Owen Oil Tools Export License Request Form (Russia) Form: OOT-EXP-LR2 Use this form for destinations in Russia. Use form OOT-EXP-LR1 for all other destinations. Complete this Sections 1 – 5 of this form and e-mail it to Jeana Mallard ([email protected]). Please answer each section completely. Your answers will be used to determine if an export license is required and the nature of the export license, if required. Section 1 – Items to be Purchased Check all items to be exported by Owen Oil Tools (click in box to check, click in box again to uncheck) Bi-directional boosters Cutters (casing, tubing, and/or SplitShot™) Detonating cord Detonators (EBW) Detonators (non-EBW), electric and/or non-electric EBW firesets (PX-1, etc.) Hardware (perforating guns, firing heads, plugs, etc.) (non-EBW) Hardware (perforating guns, firing heads, plugs, etc.) (EBW) Igniters Linear shaped charges Perforators Power charges Severing tools (EBW) Severing tools (non-EBW) Stim™ products Other explosives (describe): Other items not listed (describe): Section 2 – Intended Use of Items From the perspective of the end-user (to be identified in Section 4), check the statement(s) that best describes the intended use of the items to be exported by Owen Oil Tools (click in box to check, click in box again to uncheck) Downhole well service, including: perforating, workover, pipe recovery, and/or abandonment To be resold in the form in which received in the country identified in Section 3, Item 3, block 9 for use or consumption therein Other (describe): Section 3 – Intended Place of Use of Items From the perspective of the end-user (to be identified in Section 4), check the statement(s) that best describes the place of use of the items to be exported by Owen Oil Tools (click in box to check, click in box again to uncheck) Offshore in greater than 500 feet of water Arctic offshore Oil and/or gas shales in Russia None of the above (describe, including name of oil/gas field): Enter description and name of oil/gas field here. Form will be rejected if "None of the above is checked" and oil/gas field name is not provided. (continued on next page) 4 – Parties to the Proposed Export Item 1 – Purchaser: The person abroad who has entered into the transaction to purchase an item for delivery to the ultimate consignee. In most cases, the purchaser is not a bank, forwarding agent, or intermediary. The purchaser and ultimate consignee may be the same entity (15 CFR 748.5(c)). Completion of Item 1 is required. Block # 1 2 3 4 Information required Company Name (limit 35 characters): Contact Name (limit 35 characters): Contact E-mail (limit 35 characters): Contact Phone (limit 15 characters) Provide information required below: Enter name here Use format +X (Y) ZZZ where X is country code, Y is city code and ZZZ is phone number : 5 Contact Fax (limit 15 characters) Use format +X (Y) ZZZ where X is country code, Y is city code and ZZZ is phone number : 6 Address Line 1 (limit 35 characters) Use physical address, do not use PO Box : 7 Address Line 2 (limit 35 characters) Use physical address, do not use PO Box : 8 9 10 City (limit 35 characters): Country (limit 35 characters): Postal Code (limit 18 characters) Item 2 -- Intermediate Consignee: The person that acts as an agent for a principal party in interest and takes possession of the items for the purpose of effecting delivery of the items to the ultimate consignee. The intermediate consignee may be a bank, forwarding agent, or other person who acts as an agent for a principal party in interest (15 CFR 748.5d)). Completion of Item 2 is required. If more than one possible intermediate consignee might be used during the term of the export license, provide the following information for each possible intermediate consignee on a separate sheet.. Block # 1 2 3 4 Information required Company Name (limit 35 characters): Contact Name (limit 35 characters): Contact E-mail (limit 35 characters): Contact Phone (limit 15 