Section A: Entity 
A1. Manager’s Name: The full legal name of the responsible manager or person authorized to sign on behalf of the company.
A2. Job Title (Please provide a business card): The manager’s official job title within the company. A copy of their business card (or digital equivalent) should be attached to confirm position and authority.
A3. Company Name:T he registered legal name of the company purchasing or using the equipment.
A4. Country: Select the country where your business is based
A5. Country / Street / City / State / Zip: The complete business address of the company. This should be the official operating location or headquarters.
A6. Manager’s Email: A valid business email address of the signing manager. (Must be on the company domain. Gmail / Hotmail etc is not acceptable)
A7. Company Phone / Main Number: The company’s main telephone number
A8. Company Phone / Additional Phone: Alternate number if available (direct line, mobile, etc.).
A9. LinkedIn Profile: The LinkedIn profile of the company or manager (if available). This helps verify professional identity.
A10. Website: The official company website URL.
A11. Manager’s Signature of Authorization: A handwritten or digital signature of the authorized manager confirming the accuracy of the information provided.
A12. Date: The date the EUD form was signed.

Section B: Company’s Business Activity     
B1. Select your Business Type.
Education: Universities, colleges, technical schools, or other accredited academic institutions engaged in teaching, training, or academic research.
Government: National, state, or local government agencies, research institutes, or organizations that are publicly funded and operate on behalf of a government.
Laboratory: Independent or commercial testing labs, contract research organizations (CROs), or private R&D facilities that conduct analysis, testing, or research as a service.
OEM (Original Equipment Manufacturer): Companies that design and manufacture equipment or systems, and integrate purchased components (such as pumps, gauges, or controllers) into their final products for sale.
Repair Services: Organizations that provide repair, maintenance, or refurbishment services for equipment, instruments, or systems—either for end users or OEMs.
Reseller | Distributor: Businesses that do not manufacture products but purchase and resell equipment, components, or systems to end users or other companies (including regional distributors, dealers, and trading companies).
Other: If none of the above categories apply, please select “Other” and describe your business activity in detail.

B2. Select your Business Activity
Aerospace | Defense: Companies or institutions engaged in aircraft, spacecraft, satellites, avionics, propulsion systems, or defense technologies.
Automotive: Manufacturers, suppliers, or R&D groups involved in passenger vehicles, trucks, EVs, batteries, or automotive components.
Chemical Processin:g Organizations involved in production, refining, or processing of chemicals, petrochemicals, or specialty materials.
Energy | Environmental: Companies or labs working in power generation, renewable energy (solar, wind, hydrogen), energy storage, oil & gas, or environmental monitoring/clean technologies.
Food Processing & Packaging: Manufacturers and suppliers engaged in food safety, preservation, vacuum packaging, or food production equipment.
Glass | Ceramics: Industries producing or processing flat glass, specialty glass, ceramics, or related materials for industrial and scientific use.
Medical Devices | Healthcare: Manufacturers or service providers for diagnostic equipment, imaging systems, implants, laboratory instruments, or other healthcare technologies.
Nanotechnology | Materials Science: Organizations focused on nanomaterials, coatings, thin films, advanced alloys, composites, or other next-generation materials research and development.
Optics | Photonics: Companies or labs producing or using lasers, fiber optics, lenses, optical coatings, photonic devices, or imaging technologies.
Pharmaceuticals | Biotechnology: Organizations engaged in drug discovery, biomanufacturing, diagnostics, life sciences, genetic engineering, or related biotech/pharma activities.
Semiconductor: Fabs, equipment manufacturers, and suppliers working in IC fabrication, wafer processing, vacuum coating, lithography, or electronics packaging.
Other: If none of the above categories apply, please select “Other” and describe your business activity in detail.

B3. What do you plan to use this product or materials for?
Please describe the intended end use in detail.
Acceptable responses include: “Used as a backing pump for a mass spectrometer in a university chemistry lab” or “Used for leak detection in a semiconductor production line.”
Generic responses such as “for laboratory use” or “for research and development purposes” are not sufficient.

B4. Military Affiliation
Question: Is your company or entity part of the military sector in China, Russia, or Venezuela?
Select one: YES ☐ or NO ☐ - If you select “Yes,” please provide details (for example, the military branch, type of contract, project name, or nature of the activity).

