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Statement of Assurance
(Supplement)
保证声明

Statement of Assurance

Dear Business Partner:
尊敬的业务合作伙伴:

FormFactor, its subsidiaries and affiliates’ (“FormFactor”) commodities, hardware, software and technology (collectively, “Products”) are governed by the export laws of China, the United States, Germany or other countries where we do business.

FormFactor、其子公司及附属公司(以下统称 “FormFactor”)的商品、硬件、软件和技术(以下统称“产品”)受中国、美国、德国或我们经营业务所在的其他国家/地区的出口法律管辖。

Some of our Products are subject to the authority of: (a) Chinese government agencies such as the China Ministry of Commerce and the General Administration of Customs; (b) the US Government (“USG”) export control and economic sanctions regulations, including the Export Administration Regulations (“EAR”) administered by the US Department of Commerce, Bureau of Industry and Security, and the Foreign Asset Control Regulations administered by the Department of Treasury, Office of Foreign Assets Control; or (c) the Federal Office for Economic Affairs and Export Control of Germany (“BAFA”). These laws prohibit export, reexport and transfer of certain FormFactor Products to certain countries, certain parties or for certain end uses.

我们的特定产品受到以下官方的约束:(a) 中国政府机构,如中国商务部和海关总署;(b) 美国政府(以下简称 “USG”)的出口管制和经济制裁法规,包括美国商务部工业与安全局管理的《出口管制条例》(Export Administration Regulations,以下简称 “EAR”)和财政部海外资产控制办公室 管理的《海外资产管制条例》(Foreign Asset Control Regulations);或 (c) 德国联邦经济与出口管制局(以下简称 “BAFA”)。这些法律禁止向特定国家/地区、特定方或就特定最终用途,出口、再出口和转让特定 FormFactor 产品。

Except as we may expressly inform you in writing, FormFactor probe card products are covered by the USG regulations, FormFactor analytical probes are covered by either USG or BAFA regulations and FormFactor probe systems are covered by BAFA regulations.

FormFactor 探针卡产品适用 USG 法规,FormFactor 分析探针适用 USG 或 BAFA 法规,FormFactor 探针系统则适用 BAFA 法规,我们以书面形式明确告知您的情况除外。

If you have any questions about this form, you may email FormFactor Trade Compliance at: [email protected].

如果您对本表格有任何疑问,可发送电子邮件至 [email protected] 联系 FormFactor 贸易合规部。

Thank you in advance for your cooperation in accurately completing and submitting the SOA.

谨此预先感谢您配合准确填写和提交 SOA。

I. End-Use Certification / 最终用途证明书

Complete this section for the location to which FormFactor is shipping Products.

填写此部分,明确 FormFactor 要将产品运送到的地址。

II. Military End-Use and End-Users / 军事最终用途及最终用户

The undersigned company certifies that Products will not be used for military end-uses or military end-users except to the extent permissible under USG regulations.

下方签字的公司兹证明,除了在 USG 法规允许的情况下,产品不会用于军事最终用途或供军事最终用户使用。

Answer each question below / 请回答以下各问题

Are you a “military end-user” as defined under EAR § 744.21? / 您是否属于 EAR 第 744.21 条定义的“军事最终用户? *
Is the intended end-use of the Products for military end-use, or for military end-users as defined under EAR § 744.21? / 产品的预期最终用途是否为 EAR 第 744.21 条定义的军事最终用途,或供军事最终用户使用? *

III. Prohibited End-Users / 禁止的最终用户

The undersigned company certifies that it will not export, reexport, transfer or release hardware, software, or technology to parties named on the USG’s parties of concern lists nor on the EU/Germany equivalent lists for BAFA-controlled items. The undersigned company further certifies that it is not a denied or listed person, is not owned or controlled by a denied or listed person, on such lists and is not acting on behalf of or for a denied or listed person.

下方签字的公司兹证明,不会向 USG 出口管制名单或涉及 BAFA 管制产品的欧盟/德国对应名单上的各方出口、再出口、转让或发布硬件、软件或技术。下方签字的公司还证明,其并非此类名单上的被禁方或被列入名单方,不为被禁方或被列入名单方所拥有或控制,也不代表被禁方或被列入名单方行事。

The USG list is available at: http://export.gov/ecr/eg_main_023148.asp

USG 名单可前往以下网址下载:http://export.gov/ecr/eg_main_023148.asp

IV. Prohibited End-Uses / 禁止的最终用途

The undersigned company certifies that Products will not be used directly or indirectly in prohibited proliferation activities (EAR § 744) related to nuclear weapons, fuel production or propulsion systems; missile, rocket or unmanned aerial vehicle (UAV) systems, chemical or biological weapons end-uses; or by any party engaged in such activities.

下方签字的公司兹证明,产品不会直接或间接用于涉及核武器、燃料生产或推进系统、导弹、
火箭或无人航空载具 (UAV) 系统、化学或生物武器等最终用途的被禁止扩散活动(EAR
第 744 条);也不会被参与此类活动的任何一方使用。

V. Certification of SOA / SOA 证明书

The undersigned company understands that relevant governments from time to time may amend their export control laws and regulations including the lists of prohibited entities, restricted destinations or proliferation activities and that all such amendments will be applicable to this certification. This provision and the assurances shall survive termination of any purchase order, agreement, or contract. This is a supplemental statement of assurance and does not supersede pre-existing statements of assurance we have from your company. The undersigned company agrees to notify FormFactor of any changes to the facts stated in this SOA or if the end-use or end-user of any Products change prior to any new shipments or transfers.

下方签字的公司理解,相关政府可能会不时修订其出口管制法律和法规,包括禁止实体、受限目的地或扩散活动的名单,且所有此类修订都将适用于本证明书。这项规定和保证应在任何订单、协议或合同终止后继续有效。下方签字的公司同意,如果本 SOA 中所述事实有任何变化,或如果任何产品的最终用途或最终用户发生变化,会在进行任何新的装运或转让之前通知 FormFactor。

Certification / 资质认证 *

Useful Links: / 有用的链接:

China Ministry of Commerce and the General Administration of Customs (MOFCOM) / 中国商务部和海关总署 (MOFCOM):
http://english.customs.gov.cn/

Bureau of Industry and Security: / 工业与安全局:
https://www.bis.doc.gov/

Office of Foreign Assets Control: / 海外资产控制办公室:
https://www.treasury.gov/resource-center/sanctions/Pages/default.aspx

US Code of Federal Regulations: / 美国联邦法规:
https://www.govinfo.gov/app/collection/cfr/2020/

Federal Office for Economic Affairs and Export Control of Germany: / 德国联邦经济与出口管制局:
https://www.bafa.de/EN/Home/home_node.html

European Union Commission: /欧盟委员会:
https://ec.europa.eu/trade/