Annex A - Official Documents

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30.7.2005 EN Official Journal of the European Union L 200/15 Technical specification: ANNEX V Export or import authorisation form referred to in Article 9(1) The following form shall measure 210 • 297 mm with a maximum tolerance of 5 mm less and 8 mm more. The boxes are based on a unit of measurement of one tenth of an inch horizontally and one sixth of an inch vertically. The subdivisions are based on a unit of measurement of one tenth of an inch horizontally. Annex H 103
2005 Strategic Export Controls 104 L 200/16 EN Official Journal of the European Union 30.7.2005 EUROPEAN COMMUNITY 1 Applicant (full name, address, customs number) Type; AUTHORISATION FOR EXPORT OR IMPORT OF GOODS THAT COULD BE USED FOR TORTURE (REGULATION (EC) No 1236/2005 2 Consignee (full name and address) 5 Agent/Representative (if different from applicant) 9 End-user (full name and address) 10 Description of item 14 Specific requirements and conditions 10 Description of item 14 Specific requirements and conditions 10 Description of item 14 Specific requirements and conditions 3 Authorisation No Export Import 4 Expiry date 6 Country where the goods are located Code 7 Country of destination Code 8 Member State where a Customs procedure will take place Issuing authority 15 The undersigned certifies that, pursuant to Article 9(1) of Regulation 1236/2005 and subject to the requirements, conditions and procedures setout in this form and the attachment(s) to which it refers, the competent authority has authorised [an export] [an import] (delete as appropriate) concerning the goods described in box 10. 16 Number of attachments Done at (place, date) Name (typed or capitals) Signature: (Stamp of Issuing authority) 11 item No 1 11 item No 2 11 item No 3 12 CN code 13 Quantity 12 CN code 13 Quantity 12 CN code 13 Quantity
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2 Section 4: Statistics on Exports
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36 Annex A Schedule 1 of the Export
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Annex A - Official Documents

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