Requestor’s Number: Detailed Description: Description of Item(s) and/or Activities, including jurisdiction and classification of all Input quantity and total value of items OR attach spreadsheet: All foreign destinations with addresses: All end-uses: All end-users (if any), with addresses: 3 Provide the NASA mission-related reason for the export/import transaction (e.g., to support international agreement, foreign travel/deployment by NASA employee(s) to support a NASA-related mission, etc.): If the request is as a result of an International Agreement, attach a copy of the fully executed agreement to the completed checklist before sending it via email to the CEA/ACEA. Highlight the specific section(s) and paragraph(s) that apply to this request. List all U.S. and foreign parties to the transaction. Do all U.S. and foreign parties to the transaction pass the list checks (e.g., Denial 4 Screening Check) Yes No (If No, use of an exemption may not be authorized; if CEA/ACEA still wants to move forward, discuss with the HEA.) Are you requesting use of an ITAR exemption or EAR exception in order to export a commodity that will remain under the effective control of a NASA person for 5 the duration? Yes No Is additional documentation required (e.g. written assurances, prior consignee For statement, etc.) or pre-export approvals or notifications required from/to U.S. completion Gov’t Regulators? (e.g., STA eligibility approval, CIV Foreign National Review Request Approval; etc.) Review the appropriate regulations to make this determination: 6 by Yes No CEA/ACEA If No, Required.” “None If Yes, list the additional documentation required and provide the list to the Requestor.
Requestor’s Number: 3 Detailed Description: Description of Item(s) and/or Activities, including jurisdiction and classification of all Input quantity and total value of items OR attach spreadsheet: All foreign destinations with addresses: All end-uses: All end-users (if any), with addresses: Provide the NASA mission-related reason for the export/import transaction (e.g., to support international agreement, foreign travel/deployment by NASA employee(s) to support a NASA-related mission, etc.): If the request is as a result of an International Agreement, attach a copy of the fully executed agreement to the completed checklist before sending it via email to the CEA/ACEA. Highlight the specific section(s) and paragraph(s) that apply to this request. 4 List all U.S. and foreign parties to the transaction. Do all U.S. and foreign parties to the transaction pass the list checks (e.g., Denial Screening Check) Yes No (If No, use of an exemption may not be authorized; if CEA/ACEA still wants to move forward, discuss with the HEA.) 5 Are you requesting use of an ITAR exemption or EAR exception in order to export a commodity that will remain under the effective control of a NASA person for the duration? Yes No 6 Is additional documentation required (e.g. written assurances, prior consignee statement, etc.) or pre-export approvals or notifications required from/to U.S. Gov’t Regulators? (e.g., STA eligibility approval, CIV Foreign National Review Request Approval; etc.) Review the appropriate regulations to make this determination: Yes No If No, “None Required.” If Yes, list the additional documentation required and provide the list to the Requestor. For completion by CEA/ACEA
N_AII_2190_001B_.docx