Why this is required
U.S. and international export regulations restrict the sale of certain products and technologies to military organizations in specific countries. This includes both direct involvement (e.g., your company is operated by or part of the armed forces) and indirect involvement (e.g., supplying goods or services to a military agency or project in these countries).

Examples of “YES” responses
“Our company manufactures components under contract with the Russian Ministry of Defense.”
“We are a research institute operated by the Chinese military.”
“We provide maintenance services for equipment used by the Venezuelan Air Force.”

Examples of “NO” responses
A commercial semiconductor manufacturer in Taiwan with no ties to military organizations.
A U.S. university conducting civilian research unrelated to defense.
A private medical device company supplying only hospitals and clinics.

B5. Nuclear / Missile Activities
Question: Is your company directly or indirectly involved in any nuclear activities related to the design, development, production, or use of missiles?   
Select one: YES ☐ or NO ☐ - If you select “Yes,” please provide details of the activities (e.g., type of project, the customer, or the specific role your company plays).

Why this is required
U.S. and international export regulations restrict the sale of certain products to entities engaged in nuclear weapons development or missile delivery systems. This includes both:
Direct involvement (e.g., designing, manufacturing, or testing missile or nuclear components).
Indirect involvement (e.g., supplying materials, components, or technology that you know will be used in these programs).

Examples of “YES” responses
“We provide propulsion components used in missile development programs.”
“Our company supplies uranium enrichment equipment for a government nuclear weapons project.”
“We conduct testing services for missile guidance systems.”

Examples of “NO” responses
A power utility company operating a civilian nuclear power plant for electricity generation.
A medical research company using radioisotopes for diagnostics and cancer treatment.
A commercial aerospace firm developing satellites with no missile applications.

B6. Chemical / Biological Weapons
Question: Is your company directly or indirectly involved in any activities related to the development, production, or use of chemical or biological weapons?  
Select one: YES ☐ or NO ☐ - If you select “Yes,” please provide details of the activities (e.g., program name, customer, or the specific role your company plays).

Why this is required
International treaties and U.S. export control regulations strictly prohibit the sale of certain products and technologies to organizations engaged in chemical or biological weapons programs. This includes both:
Direct involvement (e.g., designing, producing, or testing weaponized chemical or biological agents).
Indirect involvement (e.g., knowingly supplying equipment, materials, or services that support these programs).

Examples of “YES” responses
“We provide laboratory reactors to a defense program for development of chemical warfare agents.”
“Our company manufactures aerosol dispersal systems intended for military biological testing.”

Examples of “NO” responses
A pharmaceutical company conducting vaccine research.
A food safety lab testing for bacterial contamination in consumer products.
A university chemistry department using chemical reagents for teaching or civilian R&D.

B7. Major Customers
Question: Please list the names of your major customers or clients.
This may include your largest buyers, long-term partners, or organizations you supply products or services to on a regular basis. You do not need to list every customer—only those that represent significant business relationships or a meaningful share of your sales.

Why this is required
As part of due diligence and export control compliance, we are required to understand who the end users of our products may be. This helps ensure our products are not re-exported or used in restricted programs, such as military, nuclear, chemical, or biological weapons development.
Providing accurate information protects both your company and ours from regulatory violations.

Examples of sufficient responses
“ABC Semiconductor Corp., XYZ University Research Lab, and LMN Medical Devices Inc.”
“Our major customers include Tier 1 automotive suppliers and large diagnostic equipment manufacturers.”

Examples of insufficient responses
“Confidential” (without explanation).
“Various laboratories” or “general R&D.”
(If confidentiality agreements limit what you can disclose, please indicate this and provide as much information as possible—for example, listing by industry sector rather than company name.)

Section C: Items, Goods, Product
C1. Which ULVAC product(s) or material(s) are you purchasing parts for?
 Please specify the exact ULVAC equipment, system, or material that these parts will support.
Include the model name and number (e.g., ULVAC GLD-136C rotary vane pump or ULVAC HELIOT helium leak detector).
If applicable, provide the system name or tool type the parts will be installed into.
If multiple products apply, please list all that are relevant.

Why this is required
Export control regulations require us to confirm the end use and compatibility of replacement parts, accessories, or consumables. By identifying the exact ULVAC product, we can:
Verify that the requested items are appropriate for the equipment.
Ensure parts are not diverted to restricted or unauthorized systems.
Provide faster support by confirming the right configuration for your application.