characters) Use format +X (Y) ZZZ where X is country code, Y is city code and ZZZ is phone number : 5 Contact Fax (limit 15 characters) Use format +X (Y) ZZZ where X is country code, Y is city code and ZZZ is phone number : 6 Address Line 1 (limit 35 characters) 7 Address Line 2 (limit 35 characters) 8 9 10 City (limit 35 characters): Country (limit 35 characters): Postal Code (limit 18 characters) Use physical address, do not use PO Box : Use physical address, do not use PO Box : (continued on next page) Provide information required below: Enter name here Item 3 -- Ultimate Consignee: The principal party in interest located abroad who receives the exported or reexported items. The ultimate consignee is not a forwarding agent or other intermediary, but may be the end-user (15 CFR 748.5(e)). Completion of Item 3 is required. Block # 1 2 3 4 Information required Company Name (limit 35 characters): Contact Name (limit 35 characters): Contact E-mail (limit 35 characters): Contact Phone (limit 15 characters) Provide information required below: Enter name here Use format +X (Y) ZZZ where X is country code, Y is city code and ZZZ is phone number : 5 Contact Fax (limit 15 characters) Use format +X (Y) ZZZ where X is country code, Y is city code and ZZZ is phone number : 6 Address Line 1 (limit 35 characters) 7 Address Line 2 (limit 35 characters) 8 9 10 City (limit 35 characters): Country (limit 35 characters): Postal Code (limit 18 characters) Use physical address, do not use PO Box : Use physical address, do not use PO Box : Item 4 -- End-User: The person abroad that receives and ultimately uses the exported or reexported items. The end-user is not a forwarding agent or intermediary, but may be the purchaser or ultimate consignee (15 CFR 748.5(f)). Completion of Item 4 is required. If same as purchaser, enter “Same as Purchaser” in Block 1. If same as ultimate consignee, enter “Same as Ultimate Consignee” in Block 1. Block # 1 2 3 4 Information required Company Name (limit 35 characters): Contact Name (limit 35 characters): Contact E-mail (limit 35 characters): Contact Phone (limit 15 characters) Use format +X (Y) ZZZ where X is country code, Y is city code and ZZZ is phone number : 5 Contact Fax (limit 15 characters) Use format +X (Y) ZZZ where X is country code, Y is city code and ZZZ is phone number : 6 Address Line 1 (limit 35 characters) 7 Address Line 2 (limit 35 characters) 8 9 10 City (limit 35 characters): Country (limit 35 characters): Postal Code (limit 18 characters) Use physical address, do not use PO Box : Use physical address, do not use PO Box : (continued on next page) Provide information required below: Enter name here Section 5 – Submitting Party Identification Block # 1 2 3 4 Information required Company Name: Contact Name: Contact E-mail: Contact Phone Use format +X (Y) ZZZ where X is country code, Y is city code and ZZZ is phone number : 5 Contact Fax Use format +X (Y) ZZZ where X is country code, Y is city code and ZZZ is phone number : 6 Date Prepared: OOT-EXP-LR2, Export License Request form (Russia).doc (8/19/2014) Provide information required below: Enter name here 1.4 OWEN COMPLIANCE SERVICES, INC. EXPLOSIVES S 1 Tel: +1 (817) 551-0660 P.O. Box 765 Godley, TX 76044-0765 USA Fax: +1 (817) 396-4584 e-mail: [email protected] Memo From: David W. Boston To: Owen International Order Processing, Owen International Managers, Don Dumas, Tasos Nicolakis, Nora Javier, Vera Dubrocq CC: Jeff West, Les Weisner, Debbie Payne, Jeana Mallard, Gina Escalante Date: July 15, 2004 (Updated August 29, 2011) Re: Export License Requests Export licenses are required to most destinations for EBW detonators, EFI detonators, devices used to fire these commodities (firesets), and tools containing these commodities. Information regarding what countries require an export license is available at: http://www.ocsresponds.com/ref/ref-export.htm. Current items requiring an export license are: 167-8676 167-9225 1687-9643 188-7042 