Form DSP-83 Non-Transfer and Use Certificate

Non-Transfer and Use Certificate

DSP-83, Form

Non-Transfer and Use Certificate

OMB: 1405-0021

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INSTRUCTIONS FOR DSP-83
The U.S. Department of State requires that this completed form DSP-83 be included as a part of an application for
authorization to export significant military equipment and classified equipment or data (22 CFR §§123.10(a), 124.10
and 125.7.) Failure to submit will result in the application being returned without action. The form DSP-83 must be
completed by the appropriate foreign persons (e.g., consignee, end-user, government) and forwarded to the U.S.
Department of State through the U.S. person making the application.

1.

Item 1.

The U.S. Department of State will enter the application number when the form DSP-83 is
submitted with the application. The U.S. applicant must provide the application number
when form DSP-83 is submitted separately from the application.

2.

Item 2.

Show the name of the U.S. person submitting the application to the U.S. Department of
State.

3.

Item 3.

Show the foreign person that will receive the articles/data for end-use. A bank, freight
forwarding agent, or other intermediary is not acceptable as an end-user.

4.

Item 4.

Show the country in which the articles/data will ultimately receive end-use.

5.

Item 5.

Show precise quantities of the articles/data. List each article/data clearly, giving type, model
number, make and (if known) U.S. military designation or national stock number. When
components and spare parts are involved, fully identify the minor component, major
component and end item in which they will be used (e.g., turbine blades for C-34 jet engine
for F24B aircraft). Give a separate value for each major component. Values must represent
only the selling price and not include supplementary costs such as packing and freight.

6.

Item 6.

To be completed by the foreign person who has entered into the export transaction with the
applicant to purchase the articles/data for delivery to the end-user. This item shall be
completed only if the foreign consignee is not the same as the foreign end-user.

7.

Item 7.

To be completed by the foreign person, in the country of ultimate designation, who will make
final use of the articles/data.

8.

Item 8.

When requested by the U.S. Department of State, this item is to be completed by an official
of the country of ultimate destination having the authority to so commit the government of
that country.

9.

Item 9.

Certification of U.S. applicant.

*Public reporting burden for this collection is estimated to average 1 hour per response, including time required for searching existing data sources, gathering the
necessary data, providing the information required, and reviewing the final collection. Send comments on the accuracy of this estimate of the burden and
recommendations for reducing it to: U.S. Department of State (A/ISS/DIR) Washington, DC 20520.

DSP-83
07-2008

Instruction Page 1 of 1

U.S. Department of State

UNITED STATES OF AMERICA

1. This certificate is submitted in
connection with export application no.

NONTRANSFER AND USE CERTIFICATE
2. Name of United States applicant

3. Name of foreign end-user

OMB No. 1405 0021
EXPIRATION DATE: 09-30-2008
*ESTIMATED BURDEN: 1 Hour
(Instruction Page)

4. Country of ultimate destination

5. Articles/data
We certify that we have placed an order with the person named in item 2 for the following articles/data in the quantity and value shown below:
QUANTITY

ARTICLES/DATA DESCRIPTION

VALUE (U.S. $)

$
$
$
$
$
$
$
$
$
$
$
$
6. Certification of foreign consignee
We certify that we are importing the articles/data listed in item 5 for delivery to the end-user in item 3. Except as specifically authorized by prior written
approval of the U.S. Department of State, we will not re-export, resell, or otherwise dispose of any of those articles/data (1) outside the country in item 4
above, or (2) to any person, including the end-user, if there is reason to believe that it will result, directly or indirectly, in disposition of the articles/data
contrary to the representations made in this certificate by any party. We further certify that all of the facts contained in this certificate are true and correct to
the best of our knowledge and belief and we do not know of any additional facts that are inconsistent with this certificate. We will promptly send a
supplemental certificate to the U.S. applicant in item 2 disclosing any change of facts or intentions set forth in this statement.
Sign here
in ink
Type or print

Signature of Official, Foreign Consignee

Name and Title of Signer

Date Signed (mm-dd-yyyy)
Seal

7. Certification of foreign end-user
We certify that we are the end-user of the articles/data in item 5. Except as specifically authorized by prior written approval of the U.S. Department of State,
we will not re-export, resell, or otherwise dispose of any of those articles/data (1) outside the country in item 4 above, or (2) to any other person. If the
end-user is a foreign government, we certify that we will observe the assurances contained in item 8. We further certify that all of the facts contained in this
certificate are true and correct to the best of our knowledge and belief and we do not know of any additional facts that are inconsistent with this certificate.
Sign here
in ink

Type or print

Signature of Official, End-User

Name and Title of Signer

Date Signed (mm-dd-yyyy)
Seal

8. Certification of foreign government
We certify that we will not authorize the re-export, resales or other disposition of the articles/data authorized in item 5 outside the country in item 4 without
prior written approval of the U.S. Government. If the articles/data are for use by our "armed forces" (i.e., army, navy, marine, air force, coast guard, national
guard, national police, and any military unit or military personnel organized under or assigned to an international organization), we certify that we will use the
authorized articles/data only: (a) for the purposes specified in the Mutual Defense Assistance Agreement, if any, between the U.S. Government and this
government; (b) for the purposes specified in any bilateral or regional defense treaty to which the U.S. Government and this government are both parties, if
subparagraph (a) is inapplicable; or (c) for internal security, individual self-defense, and/or civic action, if subparagraphs (a) and (b) are inapplicable.
Sign here
in ink

Type or print

Signature of Government Official

Name and Title of Signer

Date Signed (mm-dd-yyyy)
Seal

9. We certify that no corrections, additions or alterations were made on this form by us after it was signed by the foreign consignee, foreign
or foreign government.
Sign here
in ink
Signature of Applicant
Date Signed (mm-dd-yyyy)
Type or print
DSP-83
07-2008

Name and Title of Signer

end-user

Seal

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File Typeapplication/pdf
File TitleDSP0083.far - Design Mode
Authorkimdd
File Modified2008-07-30
File Created2008-07-11

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