Edited Version of the Old BIS-645P showing changes made.

General Instructions
The International Import Certificate, BIS-645P form is available on the BIS Web site. BIS
requires only one signed copy to be submitted via mail. Once the IIC is signed with the authorized
signature, the original and a copy(s) will be returned to you.
The IIC=s, BIS-645P form should be mailed to the following address.
Via Courier or Regular mail:
Bureau of Industry and Security
U.S. Department of Commerce
14th Street and Pennsylvania Avenue, N.W.
Room 2705
Washington, D.C. 20230
Attn: AIIC enclosed@

Please disregard the P.O. Box address for
the Department of Commerce listed on
the back of the IIC Form.

Form Approved: 0MB No. 0694-0017 - Modele approuve: 0MB No. 0694-0017

FORM BIS-645P/ATF-4522/DPS-53 (REV 8/02)

U.S. DEPARTMENT OF COMMERCE
Bureau of Industry and Security
U.S. DEPARTMENT OF THE TREASURY
Bureau of Alcohol, Tobacco and Firearms
U.S. DEPARTMENT OF STATE
Office of Munitions Control
NOTE:

INTERNATIONAL IMPORT CERTIFICATE
( CERTIFICAT INTERNATIONAL D'IMPORTATION)

Read instructions on the reverse side before completing and
submitting this form. (Lire les instructions au verso avant de
remplir et de presenter la presente formule.)

Certificate Number

1. U.S. Importer/lmportateur (Name and address-Norn et adresse)

FOR U.S. GOVERNMENT USE (Reserve pour le Gouvernment des Etats­
Unis)

2. Exporter/Exportateur (Name and address-Norn et adresse)

If this form has been approved by the Department of Commerce or the De­
partment of State, it is not valid unless the official seal of the Department of
Commerce, or the Department of State, appears in this space. If this form is
approved by the Treasury Department, a seal is not required. (Si ce formulaire
a ete approuve par le Ministere du Commerce, ou le Ministere des Affaires
Etrangeres, il n'est pas valide a moins qu'un sceau officiel du Ministere du
Commerce ou du Ministere des Affaires Etrangeres soit appose sur le docu­
ment. Si ce formulaire est approuve par le Ministere des Finances, un sceau
officiel n'est pas necessaire.

3.

TSUSAnno. No.
(Numero de la
liste)

Description of goods
(Designation de la Marchandise)

Quantity
(Quantite)

Value
(Valeur)
(FOB, CIF, etc.)

4. Representation and undertaking of U.S. importer or principal
The undersigned hereby represents that he has undertaken to import into the United States ofAmerica under a U.S. Consumption Entry or U.S. Warehouse Entry
the commodities in quantities described above, or, if the commodities are not so imported into the United States of America, that he will not divert, transship, or
reexport them to another destination except with explicit approval of the Department of Commerce, the Department of State, or the Department of the Treasury,
as appropriate. The undersigned also undertakes to notify the appropriate Department immediately of any changes of fact or intention set forth herein. If a
delivery verification is required, the undersigned also undertakes to obtain such vertification and make disposition of it in accordance with such requirement.
Any false statement willfully made in this declaration is punishable by fine and imprisonment. (See experts from U.S. Code on reverse side.)
Declaration et engagement de l'importateur ou du commettant des Etats-Unis
Le soussigne declare par la presente qu'il a pris !'engagement d'importer aux Etats-Unis d'Amerique, en vertu d'une Declaration americaine de Mise en Consommation,
ou d'une Declaration americaine d'Entree en entrepot, la quantite de produits ci-dessus et que, dans le cas ou ces produits ne seraient pas ainsi importes aux
Etats-Unis d'Amerique, il ne le detoumera, ne les transbordera, ni les reexportera a destination d'un autre lieu, si ce n'est avec !'approbation explicite du Ministere
du Commerce, du Ministere des Affaires Etrangeres ou du Ministere des Finances, comme il est requis. Le soussigne prend egalement !'engagement d'aviser le
Ministere interesse des Etats-Unis de tous changements survenus dans les actes ou les intentions enonces dans la presente declaration. Si demande est faite d'une
confirmation de la livraison le soussigne prend egalement !'engagement d'obtenir cette confirmation et d'en disposer de la maniere prescrite par cette demande.
Toute fausee declaration faite intentionnellement espose l'auteur aux penalites prevues par la loi. (Voir Extrait du Code des Etats-Unis au verso.)
Type or Print
(Priere d'ecrire
a la machine ou
en caracteres
d imprimerie)