Examples of sufficient responses
“ULVAC VD40C rotary vane vacuum pump.”
“ULVAC LS120A-C dry screw vacuum pump, used as a backing pump for a mass spectrometer.”
“ULVAC HELIOT 900 helium leak detector.”

Examples of insufficient responses
“Vacuum pump parts” (too general).
“For research equipment” (not specific).
“Leak detector” (without model name/number).

C2. Do you have an existing ULVAC product?
Select one: YES ☐ or NO ☐
YES → If you currently own or operate a ULVAC product (pump, leak detector, gauge, power supply, etc.), please continue to C3 and provide details about the specific product(s).
NO → If this is your first purchase of a ULVAC product or you are buying parts on behalf of an OEM/distributor without directly owning a ULVAC product, no further information is required for this section.

Why this is required
This information helps us:
Confirm whether the requested items are replacement parts or for a new installation.
Provide the correct support (e.g., service guidance, compatible parts, or maintenance recommendations).
Ensure compliance with export regulations by verifying the end-use equipment.

Examples of “YES” responses
A lab that owns an ULVAC GLD-136C rotary vane pump and is buying replacement oil or service parts.
A semiconductor fab that operates multiple ULVAC HELIOT leak detectors.

Examples of “NO” responses
A distributor buying parts for resale.
A new customer purchasing their first ULVAC pump.
An OEM integrating ULVAC products into equipment for shipment to an end user.

C3. Please provide the ULVAC Model and Serial Number or Plate Number
Model Number: The official ULVAC product model designation (e.g., GLD-136C, VD40C, HELIOT 900, DISL-101).
Serial Number / Plate Number: The unique identifier found on the product’s nameplate or identification label, usually located on the side or back of the equipment. If multiple ULVAC products apply, please list each model and serial number separately.

Why this is required
Providing the exact model and serial/plate number helps us:
Confirm that the correct replacement parts or service kits are being supplied.
Verify product configuration and compatibility with newer parts or upgrades.
Track the product’s manufacturing history for warranty, service, and export compliance.

Where to find this information
Look for the ULVAC nameplate or sticker on the pump, gauge, or system.
The plate typically includes fields such as: Model, Serial No., Voltage, Frequency, Year of Manufacture.
For older products, the plate number may serve as the identifying code if a serial number is not available.

Examples of sufficient responses
Model: GLD-136C | Serial No.: 23A45897
Model: HELIOT 900 | Plate No.: HLT-2024-1156

Examples of insufficient responses
“Vacuum pump” (too general).
“HELIOT” (missing full model and identifier).

C4. Restricted End Use Declaration
Question: Will ULVAC’s products be utilized in the development or production of any of the following:
Nuclear weapons or related delivery systems.
Military-grade chemical or biological warfare agents.
Devices designed to disperse chemical or biological agents.
Rockets or unmanned aerial vehicles (UAVs/drones) capable of transporting such weapons, including components with a range or flight capability exceeding 300 km.

Select one: YES ☐ or NO ☐ - If you selected YES, please explain in detail (e.g., type of program, customer, or intended use).

Why this is required
ULVAC is legally obligated under U.S. and international export control laws (such as the Wassenaar Arrangement and MTCR – Missile Technology Control Regime) to ensure that our products are not used in weapons of mass destruction (WMD) programs or in long-range missile/drone systems. This question applies to both direct and indirect involvement (e.g., knowingly supplying products for these restricted uses).

Examples of “YES” responses
“We are under contract to supply vacuum systems for a government defense program developing long-range missiles.”
“Our lab provides specialized vacuum technology used in chemical weapons testing.”

Examples of “NO” responses
A university using pumps for physics research or material science studies.
A biotech company using vacuum equipment for vaccine production.
A manufacturer using pumps in semiconductor fabrication.

Important clarification
Civilian and commercial uses (e.g., nuclear power generation for electricity, medical isotope production, industrial materials processing, drone systems with short-range commercial applications) should be marked as NO.
Only military WMD-related or missile/drone programs with extended range capability (>300 km) fall under a YES answer.

C5. Military Application
Question: Will ULVAC’s products be used for any military application?
Select one: YES ☐ or NO ☐ - If you select YES, please explain in detail (e.g., type of program, project name, customer, or the specific military use).

