# End-Use and End-User Statement Template

> Source: https://netray.co/tools/end-use-end-user-statement-template
> Publisher: Netray (netray.co), AI and integration engineering for ERP and manufacturing systems.
> Section: Free Tools

## Short answer

A statement a foreign buyer completes to declare the end user, end use and commitment not to re-export or divert the items.

## Category

compliance-legal

## Industry

Defense Contracting

## Region

United States

## Audience

- Export compliance officer
- Sales operations

## Tool

**Kind:** template

**Output:** document

**Fields:**

#### Exporter

**Key:** exporter

**Type:** text

**Default:** Apex Precision Components Inc.

#### Buyer / consignee

**Key:** buyer

**Type:** text

**Default:** Example Systems Ltd

#### End user

**Key:** end_user

**Type:** text

**Default:** Example Systems Ltd, Defence Electronics Division

#### Country of ultimate destination

**Key:** country

**Type:** text

**Default:** United Kingdom

#### Purchase order or quote

**Key:** po

**Type:** text

**Default:** PO 45-77310

#### Item description and quantity

**Key:** items

**Type:** textarea

**Default:** 200 units, sensor housing assemblies, part number HSG-2210 rev C

#### Stated end use

**Key:** end_use

**Type:** textarea

**Default:** Installation in ruggedized sensor modules to be integrated into vehicle systems by the end user.

#### End user type

**Key:** type

**Type:** select

**Options:**

- Commercial company
- Government agency
- Armed forces
- Distributor or reseller
- Research institution

**Default:** Commercial company

#### Date

**Key:** date

**Type:** date

**Default:** 2026-10-20

**Blocks:**

#### End-Use and End-User Statement

**Body:** Date: {{date}}
Exporter: {{exporter}}
Reference: {{po}}

#### 1. Parties

**Body:** Buyer / consignee: {{buyer}}
End user: {{end_user}}
End user type: {{type}}
Country of ultimate destination: {{country}}

#### 2. Items

**Body:** {{items}}

#### 3. Stated End Use

**Body:** {{end_use}}

#### 4. Commitments

**Body:** We certify that the information above is true and complete. The items will be used only for the end use stated above and only by the end user named above in the country of ultimate destination.

We will not re-export, resell, transfer or divert the items, or provide related technical data, to any other party or destination without prior written authorization from the exporter and any required government authorization.

The items will not be used in the design, development, production or use of nuclear, chemical or biological weapons or missiles, except as authorized under applicable law.

We will notify the exporter promptly if we learn of any change to the end user, end use or destination.

#### 5. Signature

**Signatures:**

- Authorized signatory for end user (name, title, date)
- Authorized signatory for buyer (name, title, date)

**Notes:** This is a generic starting form. Some licenses, agreements and government programs require specific official forms or wording, for example DSP-83 for certain significant military equipment, so check which applies before substituting this. Not legal advice.

## Content

**Intro:** Before shipping controlled or sensitive items to a foreign buyer, many exporters ask the buyer to state who will use them and for what. This template produces a clean statement with the usual non-diversion commitments.

**Sections:**

#### How to use it

**Body:** Complete the exporter, buyer, items and stated end use, then send the exported Word or PDF file to the buyer for signature on company letterhead. File the signed copy with the order record. Screen all named parties against restricted party lists before accepting the statement, and look for red flags such as a vague end use or a freight forwarder as the final destination.

**Bullets:**

- Name the real end user, not only the buyer
- Describe the end use specifically
- Screen every party listed
- Retain the signed original with the order

#### What the commitments cover

**Body:** The non-diversion paragraph asks the buyer not to re-export or transfer the items. The proliferation paragraph reflects the end-use controls of the EAR that restrict certain nuclear, chemical, biological and missile uses. A change-notification paragraph helps you stay informed if the facts shift after shipment.

#### When a statement is required

**Body:** Some export licenses, agreements and government-to-government programs require a statement as a condition of approval. Even when none is required, collecting one is a reasonable due diligence step for higher-risk destinations, distributors and unfamiliar buyers. A statement does not replace screening or a license; it adds evidence.

#### Common mistakes

**Body:** Accepting statements signed by someone with no authority, reusing a statement for a different order, and ignoring contradictions between the statement and the purchase order. Each statement should match one order or a defined period.

**Cta:** Netray can discuss attaching signed statements and screening results to your ERP sales order so shipments hold until they are present. The template is free either way.

**Faq:**

#### Is an end-user statement legally required?

**Answer:** Not always. Some licenses and government programs require one, and certain destinations or items make it prudent. Even where optional, it supports due diligence. Check your specific authorization and consult counsel for the required wording.

#### Who should sign it?

**Answer:** An officer or authorized signatory of the end user, and often the buyer as well. Verify the signer's authority and company details, and avoid signatures from unnamed or unreachable individuals.

#### Does this replace screening?

**Answer:** No. You still need to screen the buyer, end user and other parties against the consolidated screening lists and check for red flags. The statement is one piece of evidence in your overall due diligence file.

#### Can one statement cover many orders?

**Answer:** It can if you state the period and items clearly, but a statement per order or per authorization is cleaner and easier to audit. Renew whenever the end use, end user or destination changes.

## Search terms

end user statement template, end use certificate template export, end user certificate sample, non-diversion statement template, export end user undertaking form, ear end user statement

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