OMB Control No. 0625-0125
Expiration date: 04/30/2018
U.S. DEPARTMENT OF COMMERCE
International Trade Administration
APPLICATION FOR AN
Application for Amendment
EXPORT TRADE CERTIFICATE OF REVIEW
No Export Trade Certificate may be issued unless a completed application form has been received
Request for Expedited Review
(15 USC 4011-4021).
DEPARTMENT OF COMMERCE USE ONLY
See instructions below
NAME OF APPLICANT
DATE DEEMED SUBMITTED
CONFIDENTIALITY OF APPLICATION
Information submitted by any person in connection with the issuance, amendment, or revocation of a Certificate of Review is exempt from disclosure under the
Freedom of Information Act, Section 552, Title 5, United States Code.
Except as provided under Section 309(b)(2) of the Export Trading Company Act (“ACT”) and 15 CFR 325.16(b)(3), no officer or employee of the
United States shall disclose commercial or financial information submitted pursuant to the Act if the information is privileged or confidential and if
disclosure of the information would cause harm to the person who submitted the information.
NOTE: The exchange among competitors of competitively sensitive information may, in some circumstances, create risks that competition among the
firms will be lessened and antitrust questions raised. The exchange of information about recent or future prices, production, sales or confidential business plans
is especially sensitive. As a general matter, the danger that such exchanges will have anticompetitive effects is less when the firms involved have a small share
of the market and greater if they have a substantial share.
Applicant may wish to consider seeking the advice of legal counsel on whether any steps would be advisable in the applicant’s particular circumstances to
avoid issues of this nature. One possible step that the applicant may wish to consider in preparing the application is to compile and submit these types of
information through an unrelated third party, such as an attorney or consultant.
The Department of Commerce urges applicants to read Title III of the Export Trading Company Act (P.L. 97-290, Section 4011-4021, Title 15,
United States Code) and the accompanying regulations (Volume 15, Code of Federal Regulations, Part 325) and the guidelines (50 FR 1786) before completing
this application form. These documents and additional information and guidance on the certification program are available free from Export Trading Company
Affairs, Telephone (202) 482-5131, and can also be found at
Space is provided on the attached form for some of the information requested. In most cases you are being asked to supply additional information on
supplemental sheets or attachments. Please include the name of the applicant on each supplement or attachment, and specifically identify the item number to
which the attachment refers. The two certifying statements on the last page of this form MUST be completed before your application will be deemed
submitted. Please designate the documents or information which you consider privileged or confidential and disclosure of which would cause you harm.
File an original and two copies of the completed application by first class mail, registered mail, or email to: Export Trading Company Affairs, International
Trade Administration, Room 21028, U.S. Department of Commerce, Washington, DC 20230; or by personal courier service during business hours to: U.S.
Department of Commerce Courier Center, Room 1874; or by email to: email@example.com.
In response to the questions in this application the applicant is requested to be as specific as possible. Some information, in particular the identification of
goods or services that the applicant exports or proposes to export, is requested in a certain form (North American Industry Classification System (NAICS) if
reasonably available.) Where information does not exist in the requested form, an applicant is not required to create it, and may satisfy the request for
information by providing it in some other convenient form.
NOTE: It may not be necessary for every applicant to respond to every question on this form. If an applicant believes that certain information requested is not
necessary for a determination on the application, the applicant may request a waiver prior to submitting the application. The applicant should contact Export
Trading Company Affairs on (202) 482-5131.
AGENCY DISCLOSURE OF ESTIMATED BURDEN
This collection of information contains Paperwork Reduction Act (PRA) requirements approved by the Office of Management and Budget (OMB).
Notwithstanding any other provision of law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a
collection of information subject to the requirements of the PRA unless that collection of information displays a currently valid OMB control number. Public
reporting burden for this collection of information is estimated to be 32 hours per response, including time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Persons wishing to comment on the burden
estimate or any aspect of this collection of information, or offer suggestions for reducing this burden, should send their COMMENTS to the ITA Reports
Clearance Officer, International Trade Administration, Room 4001, U.S., 14th & Constitution Avenue, NW, Washington, DC 20230.