Why this is required
ULVAC is obligated under U.S. and international export control regulations to determine whether our products are intended for military use. This includes both direct applications (e.g., equipment installed in a weapons system) and indirect applications (e.g., use in the development, testing, or production of military technologies).
Providing this information ensures compliance with global trade laws and helps avoid delays or restrictions in order processing.

Examples of “YES” responses
“Used in a defense contractor facility to support radar system production.”
“Integrated into a vacuum coating system for military aircraft components.”
“Applied in testing laboratories for research sponsored by the U.S. Department of Defense.”

Examples of “NO” responses
A semiconductor fab producing consumer electronics.
A hospital using vacuum pumps for medical equipment.
A university research project with no defense-related funding or objectives.

Important clarification
This question applies to all countries, not only restricted ones.
Civilian or commercial applications should be answered as NO.
If your organization serves both civilian and military customers, please indicate that and specify whether the ULVAC product will be directed to the military portion of your business.

Section D: End User Destination 

D1. Company Name of the End User Destination
The end user is the final company or organization where the ULVAC product will be installed and used. If you are a distributor, reseller, or OEM, please provide the destination end user’s company name for compliance verification.”

Question: Please provide the full legal name of the company or organization that will be the final end user of the ULVAC product(s).
The end user is the company or entity that will ultimately own and operate the equipment or materials.
This may or may not be the same as the purchaser, distributor, or intermediary.
If the product is being purchased through a reseller, distributor, or OEM, please list the final company name where the ULVAC product will be installed or used.

Why this is required
Export control regulations require us to identify the true end user of our products to ensure they are not diverted to restricted entities or prohibited applications. This protects both your company and ULVAC from compliance risks.

Examples of sufficient responses
“ABC University – Department of Physics.”
“XYZ Semiconductor Manufacturing Ltd.”
“LMN Medical Devices, Inc.”

Examples of insufficient responses
“Distributor customer” (too vague).
“Research lab” (without company name).
“Confidential” (without explanation).

(If confidentiality restrictions apply, please indicate this and provide as much detail as possible—for example, “U.S.-based Tier 1 automotive manufacturer” instead of leaving it blank.)

D2. Is this for Resale?
Please indicate if the ULVAC product is for resale. If ‘YES,’ specify whether you are a distributor, reseller, or OEM, and provide details of the end user (if known) or the typical customer industry.

Question: Is this ULVAC product being purchased for resale (i.e., you are not the end user but will be reselling or transferring the product to another company or customer)?
Select one: YES ☐ or NO ☐  - If you select YES, please explain:
Identify whether you are acting as a distributor, reseller, trading company, or OEM.
Provide the company name of the end user destination (if known).
If the final end user is not yet determined, please explain the typical customer type or industry sector (e.g., “sold to semiconductor fabs” or “sold to universities for R&D”).

Why this is required
This information ensures compliance with export regulations by clarifying whether:
The purchaser is the final end user, or
The product will be resold and shipped to another customer.

Knowing the resale status helps ULVAC verify the true end user and prevent diversion of products to restricted programs or entities.

Examples of sufficient responses
YES: “We are a distributor. This product will be resold to XYZ University for use in a materials science lab.”
YES: “We are an OEM. This vacuum pump will be integrated into our mass spectrometer system and sold to end users in the medical diagnostics industry.”
NO: “We are the end user and will operate this pump in our own semiconductor production line.”

Examples of insufficient responses
“Yes, for resale” (without identifying type or customer).
“No” when the company is actually a distributor.
Leaving the explanation blank when “Yes” is selected.

D3. End User Location
Please provide the complete street address of the facility where the ULVAC product(s) will be installed and used. General answers such as country name or company headquarters are not sufficient for compliance purposes.

Question: What is the full physical address (Country / Street / City / State / Zip/Postal Code) where the ULVAC product(s) will be installed and used?
This should be the actual site of use, not just the purchasing office or billing address.
If your company has multiple facilities, please specify the exact facility address where the product will be operated.
If the products will be shipped to a central warehouse first, please indicate the final destination address where the equipment will be put into service.

Why this is required
Export regulations require ULVAC to confirm the end-use location of its products. Knowing the exact site ensures that equipment is not diverted to restricted countries, embargoed regions, or unauthorized facilities.
 It also helps ULVAC provide accurate service, maintenance, and technical support.

