SC-A-063 (Ver 10-09/15) Page 3 of 6

Transcription

1 Singapore Customs, Procedures & Systems Branch 55 Newton Road, #07-01, Revenue House Singapore Contact.: Fax.: APPLICATION FOR PERMIT TO TRANSMIT OR HAND-CARRY STRATEGIC GOODS RELATED SOFTWARE AND TECHNOLOGY This form may take you 15 minutes to complete. You will need the following information to fill in the form: (a) Particulars of your company; (b) Information on the software or technology you will be exporting or transmitting; and (c) End-user s information and the intended end-use of software or technology. te: (1) Please fill in all fields. Indicate NA if the field is not applicable. (2) Tick ( ) where applicable. (3) This application must be signed: (a) If an individual, by the person directly interested or one of his employees authorised by him in writing; (b) If a partnership, by one of the partners or an employee of the firm duly authorised in writing by one of the partners; or (c) If a body corporate, by a director, the secretary or an employee duly authorised in writing by a director or the secretary of the body corporate. (4) Please complete the application form and submit it together with the relevant supporting documents (via , fax or post) to Singapore Customs. SECTION A APPLICATION PURPOSE (1) New Application Renewal of Permit Updating of Record Addition of Product(s) If the purpose is for the renewal of permit or updating of record, please fill in the existing permit number in the Existing Permit. field and Sections B, E, G and J. If the purpose is for the addition of product(s), please fill in the existing permit number in the Existing Permit. field and Sections F, G and J. If the purpose is Updating of Record, please state which fields have been amended. Existing Permit.: SECTION B APPLICANT S INFORMATION (2) Application Type: Organisation Individual (3) Name: (4) Entity Identifier / UEN: (5) Address: (6) Website Address: (7) Principal Business Activities: SC-A-063 (Ver 10-09/15) Page 1 of 6

2 (8) Name of Contact Person: (9) Designation: (10) Contact.: (11) Fax.: (12) SECTION C RECIPIENT S INFORMATION (13) Recipient Type: Organisation Individual (14) Recipient s Name: (15) Recipient s Address: (16) Contact Person s Name and Designation: (For organisation only) (17) Contact.: (18) Fax.: (19) Website Address: (For organisation only) (20) SECTION D END-USER S INFORMATION (Please fill in Section D only if end-user is different from recipient.) (21) End-User Type: Organisation Individual (22) End-User s Name: (23) End-User s Address: (24) Contact Person s Name and Designation: (For organisation only) (25) Contact.: (26) Fax.: (27) Website Address: (For organisation only) (28) SC-A-063 (Ver 10-09/15) Page 2 of 6

3 SECTION E EXPORT OR TRANSMISSION DETAILS (29) Mode of Export or Transmission: (e.g. , fax, hand-carry, etc.) Server Posted / Hosted On (30) Export or Transmission Date / Period: SECTION F SOFTWARE/TECHNOLOGY TO BE EXPORTED OR TRANSMITTED (Please attach additional sheet(s) if necessary.) (31) Description and Product Code of software / technology to be Exported or Transmitted (Please attach a copy of the contract, if applicable.) (32) Is an Export Licence required from the Country of Origin in order for the software / technology to be transferred to Singapore? (If yes, please attach copy. If unable to attach copy, please explain why.) (33) Is a Re-export Approval required from the Country of Origin in order for the software / technology to be transferred from Singapore to the destination country? (If yes, please attach copy. If unable to attach copy, please explain why.) (34) Purpose / Usage of the software / technology = Weapons of Mass Destruction (a) n- n-military n- SC-A-063 (Ver 10-09/15) Page 3 of 6

4 (b) n- n-military n- (c) n- n-military n- (d) n- n-military n- SC-A-063 (Ver 10-09/15) Page 4 of 6

5 SECTION G SUBMISSION OF SUPPORTING DOCUMENTS (35) Please submit relevant supporting documents (via , fax or post) to Singapore Customs together with this application form. All supporting documents have to be numbered and the total number of pages indicated at the top right-hand corner of every page. Supporting documents submitted: SECTION H REMARKS (if any): SECTION I CONDITIONS (36) The approval of this permit is subject to your company's compliance to the following conditions and other requirements of the (Control) Act (SGCA) and (Control) Regulations (SGCR): (a) The strategic goods or technology are not transferred to a country, a person or entity that is subject to any sanction imposed pursuant to a decision of the United Nations Security Council or any unilateral sanction imposed by the supplying countries; (b) The strategic goods or technology transaction must obtain the necessary approvals from other local Competent Authorities (if applicable) and relevant authorities in the importing or exporting countries (if the transfer of these goods or technology are subjected to controls by these countries); and (c) The strategic goods or technology are not known, believed or suspected to be used in relation to a nuclear, chemical, or biological weapons programme; or missiles capable of delivering these weapons. (37) Under Regulation 20 of the SGCR, the following records shall be kept for a period of at least 5 years from the end of the calendar year in which the act authorised by the permit is carried out: (a) a description of the software/technology; (b) the date on which the software/technology was exported or transmitted; (c) in so far as it is known to the permit holder, the particulars of the recipient and end-user of the software/ technology; and in so far as it is known to the permit holder, the particulars of the supplier of the software/technology. (38) If the software or technology is intended for hand-carry by the applicant, the exportation must fulfil the following conditions: (a) The software/technology can only be carried by the applicant; and (a) The software/technology must remain in the possession of the applicant until it is delivered to the enduser. (39) The Director-General may at any time require the records to be audited and verified by an authorised officer. (40) Every permit holder shall allow the records or documents to be inspected and copied by any authorised officer. (41) Where any document or record is not legible, the permit holder who is required to maintain the document or record shall at the request of the authorised officer reproduce the document or record in a legible manner. (42) If there are any changes to the particulars or information declared on the permit application form, the permit holder is required to apply for amendment to the permit in writing within 14 days of such change. SC-A-063 (Ver 10-09/15) Page 5 of 6

6 (43) Please note that you are obliged to inform Singapore Customs if you: (a) know, or (b) have reasonable grounds to suspect that the end-user is intending or likely to use, wholly or in part, the strategic goods/technology in the development, production, maintenance or storage of nuclear, chemical or biological weapons or missiles which are capable of delivering any of these weapons. (44) Singapore Customs has the right to revoke your permit should you fail to comply with the SGCA and the SGCR, any other applicable or related domestic laws or any condition of this permit. SECTION J DECLARATION AND UNDERTAKING For permit renewal or updating of record: (45) Information provided on (date of original permit application in dd/mm/yyyy) is still valid. (46) A new application is required if there is any change in the information provided in sub-section 45. (47) I / We have read and understood the conditions under Section I of the application form. I / We declare that all the information provided above is true and correct, to the best of my / our knowledge. (48) Name of Authorised Personnel: (50) Designation: (For organisation only) (49) NRIC / Passport.: (51) Contact.: (52) Fax.: (53) (54) Date: (dd/mm/yyyy) (55) Signature: (56) Company s Stamp: (For organisation only) FOR OFFICIAL USE ONLY Application.: Date Received: Date Approved / Rejected: Validity: SC-A-063 (Ver 10-09/15) Page 6 of 6