188-7080 188-7330 188-7354 188-7382 188-7405 2-300180-3 2-300180-4 902169-801 A4-139 ADP-PX16-100 ADP-PX16-110 ADP-PX16-220 ADP-PX31-100 ADP-PX31-110 DET-5000-001 EBW-3050-008C EBW-3050-308C EBW-PSCI-400 EBW-PSCI-401 EBW-RISI-080 EBW-RISI-083 EBW-RISI-085 EBW-RISI-501 EBW-RISI-502 EBW-RISI-800 EBW-RISI-810 EBW-RISI-830 EBW-RISI-880 EBW-RISI-SQ80 EFI-0020-020 EFI-1000-001 EFI-1000-002 EFI-2000-001 EFI-2000-002 EFI-2000-006 PUR-0610-007 PUR-0610-008 PUR-RISI-502 SEV-2375-200 SEV-1375-200 SEV-1375-250SA SEV-1750-200 SEV-2000-200. To request an export license, complete the Export License Request Form located at: http://www.ocsresponds.com/ref/Exports/ExportLicenseRequestform2011.pdf. Once complete, e-mail the form to Jeana Mallard at mailto:[email protected]. Export license applications will not be processed without a completed Export License Request Form. Please ensure that all your staff is advised of this requirement. O:\Compliance\Export Management System\Export license requests Page 1 1.4 OWEN COMPLIANCE SERVICES, INC. EXPLOSIVES S 1 Tel: +1 (817) 551-0660 P.O. Box 765 Godley, TX 76044-0765 USA Fax: +1 (817) 396-4584 e-mail: [email protected] Memo From: David W. Boston To: OOT Customers for Whom an Export License may be required CC: Jeana Mallard, OOT Export Documentation, OOT International Sales, OOT Responsible Parties (Godley) Date: October 11, 2011 Re: Identification of Parties to an Export License OOT is required to obtain an export license for certain of its products that may be exported to certain destinations and/or customers. To determine if an export license is required, you may be asked to complete an Export License Request Form, which is available at: http://www.ocsresponds.com/ref/Exports/exportguide.htm#processorder. When completing this form, you are asked to identify the following parties: 1. 2. 3. 4. 5. Purchaser Intermediate Consignee Ultimate Consignee End-User Submitting Party The terms listed in 1 – 4 above are defined in the U.S. Export Administration Regulations (EAR) in 15 CFR 748.5 and these definitions are provided directly on the Export License Request Form. OOT Policy regarding identification of potential export license parties. You are advised that: Page 1 • 15 CFR 748.4(b)(1) requires that license applicants “ … must disclose the names and addresses of all parties to a transaction.” Additionally this regulation requires that if “ … there is any doubt about which persons should be named as parties to the transaction, the applicant should disclose the names of all such persons and the functions to be performed by each … “ [emphasis added]. • The term “Intermediate Consignee” is defined in 15 CFR 748.5(d) as follows: The person that acts as an agent for a principal party in interest and takes possession of the items for the purpose of effecting delivery of the items to the ultimate consignee. The intermediate consignee may be a bank, forwarding agent, or other person who acts as an agent for a principal party in interest. You will note that the term “Intermediate Consignee” includes the term “forwarding agent”. • “Freight forwarders” are “forwarding agents”1,2. • You must identify any and all freight forwarders and/or potential freight forwarders when completing Item 2 of the Owen Oil Tools Export License Request Form. By leaving Item 2 blank, you are certifying that no freight forwarders will be used. If a freight forwarder is subsequently identified, shipment of your products under the export license will be delayed while a replacement license is obtained. 1 freight forwarder. Dictionary.com. Dictionary.com Unabridged. Random House, Inc. http://dictionary.reference.com/browse/freight forwarder (accessed: October 11, 2011). 2 forwarding agent. Dictionary.com. Collins English Dictionary - Complete & Unabridged 10th Edition. HarperCollins Publishers. http://dictionary.reference.com/browse/forwarding agent (accessed: October 11, 2011). 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