Shipping Review Request - Research and Technology Transfer

Items that can ship internationally WITHOUT review/approval:

Unless the following items are shipped to Iran, Syria, Cuba, North Korea, China, Russia, Venezuela, and/or to a Restricted or Prohibited party, they do NOT require an export review, approval, or license.

Basic laboratory supplies such as test tubes, beakers, etc. (“Basic Lab Supplies” do NOT include chemicals, materials, electronics, biologics, and/or other items developed at the University, which DO require export review.)
Basic office supplies
Personal items such as clothing, toiletries, beauty products, etc.
Textiles
Household goods
Promotional items (ex. cups, pens, folders, sweatshirts)
Food products
Artwork and artifacts
Currency
Documents containing published/publicly available technical data or non-technical data

ALL shipments to U.S. territories with a value of over $2500 MUST be reviewed and approved by the Export Control Office prior to shipment. Please complete this form as fully as possible. Questions should be directed to: exportcontrols@mines.edu.

Requestor's Name

First Last

Request Date

Department

Requested on Behalf Of (if different than Requestor)

First Last

Sponsored Project Code (if applicable)

Recipient Name

First Last

Recipient Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Has the consignee(s) been screened through Visual Compliance?

Yes

Not Sure

Item Description

Please include a detailed description of the item(s) that will be shipped. If you know the manufacturer and model name of the item, please include it in the description.

For shipments that include multiple items, please attach a complete list of items in a Word or Excel document.

Max. file size: 50 MB.

Please check to indicate any of the following included in the intended shipment

Laboratory instruments

Tools (of a specialized mechanical nature)

Samples/prototypes (including fabricated materials)

Biological materials or specimens

Specialized scientific software (not including typical operational software such as Microsoft Office, Adobe, etc.)

Software programs containing or constituting specialized cryptographic functionality (not including routine commercial laptop cryptographic protection)

Technical data related to any of the foregoing

Does the shipment contain Hazardous Materials or controlled biologics?

Yes

If yes, have you received approval from EHS to ship the items to the intended recipient?

Yes

Does the shipment require an executed MTA prior to shipment?

Yes

If yes, have you contacted ORED to begin the MTA process?

Yes

Please identify (if known) the export control classification of the items in this shipment (Provide ECCN or USML Category, or respond “Unknown”)

What is the recipient’s intended end use of the items?

Is the recipient a member of a foreign government, military, intelligence agency, and/or police unit?

Yes

Is the export intended as a permanent export or will the item be returned?

Will the recipient re-export the items to a different final recipient?

Yes

Unknown

What is the estimated value of the shipment?

How do you intend to ship your item(s)?

UPS/FedEx

Other

Export Controls

International Shipping

International/U.S. Territory Shipping Review Request