[별지 제7호 서식]

Annexed paper No. 7

수입목적확인(신청)서

Korean Import Certificate

Ministry of (                      )  Republic of Korea

Certificate Number:

① 수입자 Importer (Name and Address)		② 수출자 Exporter (Name and Address)
③ 업무담당자 Contact Person (Name, Phone, Email)		④ 최종사용자 End User (Name and Address)
⑤ 물품명세 Description of Items
HS 번호 HS Code	품목 및 규격 Items and Specifications		수 량 Quantity	가 액 Value (FOB, CIF etc.)
⑥ End use of the Items listed in ⑤ : 1) Items delivered by Exporter will not be used for weapons of mass destruction or their means of delivery. 2) Items delivered by Exporter will not be modified or reexported for the purpose of weapons of mass destruction or their means of delivery. 3) Items delivered by Exporter will be used for only the purposes specified in the Contract No:
It is hereby certified that the undersigned importer has undertaken to import into the Republic of Korea the described above or, if the items are not imported into the Republic of Korea, that the undersigned importer will not divert, transship or reexport them to another destination except for the explicit approval of the Minister of ( ), that the undersigned importer also undertakes to notify the appropriate Ministry immediately of any changes of fact or intention set forth herein. and that the undersigned importer will contribute to regional and international security and stability on the basis of multilateral export control regimes. 20 . . Applicant(Importer) Signature
Minister of ( ) (Official Stamp)
이 증명서는 발급일로부터 12개월 이내에 수출국 담당기관에 제출되지 않을 경우 효력을 상실합니다. This document ceases to be valid unless presented to the competent foreign authorities within twelve months from the date of issue.

210m/m×297m/m(일반용지 60g/㎡(재활용품))