Attachment_09A_Instr_DLA_Form_1822.docx

Attachment 9A SP4500-19-R-0016 Japan Scrap

INSTRUCTIONS FOR COMPLETING DLA FORM 1822, END-USE CERTIFICATE

Revision February 28, 2013

DoD Instruction 2030.08, Implementation of Trade Security Controls, Implementation of Trade Security Controls (TSC) for Transfers of DoD U.S. Munitions List (USML) and Commerce Control List (CCL) Personal Property to Parties Outside DoD Control (May 23, 2006). TSC are applied in the interest of U.S. national security. The DoD Components shall apply TSC measures to prevent illegal acquisition or other unauthorized transfers of defense and dual-use technology, goods, services and munitions by or to individuals, entities and/or countries whose interests are adverse to the United States and to prevent those technologies, goods, services and munitions from being exported directly or indirectly into unauthorized areas designated by the Secretary of State, the Secretary of Commerce, or the Director of Foreign Assets Control. DoDI 2030.08 requires that Trade Security Controls be implemented whenever United States Munitions List (USML) or Commerce Control List (CCL) property is transferred. Trade Security Controls are implemented to prevent the illegal acquisition or other unauthorized transfers of USML or CCL items to ineligible transferees. These controls include the requirement to notify purchasers of export license requirements and the requirement that purchasers complete end-use certificates. All individuals wanting to acquire Department of Defense surplus property, identified as USML or CCL items, are required to complete the End-Use Certificate (EUC), DLA Form 1822.

It is your responsibility to fully and accurately complete this form. The use of “homemade” EUCs will not be accepted because they are not covered under the Paperwork Reduction Act. Due to the critical nature of this document, failure to comply with any of these instructions and/or accurately provide the required information will result in this EUC being deemed unacceptable, will cause significant delay or denial in obtaining the Trade Security Control (TSC) Assessment required to receive USML/CCL property, or the form Returned Without Action (RWA). As part of the TSC Assessment process, personal identification information is necessary to include any one of the following forms of identification:

· U.S. Government I.D

· U.S. Passport

· Valid Driver’s License

· State Government ID Card

· Lawful Permanent Resident Card

· Visa

· Certificate of Naturalization

NOTE: All forms of identification must be current, valid, and legible.

All entries must be typed or clearly printed. When providing the required information and additional space is needed, the use of a separate sheet of paper is acceptable. At the top of each additional sheet of paper you must place your name and the IFB/Contract no./Offer No./Standard Form-122/Standard Form-123 Order No. You must also cite the appropriate block number(s) and/or letter(s) for each entry and enter “See Attached” in corresponding block.

Every block on the EUC must have an entry.

If the information being requested does not apply to your situation, the only entry which will be acceptable is indicating “NOT APPLICABLE” (do not use N/A, N/R or draw a line). If you have to repeat information that was previously entered in another block, cite the SECTION, block number and/or letter; i.e., “SAME AS SECTION 'X', BLOCK 'X'”. The Approving Official (Sales Contracting Officer, Plant Clearance Officer, or other designated individual) will review the EUC for completeness and accuracy.

AT TOP OF PAGE: IFB/CONTRACT/OFFER/SF122/SF123 ORDER NO:

Enter the number (if not pre-printed) of the Invitation For Bid (IFB), contract/offer, proposal number, order number, etc., that is used to identify the specific sale, property transfer, or exchange.

1. THIS STATEMENT IS SUBMITTED IN CONNECTION WITH: Place an "X" in the block that best identifies the type of transaction you are entering into:

· SALE - purchasing property from the Defense Logistics Agency Disposition Services or from their sales contractor, the Defense Contract Management Agency (DCMA), or any other DOD Component activity (e.g., DOD Exchange Sales).

· EXCHANGE - an agreement with a Military Service Museum transfer to exchange property for agreed upon property or services.

· OTHER – for those transactions which are not a sales or exchange and where title to property may or may not pass from government control.

2. LINE ITEM NUMBER and/or COMMODITY: Enter the line item number for each USML/CCL item you are interested in acquiring. For negotiated exchanges, or other types of transactions, enter the name or nomenclature of the property, which you will be receiving upon completion of the negotiations or property transfers.