Type or Print
(Priere d'ecrire
a la machine ou
en caracteres
d imprimerie)
Name of Firm or Corporation
(Norn de la Finne ou de la Societe)

Name and 'litle of Authorized Official
(Norn et titre de !'agent ou employe autorise)

Signature of Authorized Official
(Signature de !'agent ou employe autorise)

Date of Signature
(Date de la signature)

This document ceases to be valid unless presented to the competent foreign authorities within six months from its date of issue. (Le present document perd sa
validite s'il n'est pas remis aux autorites etrangeres competentes dans un delai de six mois a compter de sa delivrance.)
No import certification may be obtained unless this International Import Certificate has been completed and filed with the appropriate U.S. Government agency
(Department of Commerce: 50 U.S.C. app. §2411, E.O. 12214 15 C.F.R. §368; Department of the Treasury; 22 U.S.C. §2778, E.O. 11959, 27 C.F.R. §47; Department of
State: 22 U.S.C. 2778, 2779, E.O. 11958, 22 C.F.R. §123). Information furnished herewith is subject to the provisions of Section 12(c) of the Export Administration Act
of 1979, 50 U.S.C. app. 24ll(c), and its unauthorized disclosure is prohibited by law.
FOR U.S. GOVERNMENT USE (Reserve au Gouvernement des Etats-Unis)
Certification: This is to certify that the above declaration was made to the U.S.
Department of Commerce, State, or Treasury through the undersigned desig­
nated official thereof and a copy of this certification is placed in the official files.

Certification : II est certifie par la presente que la declaration ci-dessus a ete
faite au Ministere du Commerce, des Affaires Etrangeres, ou des Finances des
Etats-Unis par l'intermediaire du fonctionnaire autorise sousssigne de ce Ministere
et qu'une copie de ce certificat a ete conservee clans Jes archives officielles.

Signature___________________________________Date ____________________
Designated Commerce, State, or Treasury Official (Fonctionnaire competent du Ministere du Commerce, d'Etat, ou du Tresor)

Date
USCOMM DC 89-24414

ORIGINAL COPY

INSTRUCTIONS FOR COMPLETION AND SUBMISSION OF
FORM BIS-645P/ATF-4522/DSP-53, INTERNATIONAL IMPORT CERTIFICATE
In accordance with an agreement between the Departments of Commerce, State, and Treasury, Import Certificates issued to facilitate international cooperation in
export control matters have been standardized. Under this standardization these agencies will use the same form. The U.S. Department of the Treasury issues the
form for articles enumerated on the U.S. Munitions Import List in connection with the issuance of a Treasury Department Import Pennit. The U.S. Department of
State issues the form in connection with foreign transfer by a U.S. entity of U.S. Munitions List articles. The U.S. Department of Commerce issues the form for all
other commodities subject to an Import Certificate requirement.
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 0MB Control Number.
Public reporting for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, completing and
reviewing the collection of information, and an additional I minute per response for recordkeeping. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for reducing this burden, to the Director of Administration, Bureau of Industry and Security, Room
3889, U.S. Department of Commerce, Washington, D.C. 20230; and to the Office of Management and Budget, Paperwork Reduction Project, Washington, D.C. 20503.
GENERAL INSTRUCTIONS

