2. I (We) will not sell, transfer, export or re-export any Sorkness Aviation, Inc. supplied products for use in
activities which involve the development, production, use or stockpiling of nuclear, chemical or biological
weapons or missiles, nor use Sorkness Aviation, Inc. supplied products in any facilities which are engaged
in activities relating to such weapons.
3. I (We) acknowledge that U.S. law prohibits the sale, transfer, export or re-export or other participation
in any export transaction involving Sorkness Aviation, Inc. supplied products with individuals or
companies listed in the U.S. Commerce Department’s Table of Denial Orders, the U.S. Treasury
Department’s list of Specially Designated Nationals or the U.S. Department of State’s list of individuals
debarred from receiving Munitions List items.
4. I (We) will abide by all applicable U.S. export control laws and regulations for any products purchased
from Sorkness Aviation, Inc. and will obtain any licenses or prior approvals required by the U.S.
government prior to export or re-export of Sorkness Aviation, Inc. supplied products, software or
5. I (We) agree that the export control requirements in items No. 1-4 above shall survive the completion,
early termination, cancellation or expiration of the applicable purchase order, agreement or contract.
Print Name: ____________________________________________
Company Name: ________________________________________
THIS AUTHORIZATION DOES NOT INCLUDE MOVEMENT OF THE EQUIPMENT TO IRAN, IRAQ, LIBYA,
CUBA, NORTH KOREA, SYRIA AND SUDAN.
Please check the statement that applies:
__________ I would like this certificate to account for all the items Sorkness Aviation, Inc. sends to our facility
for one year from the date signed above.
__________ I would like this certificate to account only for the items Sorkness Aviation, Inc. is supplying in
purchase order __________________. Please send new certificates for each purchase order until otherwise
Please fax completed form to: (253) 946-7908 and mail original to:
Sorkness Aviation, Inc 29739 4th Avenue S. Federal Way, Wa. 98003 USA