Form 5713 - International Boycott Report Page 4

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4
Form 5713 (Rev. 12-2010)
Page
Part II
Requests for and Acts of Participation in or Cooperation With an International
Requests Agreements
Boycott
Yes No Yes No
13 a
Did you receive requests to enter into, or did you enter into, any agreement (see instructions):
(1)
As a condition of doing business directly or indirectly within a country or with the government, a
company, or a national of a country to—
(a)
Refrain from doing business with or in a country which is the object of an international
boycott or with the government, companies, or nationals of that country?
(b)
Refrain from doing business with any U.S. person engaged in trade in a country which is the
object of an international boycott or with the government, companies, or nationals of that
country?
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(c)
Refrain from doing business with any company whose ownership or management is made up, in
whole or in part, of individuals of a particular nationality, race, or religion, or to remove (or refrain
from selecting) corporate directors who are individuals of a particular nationality, race, or religion?
(d)
Refrain from employing individuals of a particular nationality, race, or religion?
(2)
As a condition of the sale of a product to the government, a company, or a national of a country,
to refrain from shipping or insuring products on a carrier owned, leased, or operated by a person
who does not participate in or cooperate with an international boycott?
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b Requests and agreements—if the answer to any part of 13a is “Yes,” complete the following table. If more space is
needed, attach additional sheets using the exact format and check this box .
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Type of cooperation or participation
IC-DISCs
Identifying number of
Name of country
Principal business activity
only—
person receiving the
Number of requests
Number of agreements
request or having the
Enter
agreement
Code
Description
Total
Code
Total
Code
product
(1)
(2)
(3)
(4)
(6)
(7)
(8)
(9)
code (5)
a
b
c
d
e
f
g
h
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j
k
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p
5713
Form
(Rev. 12-2010)

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