Submit this form in triplicate - 3 copies (submit in quadruplicate 4 copies for
"special nuclear material," "source material," "by-product material," "production
or utilization facilities," and "nuclear equipment" and "nuclear material" as defined
in the regulations of the Nuclear Regulatory Commission). The quadruplicate
copy of this form should be retained by the importer for record purposes, and
after the original is signed and numbered by the designated U.S. Commerce, State,
or Treasury Department official, the International Import Certificate Number
should be entered on the record copy. This will facilitate entering the correct
International Import Certificate Number on a Delivery Verification Certificate if
a delivery verification is requested by the foreign exporter. (If the form is required
to be submitted in quadruplicate, the importer should use a separate blank form
to provide his record copy.)

obtained from the Department of Commerce, Department of State, or Department
of Treasury.
*TSUS -TariffSchedules of the United States Annotated may be purchased
from the Superintendent of Documents, U.S. Government Printing Office,
Washington, D.C. 20402, local Customs Offices, or !TA District Offices located in
principal cities.
REGULATIONS COVERING USE OF THIS FORM

(a) The Department of Commerce regulation covering U.S. Import Certificates
and Delivery Verification Certificate is set forth in Supplement No. 5 to Part 748
of the Export Administration Regulations, which is available for reference
at any ITA District Office.

Import Certificates will be issued only when required by the government of a
foreign country for the commodities specified above which are subject to the
Atomic Energy Act, for the N.S.--controlled commodities on the Commodity
Control List (Supplement No. 1 to 774 of the U.S. Department of Commerce Export
Administration Regulations), and for articles enumerated on the U.S. Munitions
List and U.S. Munitions Import List

(b) The Department of State regulation covering the foreign transfer by a United
States entity of United States Munitions List equipment, previously exported from
the United States under a license of the Department of State, to any country
other than the country of ultimate destination as stated in the export license, is
set forth in Part 123.1O(b) of the International TraJJic In Arms Regulations,
which is available from the U.S. Government Printing Office.

Issuance by U.S. Department of Conunerce

PENALTIES AND SANCTIONS FOR VIOLATIONS

Requests for certification and validation of Import Certificates or requests for
amendments of Import Certificates may be filed with the Office of Exporter
Services, P.O. Box 273, Washington, D.C. 20044.

(a) Administrative - Provided in the Export Administration Regulations. The
enforcement provisions of Part 764 of the Export Administration
Regulations, the conduct of Business provisions of Supplement No. 2 to Part
736, and the denial or suspension of export privileges and imposition of civil
penalties provisions of Part 766 shall apply to transactions involving imports
into the United States covered by Supplement No. 2 to Part 736. The Export
Administration Act provides a civil penalty not to exceed $10,000 that may be
imposed for each violation of the Export Administration Act or any regulation,
order, or license issued under the Act either in addition to or instead of any
liability or penalty which may be imposed. Violations involving national security
controls imposed under Sections of the Export Administration Act are subject
to a civil penalty not to exceed $100,000 for each violation. Any provisions of
Part 764 and Supplement No. 2 to Part 736 which by their terms relate to "exports"
or "exports from the United States" are also deemed to apply and extend to
imports into the United States, applications for International Import Certificates,
International Import Certificates and Delivery Verifications, dealt with in Part
748. (A form BIS - 645P, International Import Certificate, when presented to the
U.S. Department of Commerce for certification or validation, is an application
for an International Import Certificate.)

(Blank forms are obtainable at the same offices or any other District Offices.)
(See Supplement No. 5 to Part 748 of the Export Administration Regulations, for
Special instructions to be followed when foreign excess property is involved.)
Issuance by U.S. Department of the 'lreasury

In the case of articles enumerated in the U.S. Munitions Import List (27 Code of
Federal Regulations 47) covering arms, ammunition, and implements of war,
communicate with the Bureau of Alcohol, Tobacco and Firearms, Department of
the Treasury, Washington, D.C. 20226.
Issuance by U.S. Department of State

In the case of foreign transfer by a U.S. entity of U.S. Munitions List articles (22
Code of Federal Regulations 121), communicate with the Office of Munitions
Control, Department of State, Washington, D.C. 20520.
SPECIAL INSTRUCTIONS
Item 1 The full name and the address of the U.S. importer or U.S. principal in

the transaction must be shown. (The U.S. principal in the transaction is that
person subject to the jurisdiction of the United States who is in a position to
make the representation and undertakings set forth in Item 4.)