3. NAME (Last, First, Middle): This is the name of the individual who is signing this form. Please print/type your complete legal name legibly. Provide last name, complete first name (initials for first name will not be accepted) and middle name (if any). If you do not have a middle name, use NMN (No Middle Name). If you have an initial instead of a middle name, you need to indicate this e.g., Jones, James M. (Initial only). Include if you are a Sr., Jr., II, III, etc. Include any other names ever used (e.g., maiden name, nicknames, acronyms, aliases, doing business as (DBA) and/or also known as (AKA)” name(s).) If an individual is the bidder, that individual’s name must be provided in this block. If the bid is for a business, the individual authorized to sign this EUC for the business must provide his/her name in this block.

4. SOCIAL SECURITY NUMBER (SSN)/ALIEN CARD NO./COUNTRY ID:

· If the bid is by an individual, that individual’s SSN must be provided in this block.

· If the bid is for a business, the individual signing this EUC for the business must provide their SSN in this block.

· If the bid is in the name of a Permanent Resident, enter your Alien Identification Number.

· If the bid is in the name of a Non-U.S. Citizen/National, non-Permanent Resident, enter your Country Identification Number

5. DATE OF BIRTH (DoB): Enter DoB as Month/Day/Year (MM/DD/YY).

· If the bid is by an individual, that individual’s Date of Birth must be provided in this block.

· If the bid is for a business, the individual signing this EUC on behalf of the business must provide their Date of Birth in this block.

6. PLACE OF BIRTH (City or County, State, Country): City/County name must be spelled out. Only the two-letter or standard abbreviation for the State or Country is acceptable.

· If the bid is by an individual, that individual’s Place of Birth must be provided in this block.

· If the bid is for a business, the individual signing this EUC on behalf of the business must provide their Place of Birth in this block.

7. TELEPHONE NUMBER: (Include Area Code).

· If the bid is by an individual, that individual’s telephone number (including Area Code) must be provided in this block.

· If the bid is for a business, the individual signing this EUC for the business must provide their daytime telephone number (including Area Code) in this block.

8. MAILING ADDRESS: Mailing address can be any of the following:

· P.O.Box

· Mail Service

· Business physical mailing address

· EUC Signer mailing or physical personal address

**Wherever you receive USPS mail is acceptable and must be verifiable. Enter complete mailing address. Street and City names must be spelled out; abbreviations are unacceptable. Post Office Box is acceptable. The two- letter or standard abbreviation for the State or Country “IS” acceptable.

· If the bid is by an individual, that individual’s physical personal mailing address must be provided in this block.

· If the bid is for a business, the individual signing the EUC for the business must provide their personal mailing address in this block.

9. PHYSICAL ADDRESS: Enter complete personal home address of the signer of the EUC. This address must be valid and verifiable. Street and City names must be spelled out; abbreviations are unacceptable. The two-letter or standard abbreviation for the State or Country is acceptable. Entering a Post Office Box, mail service (Mailboxes; UPS Store mailbox; etc.) is “NOT” acceptable.

· If the bid is by an individual, that individual’s physical address (Street, City, State, Zip) must be provided in this block. If the physical address is the same as mailing address (not a Post Office Box), enter “Same as MAILING ADDRESS”.

· If the bid is for a business, the individual signing this EUC for the business must provide their personal physical address (Street, City, State, Zip) in this block. If the physical address is the same as mailing address (not a Post Office Box), enter “Same as MAILING ADDRESS”.

SECTION I. GENERAL INFORMATION

10. BLOCK 1. TYPE OF FIRM:

· If the bid is by an individual, enter “Not Applicable”.

· If the bid is for a business, check the box that most closely describes the organization:

· “Sole Proprietorship” - solitary owner/independent control

· “Partnership” - two or more persons contractually associated as joint principals in a business with joint rights and responsibilities.

· “Corporation” - an association or group of individuals united in trade or similar interests that has filed Articles of Incorporation.

· “Other” - (Specify affiliation with official bidder.)

· - Principal (Person having controlling authority)

· - Agent (Person acting for or in place of another by authority from him).

· If the "Type of Firm" is a corporation, provide the state in which the Articles of Incorporation were filed. The two- letter standard abbreviation for the state or country is acceptable.

11. BLOCK 2. NATURE OF END-USER’S BUSINESS:

This should best describe the type business/interest of the ultimate end-user. If unknown, state “Unknown”.