Examples of sufficient responses
“XYZ Semiconductor Manufacturing Ltd., 123 Innovation Drive, Austin, TX 78758, USA.”
“ABC University, Department of Physics, 456 College Avenue, Cambridge, MA 02139, USA.”
“LMN Medical Devices, 22 Science Park, Dublin 4, Ireland.”

Examples of insufficient responses
“USA” (too vague).
“University Lab” (without address).
“Customer site” (unclear).

D4. Export of ULVAC Products
If the ULVAC product(s) will be exported outside of the U.S., please provide the destination country, end user name, and final installation site. This information is required for compliance with U.S. export control regulations

Question: Will the ULVAC product(s) you are purchasing be exported outside of the United States after delivery?
Select one: YES ☐ or NO ☐  - If you select YES, please explain:
Provide the destination country (or countries).
Identify the end user company name and end-use location address (if different from the U.S. delivery address).
Clarify whether the product will be exported directly (shipped abroad) or indirectly (e.g., installed into equipment by your company and then shipped overseas).

Why this is required
U.S. export control regulations require ULVAC to confirm whether products sold in the United States will remain in the country or be shipped abroad.
If exported, ULVAC must verify that the destination country, entity, and end use are not restricted or embargoed.
This ensures full compliance with U.S. laws and international treaties.

Examples of sufficient responses
NO: “The products will remain at our U.S. facility in San Jose, CA.”
YES: “Products will be exported to XYZ Semiconductor Co., Hsinchu, Taiwan, for use in wafer fabrication.”
YES: “The pump will be integrated into our OEM system and exported to a medical device customer in Germany.”

Examples of insufficient responses
“Yes, international” (without country or customer details).
“No” when the equipment will actually be shipped abroad.
Leaving the explanation blank after selecting “Yes.”

D5. Secondary Use or Transfer of Products
Please indicate whether the ULVAC product(s) will only be used by the declared end user at the declared site, or if they will be transferred/used elsewhere. If ‘YES,’ provide details of the additional location(s) or user(s).

Question: Will the ULVAC product(s) or the system they are integrated into be used at any location other than the end-user destination listed in D1–D3, or by any user other than the named end user?
Select one: YES ☐ or NO ☐ - If you select YES, please explain:
Provide the additional location(s) where the product will be used.
Identify the other organizations or users who will have access to or operate the product.
Clarify whether this will be a temporary use (e.g., shared testing facility, loaned equipment) or a permanent transfer.

Why this is required
Export control compliance requires ULVAC to confirm that products are not diverted to unlisted users or unauthorized sites after delivery. Even if the initial end user is approved, a transfer or use by another party may create compliance risks. This ensures that the equipment remains with the declared end user and is not rerouted to restricted programs, facilities, or countries.

Examples of sufficient responses
NO: “The product will remain at our facility in San Jose, CA, and only be used by our company.”
YES: “The system will be temporarily installed at a shared government research facility operated by both our company and a university partner.”
YES: “After integration into our equipment, the final system will be shipped to our customer in Japan for permanent use.”

Examples of insufficient responses
“Yes, possibly” (without explanation).
“No” when the company intends to transfer the product to a subsidiary or partner.
Leaving the explanation blank after selecting “Yes.”

D6. What is the Final End Product?
Please describe the final goods that result from using ULVAC’s products. General responses such as ‘R&D’ or ‘laboratory use’ are not sufficient. Examples of end products include smartphones, electric vehicles, medical diagnostic equipment, and solar cells

Question: What is the final product that will be manufactured using the ULVAC equipment, parts, or materials?
The end product refers to goods that are ready for sale to consumers or commercial markets, either manufactured directly by your company or by your downstream customer.
Please provide a clear description of the end product(s) that result from the use of ULVAC’s equipment.

Why this is required
Export regulations require ULVAC to confirm the ultimate end use of its products. This helps ensure they are applied only in permitted civilian and commercial applications (e.g., semiconductors, medical devices, renewable energy) and not diverted into restricted or military uses.
By identifying the final product, ULVAC can also:Verify the suitability of the supplied equipment & Provide better technical support and application guidance.

Examples of sufficient responses
“Semiconductor wafers for smartphone processors.”
“Lithium-ion batteries for electric vehicles.”
“Diagnostic medical equipment for hospitals.”
“Solar panels for renewable energy installations.”

Examples of insufficient responses
“Research and development” (too generic).
“Laboratory use” (not an end product).
“Electronics” (too broad).