Item 2 - Name and full address of foreign exporter must be shown.
Item 3 - Description of goods must be shown in normal commercial terms, and

should include composition, type, size, gauge, grade, horsepower, manufacturer's
name, serial number, as well as brand or trade names, cataiog numbers, or other
trade characteristics which will aid in exact recognition of commodities. Indicate
also status of equipment or material such as new or used.

The Tariff Schedules of the United States (TSUS) Annotated* number and the
quantity must be shown in accordance with the Tariff Schedules and/or normal
commercial terms.
Values must be shown in customary form of quotation, such as: f.o.b. (named
port), c.i.f., or other form.
Item 4 - Where the representation is made that the commodities will be brought

into the United States under a U.S. Consumption or Warehouse Entry, the
temporary unlading of goods in a foreign trade zone which are intended for
subsequent entry into the economy of the United States is not precluded. The
U.S. Department of Commerce, Department of State, and/or Department of
Treasury, shall be notified immediately of any changes of fact or intention set
forth on this form. Such notification shall be in writing and should include the
International Import Certificate Number. There must be shown in the name of
firm or corporation on whose behalf this document is filed If signed by an agent
of the Importer, such agency must be indicated in the space marked "Type or
Print Name and Title of Authorized Official.•
Where the commodities are not imported into the U.S. under such Customs
entries, pennission to divert, transship or reexport the commodities must be

Any person, either in the United States or abroad, who violates the Export
Administration Act or any regulation, order, or license issued thereunder,
including the provisions of Part 748, is subject to administrative action which
may result in disqualification from eligibility to obtain a certified Import Certificate
from the Office of Exporter Services, in suspension, revocation and denial of
export privileges under the Export Administration Act; and in exclusion from
practice before the Bureau of Industry and Security of the U.S. Department of
Commerce on behalf of another, in connection with any export control matter,
as provided in Part 766.
(b) Administrative· Provided in the International Traffic in Arms Regulations.
Part 127 of the International Traffic in Arms Regulations provides that a violator
of these regulations may, through administrative action described in Part 128, be
debarred (prohibited) from exporting all U.S. Munitions List articles or technical
data from the United States. Part 127 also subjects such a violator to a civil penalty
not to exceed that authorized by law.
(c) Criminal. [1] The False Statements Act makes it a criminal offense to make a
willfully false statement or conceal a material fact or knowingly use a document
containing a false statement, in any matter within the jurisdiction of a United
States department or agency. Maximum penalties under the provision are a$10,000
fine or imprisonment for five (5) years, or both. [2] The Export Administration
Act provides that whoever knowingly violates any provision of this Act or any
regulation, order, or license issued thereunder, shall be fined not more than five
(5) times the value of the exports involved or $50,000, whichever is greater, or
imprisoned not more than five (5) years, or both. (See also §764.3 of the Export
Administration Regulations.) [3] For purposes of this paragraph, "controlled
country" means any country described in section 620(f) of the Foreign Assistance
Act of 1961. [4] Any person who willfully violates any provision of section 38 of
the Arms Export Control Act, or any rule or regulation issued under that section
is subject, upon conviction, to a maximum fine of $100,000 or a maximum of two
(2) years imprisonment or both (also see §127.01 et.seq. of the International Traffic
In Arms Regulations).

NOTE
Applications for Import Certificates and Delivery Verifications, as specified in
Part 748, are included within the definition of export control documents set forth
in Part 772 of the Export Administration Regulations.