12. BLOCK 3 - NATURE OF PRINCIPAL’S BUSINESS

This should best describe the type business/interest of the bidder for these items.

13. BLOCK 4 - FIRM’S ID/FEDERAL TAX NUMBER:

If the bid is by an individual, enter “Not Applicable”.

If the bid is in a company name and that company does not have a Federal Tax Number but is using some other form of tax identifying number (e.g., a personal SSN) please provide that number and specify who it is registered to (e.g., SSN is for “John Doe”) in block 4.

BLOCK 5 – BUSINESS/CORPORATION HEADQUARTERS

14. BLOCK 5A - NAME:

If bid is by an individual, enter “Not Applicable”.

If the bid is in a company name, the individual signing this EUC for the company must provide the company headquarters name in this block (include aliases/acronyms/trade styles).

15. BLOCK 5B - ADDRESS: Physical location of the Business. Street and City names must be spelled out; abbreviations are unacceptable.

· Only two-letter (or standard) abbreviation for State or Country is acceptable.

· If the bid is by an individual, enter “Not Applicable”.

· If the bid is in a company name, the individual signing this EUC for the company must provide the complete address of company headquarters. (Post Office Box is unacceptable). Provide business daytime phone number in this block.

**DO NOT ENTER: P.O. Box, Mail Service, or anything other than the PHYSICAL LOCATION of the Business. The EUC will be returned without action if this is not completed correctly.

BLOCK 6 - BRANCH OFFICE:

16. BLOCK 6A - NAME:

· If the bid is by an individual, enter “Not Applicable”.

· If the bid is in a company name, the individual signing this EUC for the company must provide all company branch name(s) in this block (include aliases/acronyms/trade styles). Provide business daytime phone number in this block.

· If the official company branch and headquarters’ names are the same, enter “Same as Block 5A”.

· If the bid is in a company’s name and there is no branch office for this company, enter “Not Applicable”.

17. BLOCK 6B - ADDRESS: Physical location of the Branch. Street and City names must be spelled out; abbreviations are unacceptable. Only two-letter or standard abbreviation for State or Country is acceptable.

· If the bid is by an individual and there are no branch offices, enter “Not Applicable”.

· If the bid is in a company name, the individual signing this EUC for the company must provide the complete physical address (Street, City, State, Zip Code) of all company branch office(s). (Post Office Box is unacceptable).

· If company’s branch and headquarters offices use the same address, enter “Same as Block 5B”

· If there are no branch offices, enter “Not Applicable”.

**DO NOT ENTER: P.O. Box, Mail Service, or anything other than the PHYSICAL LOCATION of the Branch. The EUC will be returned without action if this is not completed correctly.

18. BLOCK 7 - ON SEPARATE SHEET(S) OF PAPER, ATTACH THE NAMES, ADDRESSES, SSNs, DATES AND PLACES OF BIRTH OF CORPORATE OFFICERS, PARTNERS AND/OR AGENTS.

Officer(s) that have control of where the physical location of the property will be located. In other words, we don't need the CEO of the company. Identify the President, VP, Secretary, Treasure are the ONLY officers at the location that are required. If there are no officers, the Owner or other individuals affiliated with the Business should be listed.

You MUST provide:

· Full Legal Name,

· DOB,

· SSN,

· Birth State/Country,

· Current Home physical address.

**If the Officers are Foreign Born, they MUST provide PROOF OF CITIZENSHIP as part of the EUC package. Note: Photo IDs/Drivers license of the Officers, Partners and Agents are not required.

Failure to comply will cause your EUC to be placed on hold or to be returned without action. In order to preclude delays in processing, it is essential that complete disclosure of all company officials be fully identified. If the bid is by an individual, enter “Not Applicable”.

· If the bid is submitted by a sole proprietorship, enter “Not Applicable”.

· If the bid is for a company, the required information for each of the officers, partners and/or agents must be submitted on separate sheet(s) of paper and attached to the corresponding EUC. The submitter has the option of

(1) providing this information individually on separate sheets for each person identified or (2) submitting the information for all persons identified on a single sheet.

SECTION II. END-USERS/USER INFORMATION

If this is a negotiated exchange, identify the item(s) you will be providing the government in this exchange on the space provided on the form. If not a negotiated exchange, enter “Not Applicable”.

