Applicable to H-1B, H-1B1, L-1, and O-1A petitions only.

In order to comply with current immigration requirements, the hiring entity (University of North Texas Health Science Center) must certify that we are in compliance with U.S. Export Control Regulations.  Therefore, as the departmental personnel who will be directing the work of the person identified below, you must check the box below that is appropriate.  Please read the question carefully and provide your response.
2

UNTHSC Petitioner: I certify, based on my review, I have indicated the applicable box for the Beneficiary named.

Print Name & Signature:                                                            		Date:

Department:

Acknowledgement by Department Chair

Print Name & Signature:                   

Date:

1. 

For assistance in determining whether the technology or technical data is subject to export controls, you may contact Rhonda Dash, MPH; Director of Research Compliance, Department of Research at 817.735.2458. In addition, you may visit the following websites: 

University of North Texas Health Science Center 
Certification Pertaining to the Release of Controlled Technology or Technical Data to Foreign Persons in the United States

With respect to the technology or technical data the petitioner will release or otherwise provide access to the beneficiary, the petitioner certifies that it has reviewed the Export Administration Regulations (EAR), the International Traffic and Arms Regulations (ITAR) and Office of Foreign Assets Control (OFAC) regulations and has determined that:

        (Beneficiary: Enter name as shown on visa application)

A license is not required from either U.S. Department of Commerce or the U.S. Department of State or the U.S. Department of Treasury to release such technology or technical data to the foreign person; or

A license is required from the U.S. Department of Commerce, U.S. Department of State, and/or U.S. Department of Treasury to release such technology or technical data to the beneficiary and the petitioner will prevent access to the controlled technology or technical data by the beneficiary until and unless the petitioner has received the required license or other authorization to release it to the beneficiary. 

NOTE:  If the University is required to obtain a license, it may take up to 6 months for that license to be granted.  

U.S. Department of Commerce, Export Administration Regulation   http://www.access.gpo.gov/bis/ear/ear_data.html#ccl  
U.S. Department of State, Directorate of Defense Trade Controls   http://www.pmddtc.state.gov/regulations_laws/itar.html  
U.S. Department of Treasure, Office of Foreign Assets Control   http://www.treas.gov/offices/enforcement/ofac/   
U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services   http://www.uscis.gov/portal/site/uscis 

Remit completed form to Human Resource Services, Attn: Karen Gonzalez, EAD 284.   If Box 2 was checked, you must contact Rhonda Dash to proceed with license procurement.