Form ITA-4014P International Buyer Program Exhibitor Data

OMB Control No. 0625-0151

Expiration Date: xx/xx/xxxx

Form ITA- 4014P U.S. Department of Commerce (Rev. 6/2010) International Trade Administration EXHIBITOR DATA ON U.S. FIRMS INTERESTED IN MEETING WITH INTERNATIONAL BUSINESS VISITORS INTERNATIONAL BUYER PROGRAM
This report is authorized by law (15 U.S.C 1512 et seq.; 15 U.S.C. 171 et seq. ;). While you are not required to respond, your cooperation is needed in evaluating export expansion results under the International Buyer Program. Except to the extent required by law no information of a proprietary nature reported on this form will be disclosed without prior written consent of the relevant firm.
Please complete and return this form to the following address (show organizer): Name Address City State Zip Code
Exhibit Name: Site: Date:		Company Name and U.S. Address: (Street, City, State, Zip Code) Name Address City State Zip Code Size of Business (# of Employees):
Booth Number(s) at Show:	Telephone Number (Include Area) Code: Fax Number: E-mail Address: Website:
Company Profile: Never Exported Has not exported within the last 12 months Currently Exporting to the following markets: A frica, Near East, Sub-Africa E ast Asia, Pacific E urope N orth America C entral and South America	Name and title of company official(s) at show for contact with international business visitors: Title: Title:
	Name and contact information for company official in charge of international sales/marketing:
	9. Name and contact information for company official in charge of financing:
10. Product Lines or services your company wishes to export:
1 1. Are you interested in learning more about exporting? Yes No Type of Export Counseling desired: Documentation Requirements Financing Trade Statistics Logistics Market Access Market Research All of the Above Other:___________________________
1 2. International business in which your company is interested in: Direct Sales Foreign Agents/Distributors Joint Ventures Licensing Agreements	13. Where are you most interested in marketing your product? Asia, Near East, Sub Africa India Israel South Africa Other:_____________________ East Asia, Pacific China Japan Australia Vietnam Other: ___________________ Europe Germany United Kingdom Sweden Finland Other: _____________________ Western Hemisphere Canada Brazil Mexico Other: ___________________
14. Would you like a free subscription to Commercial News USA (CNUSA)? Y es No
I certify that each item listed in section 9 is of U.S. origin ((i) produced or manufactured in the United States; or, (ii) if produced or manufactured outside the United States, be marketed under the name of a U.S. firm and have U.S. content representing at least 50 percent of the value of the finished product or service being exported. U.S.-sourced inputs that may be considered as contributing to U.S. content, to the extent that they are incorporated into the finished product or service being exported, may include but are not limited to: materials; components; packaging; labor; production equipment and factory overhead; research & development; design; intellectual property; warehousing; distribution; sales; administration & management; advertising; and marketing and promotion.) _______________________________________________________ ___________________________ Signature of Duly Authorized Company/Participant’s Representative Date _______________________________________________________ Print Name and Title

Public reporting for this collection of information is estimated to be 10 minutes per response, including the time for reviewing instructions, and completing and reviewing the collection of information. All responses to this collection of information are voluntary, and will be provided confidentially to the extent allowed by law. Notwithstanding any other provision of law, no person is required to respond to, nor shall a person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control Number. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Reports Clearance Officer, International Trade Administration, Department of Commerce, Room 4001, 14^th and Constitution Avenue, N.W., Washington, D.C. 20230.