BLOCK 1 - PURPOSE. THE PROPERTY REFERRED TO IN ABOVE IFB/OFFER NUMBER WILL BE UTILIZED FOR THE FOLLOWING: This information pertains to the intended disposition by the official bidder completing the EUC form.

· Enter an “X” in the appropriate item(s) below. All Blocks require an entry.

· In the case of resale, item 1F or 1G must be marked in addition to any other item.

19. BLOCK 1A. RETENTION FOR THE FOLLOWING SPECIFIC USE (see note at bottom of page 1 of this form)

· If property is being retained for official bidder’s own use, explain intended use.

· If statement in Block 1A does not apply, enter “Not Applicable” and go to Block 1B.

20. BLOCK 1B. Resold in form received for the following use (see note at bottom of page 1 of the form).

· If property is being resold by the bidder, give specific information about resale customer’s intended use.

· If statement in Block 1B does not apply, enter “Not Applicable” and go to Block 1C.

21. BLOCK 1C. The property will not be sold or otherwise disposed of for use outside of the U.S. or sold to non- U.S. Citizens/Nationals in the United States.

· If the official bidder will not sell/dispose of property outside of the U.S. or to non-U.S. persons in the U.S., check this box.

· If statement in Block 1C does not apply, enter “Not Applicable” and go to Block 1D.

22. BLOCK 1D. The property may be exported/re-exported in the form received to the following country/countries:

· If the bidder is going to export/re-export the property, check this box if applicable, and list the country(ies).

· If this EUC is for a U.S. Munitions List or Commerce Control List Item being resold or exported, attach a copy of your current Department of State or Commerce Registration Form or license approvals for the intended export. If No License is Required (NLR) for export, please provide a copy of NLR determination from the Department of Commerce.

· If statement is Block 1.D. does not apply, enter “Not Applicable” and go to Block 1E.

23. BLOCK 1E. Resale after following alteration (description of final production):

· Describe the altered product;

in (Country/Countries): List all countries where this product will be sold. (If necessary use a separate sheet of paper to list countries. Identify this as “BLOCK 1E” on the sheet of paper).

and distribution in (Country/Countries) List all countries where this product will be distributed. (If necessary use a separate sheet to list countries. Identify this as SECTION II, “BLOCK 1E” on the sheet of paper).

Note: If this EUC is for a U.S. Munitions List or Commerce Control List Item being resold or exported, attach a copy of your current Department of State or Commerce Registration Form or license approvals obtained for the intended export. If No License is Required (NLR) for export, please provide a copy of NLR determination from the Department of Commerce.

If this statement does not apply to you, enter “Not Applicable” and go to Block 1G.

24 BLOCK 1F. If property is to be sold, provide the name, address, and telephone number of sub-purchaser(s):

· Provide the full name, physical address and telephone number of the individual/company that purchased the item(s).

· If this block does not apply to you, enter “Not Applicable”.

25. BLOCK 1G. The customers are unknown at this time. If required by the contract/offer/transfer, I will obtain prior written approval for the resale of any of the property covered by this contract.

· If this block does not apply to you, enter “Not Applicable”.

26. ADDITIONAL INFORMATION: State any other material facts relating to end user and use of the property that may be of value in considering the proposal:

· If this block does not apply to you, enter “Not Applicable”.

SECTION III - UNDERSTANDING AND NOTIFICATION

Please read carefully. This section cites various laws and regulations you must comply with in the use, disposition and export of property.

SECTION IV - CERTIFICATION STATEMENT TO BE SIGNED BY BIDDER AT TIME OF RESPONSE TO IFB.

This section is self-explanatory. By signing and dating this form, you are certifying that all the information you are providing is true and correct and you understand and agree to all the provisions in this end use certificate. This form will become part of the contract.

26. PARAGRAPH 4. The person signing this DLA Form 1822 is:

· Check the block that applies to you and fill out any applicable portion.

28. BLOCK A - NAME (Type or Print)

· Be sure your name is legible and use the following format: First, Middle, Last.

** MUST be signers full LEGAL name as stated on page 1 of EUC.

29. BLOCK B – SIGNATURE. Be sure to sign this form. Signatures on EUC must be legible.

· If signer of EUC is an Officer, Director, Partner, Principal, Agent, etc., for official bidder, provide title/authority.

30. BLOCK C - DATE SIGNED. Be sure you date this form